The anti-inflammatory effect of acupuncture on peripheral inflammatory cytokines in patients with major depressive disorder: A systematic review and meta-analysis

Ya-Nan Zhao , Yu Wang , Shuai Zhang , Yu Chen , Hao Chen , Yu-Ting Duan , Shao-Yuan Li , Lei Wang , Hai Lin , Pei-Jing Rong
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Abstract

There is robust evidence that inflammation is closely associated with major depressive disorder (MDD). The antidepressant effect of acupuncture has been associated with favorable changes in peripheral levels of inflammatory cytokines. However, the findings of these studies were not consistent. This systematic review and meta-analysis were performed to explore the peripheral inflammatory cytokines of acupuncture in treating MDD. The study protocol was registered at PROSPERO, CRD42021289207. We conducted a systematic search for eligible randomized controlled trials (RCTs) that reported acupuncture as an intervention for patients with MDD. The outcome of interest was changes in inflammatory cytokine levels measured before and after the intervention. We searched electronic databases including PubMed, Embase, Cochrane, SinoMed, Wanfang, China National Knowledge Infrastructure (CNKI), and Chongqing VIP (CQVIP). Nine studies including 848 patients were eligible and included. The findings from two studies suggest that acupuncture may lead to changes in inflammatory cytokine levels, irrespective of comparisons with sham acupuncture or Selective Serotonin Reuptake Inhibitors (SSRIs) and Selective Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). While the small sample size, no firm conclusions can be drawn yet. Compared with SSRIs/SNRIs alone, the pooled effect estimation indicates acupuncture combined with SSRIs/SNRIs decreased levels of pro-inflammatory cytokines IL-6, TNF-α and IFN-γ, and elevated levels of anti-inflammatory cytokines IL-4 and IL-10. This study demonstrates that acupuncture appears to have an efficacy in producing anti-inflammatory effects in individuals with MDD.

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针灸对重度抑郁症患者外周炎症细胞因子的抗炎作用:系统回顾与荟萃分析
有大量证据表明,炎症与重度抑郁症(MDD)密切相关。针灸的抗抑郁作用与外周炎症细胞因子水平的有利变化有关。然而,这些研究的结果并不一致。本系统综述和荟萃分析旨在探讨针灸治疗 MDD 的外周炎症细胞因子。研究方案已在 PROSPERO 注册,编号为 CRD42021289207。我们对符合条件的随机对照试验(RCT)进行了系统检索,这些试验报告了针灸作为对 MDD 患者的干预措施。研究结果为干预前后炎症细胞因子水平的变化。我们检索了包括PubMed、Embase、Cochrane、SinoMed、万方、中国国家知识基础设施(CNKI)和重庆VIP(CQVIP)在内的电子数据库。符合条件并纳入的研究有 9 项,包括 848 名患者。两项研究结果表明,无论与假针灸或选择性羟色胺再摄取抑制剂(SSRIs)和选择性羟色胺-去甲肾上腺素再摄取抑制剂(SNRIs)进行比较,针灸都可能导致炎症细胞因子水平的变化。由于样本量较小,目前还不能得出肯定的结论。与单独使用SSRIs/SNRIs相比,汇总效应估计表明,针灸与SSRIs/SNRIs联合使用可降低促炎细胞因子IL-6、TNF-α和IFN-γ的水平,提高抗炎细胞因子IL-4和IL-10的水平。这项研究表明,针灸似乎对 MDD 患者具有抗炎作用。
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