Efficacy of frequently-used acupuncture methods for specific parts and conventional pharmaceutical interventions in treating post-stroke depression patients: A network meta-analysis

Background: Acupuncture is considered as an effective alternative treatment for post-stroke depression because of its low side effects and easy availability. However, it usually depends on the skills and experience of doctors to choose which acupuncture methods for specific parts. This study compared the effectiveness of different frequently-used acupuncture methods for specific parts in treating post-stroke depression patients by using network meta-analysis.

Methods: We searched eight databases including China National Knowledge Infrastructure (CNKI) database, Wanfang database, Chinese Biomedical Database (CBM), VIP Chinese Science, the Cochrane Library, Embase, PubMed and Web of Science from the date of database inception to November 29, 2020 to identify eligible RCTs. The trial registers in ClinicalTrials.gov, World Health Organization, and Cochrane trials were searched as a supplement. The effective rate was extracted from the included RCTs as primary outcomes after screening. The network meta-analysis was performed by Review Manager 5.3, Stata14.0, and R 3.6.3.

Results: 51 studies were included, which contained 3966 participants among 12 interventions. Based on the ranking probability, scalp acupuncture plus conventional acupuncture was considered to be the most effective method, followed by auricular acupuncture, eye acupuncture, eye acupuncture plus drug, auricular acupuncture plus drug, auricular acupuncture plus conventional acupuncture, scalp acupuncture, scalp acupuncture plus drug, abdominal acupuncture, conventional acupuncture plus drug, drug, conventional acupuncture.

Conclusions: 12 acupuncture methods may be effective and safe in improving the condition of patients with PSD. Higher quality randomized controlled trials need sufficient evidence because the overall quality of included trials can only be classified as low quality. This study is registered with PROSPERO (CRD42020177099).