Effect of acupuncture on menopausal depressive disorder and serum hormone levels: a systematic review and meta-analysis.

IF 3.2 3区医学 Q2 PSYCHIATRY

Frontiers in Psychiatry Pub Date : 2025-07-14 eCollection Date: 2025-01-01 DOI:10.3389/fpsyt.2025.1591389

Shunxia He, Zhijie Wang, Shiqiu Dong, Yuzi Diao, Hongwei Qiao, Xiaoguang Lin, Xiao Gao

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引用次数: 0

Abstract

Background: Menopause, marked by ovarian decline and hormonal shifts, increases vulnerability to depressive disorders, with menopausal depressive disorder (MDD) affecting 33-36% of women via psychosocial-biological interactions. Acupuncture shows promise in improving MDD through neuroendocrine regulation but lacks robust evidence, with unclear links to reproductive hormone modulation; this study evaluates its efficacy and safety.

Methods: A comprehensive database search was conducted using PubMed, Embase, the Cochrane Library, Web of Science, EBSCO, Scopus, Cnki, Wan Fang and VIP Database to identify randomized controlled trials (RCTs) investigating the impact of acupuncture on menopausal depressive disorder. RCTs published until April 21, 2025, that met our predetermined inclusion and exclusion criteria were included. Data extraction, literature review, and assessment of the methodological quality of the trials were performed. The meta-analysis was conducted using Review Manager (RevMan) 5.3 software.

Results: Our findings demonstrate that acupuncture significantly outperforms control interventions in improving clinical effectiveness rates (OR=2.70, 95%CI[1.63,4.48], P=0.0001) and reducing depressive symptoms, as evidenced by HAMD-17 (SMD=-0.28, P<0.0001) and HAMD-24 scores (post-sensitivity SMD=-0.39, P=0.03). Notably, acupuncture also enhanced quality of life (MENQOL: SMD=-0.25, P=0.003), though its effects on sex hormones (FSH, LH, E2) remained nonsignificant (P>0.05). Safety profiles were comparable between groups (OR=0.16, P=0.05), yet sensitivity analysis revealed reduced adverse events in the acupuncture group after excluding outlier studies (OR=0.49, P=0.03). In conclusion, the intervention of acupuncture is beneficial for MDD.

Conclusion: This systematic review demonstrates that acupuncture serves as an effective and safe non-pharmacological intervention for alleviating menopausal depressive symptoms and improving quality of life. While acupuncture did not significantly modulate sex hormone levels, its therapeutic benefits are likely mediated through non-hormonal mechanisms, such as neurotransmitter regulation and neuroendocrine network modulation.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251037010.

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针刺对绝经期抑郁症和血清激素水平的影响：一项系统回顾和荟萃分析。

背景：更年期以卵巢功能衰退和激素变化为特征，增加了患抑郁症的易感性，绝经期抑郁症（MDD）通过心理-社会-生物相互作用影响着33-36%的女性。针刺有希望通过神经内分泌调节改善重度抑郁症，但缺乏强有力的证据，与生殖激素调节的联系尚不清楚；本研究评价其有效性和安全性。方法：综合检索PubMed、Embase、Cochrane图书馆、Web of Science、EBSCO、Scopus、知网、万方、VIP数据库等数据库，筛选针刺治疗绝经期抑郁症的随机对照试验（RCTs）。纳入2025年4月21日前发表的符合我们预定纳入和排除标准的随机对照试验。进行数据提取、文献回顾和试验方法学质量评估。meta分析采用Review Manager (RevMan) 5.3软件进行。结果：我们的研究结果表明，针灸在提高临床有效率（OR=2.70, 95%CI[1.63,4.48]， P=0.0001）和减轻抑郁症状方面明显优于对照干预，HAMD-17 （SMD=-0.28, P0.05）证明了这一点。两组间的安全性具有可比性（OR=0.16， P=0.05），但敏感性分析显示，排除异常研究后，针灸组的不良事件减少（OR=0.49， P=0.03）。综上所述，针刺干预对重度抑郁症是有益的。结论：本系统综述表明，针灸是一种有效、安全的非药物干预措施，可缓解绝经期抑郁症状，改善生活质量。虽然针灸不能显著调节性激素水平，但其治疗效果可能是通过非激素机制介导的，如神经递质调节和神经内分泌网络调节。系统评价注册：https://www.crd.york.ac.uk/prospero/，标识符CRD420251037010。

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来源期刊

Frontiers in Psychiatry Medicine-Psychiatry and Mental Health

CiteScore

6.20

自引率

8.50%

发文量

2813

审稿时长

14 weeks

期刊介绍： Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.