Acupuncture and Moxibustion for Subthreshold Depression: a systematic review and Bayesian network meta-analysis.

IF 1.5 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

Journal of Pharmacopuncture Pub Date : 2026-09-30 DOI:10.3831/KPI.2026.29.3.245

Hong Luo, Chengyu Han, Ximei Wang, Yuling Wan, Yunyan Shi, Tianshu Hou, Tingting Ma

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引用次数: 0

Abstract

Objectives: Subthreshold depression (SD), a precursor stage of depression, has gained considerable interest in recent years. Acupuncture and moxibustion have unique advantages in the treatment of depressive disorders. This systematic review and Bayesian network meta-analysis (NMA) aimed to evaluate the comparative effects of acupuncture and moxibustion therapies on SD and provide clinical recommendations.

Methods: Eight databases were searched from their inception to January 1, 2026, for randomized controlled trials (RCTs) on acupuncture and moxibustion for SD. We included 17 studies with six different therapies. The primary and secondary outcomes were scores on the Hamilton Depression Rating Scale (HAMD) and the Center for Epidemiologic Studies Depression scale (CES-D), respectively. A random-effects Bayesian NMA was conducted using the gemtc package in R.

Results: Acupuncture + moxibustion and acupuncture alone were associated with greater reductions in HAMD scores than placebo, no treatment, and Western medicine. In addition, acupuncture + moxibustion showed greater reductions in HAMD scores than acupoint herbal patching and psychological treatment. Acupuncture + moxibustion and moxibustion were associated with greater reductions in CES-D scores than placebo. Acupuncture + moxibustion and acupuncture alone resulted in greater score reductions than no treatment. Among the included therapies, acupuncture + moxibustion therapy was ranked highest in terms of surface under the cumulative ranking curve values for both HAMD (93.56%) and CES-D (96.21%).

Conclusion: This Bayesian NMA suggests that acupuncture + moxibustion may have a relatively favorable ranking for improving SD symptoms, providing preliminary evidence to inform future clinical research and practice. However, the generalizability and evidence quality were limited by the single-center, small-sample design of most included studies. Further high-quality RCTs are warranted to validate these findings.Systematic review registration PROSPERO, CRD42023483384 (version 2.0).

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针灸治疗阈下抑郁症：系统回顾和贝叶斯网络荟萃分析。

阈下抑郁（SD）是抑郁症的一个前兆阶段，近年来引起了人们相当大的兴趣。针灸在治疗抑郁症方面具有独特的优势。本系统综述和贝叶斯网络荟萃分析（NMA）旨在评价针灸疗法对SD的比较效果，并提供临床建议。方法：检索8个数据库，从建立到2026年1月1日，检索针灸治疗SD的随机对照试验（rct）。我们纳入了17项研究和6种不同的治疗方法。主要和次要结果分别是汉密尔顿抑郁评定量表（HAMD）和流行病学研究中心抑郁量表（CES-D）的得分。随机效应贝叶斯NMA研究采用日本gemtc包进行。结果：针灸+艾灸和单独针灸比安慰剂、不治疗和西医更能降低HAMD评分。此外，针刺+艾灸在HAMD评分上的下降幅度大于穴位补药和心理治疗。针刺+艾灸组和艾灸组比安慰剂组在CES-D评分上有更大的降低。针刺+艾灸和单独针灸治疗的评分下降幅度大于不治疗。在纳入的疗法中，针刺+艾灸疗法HAMD（93.56%）和CES-D（96.21%）的累积排序曲线下表面积均为最高。结论：该贝叶斯NMA提示针刺+艾灸在改善SD症状方面可能具有较好的排名，为今后的临床研究和实践提供初步依据。然而，大多数纳入研究的单中心、小样本设计限制了通用性和证据质量。需要进一步的高质量随机对照试验来验证这些发现。系统评价注册PROSPERO， CRD42023483384（版本2.0）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pharmacopuncture INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

2.10

自引率

7.10%

发文量

审稿时长

10 weeks

期刊介绍： The Journal of Pharmacopuncture covers a wide range of basic and clinical science research relevant to all aspects of the biotechnology of integrated approaches using both pharmacology and acupuncture therapeutics, including research involving pharmacology, acupuncture studies and pharmacopuncture studies. The subjects are mainly divided into three categories: pharmacology (applied phytomedicine, plant sciences, pharmacology, toxicology, medicinal plants, traditional medicines, herbal medicine, Sasang constitutional medicine, herbal formulae, foods, agricultural technologies, naturopathy, etc.), acupuncture (acupressure, electroacupuncture, laser acupuncture, moxibustion, cupping, etc.), and pharmacopuncture (aqua-acupuncture, meridian pharmacopuncture, eight-principles pharmacopuncture, animal-based pharmacopuncture, mountain ginseng pharmacopuncture, bee venom therapy, needle embedding therapy, implant therapy, etc.). Other categories include chuna treatment, veterinary acupuncture and related animal studies, alternative medicines for treating cancer and cancer-related symptoms, etc. Broader topical coverage on the effects of acupuncture, the medical plants used in traditional and alternative medicine, pharmacological action and other related modalities, such as anthroposophy, homeopathy, ayurveda, bioelectromagnetic therapy, chiropractic, neural therapy and meditation, can be considered to be within the journal’s scope if based on acupoints and meridians. Submissions of original articles, review articles, systematic reviews, case reports, brief reports, opinions, commentaries, medical lectures, letters to the editor, photo-essays, technical notes, and book reviews are encouraged. Providing free access to the full text of all current and archived articles on its website (www.journal.ac), also searchable through a Google Scholar search.