The dose-effect association between acupuncture sessions and its effects on major depressive disorder: A meta-regression of randomized controlled trials

Guixing Xu; Hanzhou Lei; Liuyang Huang; Qiwei Xiao; Biqing Huang; Zhuo Zhou; Hao Tian; Fengyuan Huang; Yilin Liu; Ling Zhao; Xiang Li; Fanrong Liang

doi:10.1016/j.jad.2022.04.155

The dose-effect association between acupuncture sessions and its effects on major depressive disorder: A meta-regression of randomized controlled trials

J Affect Disord. 2022 Aug 1:310:318-327. doi: 10.1016/j.jad.2022.04.155. Epub 2022 May 2.

Authors

Guixing Xu¹, Hanzhou Lei¹, Liuyang Huang¹, Qiwei Xiao², Biqing Huang¹, Zhuo Zhou¹, Hao Tian¹, Fengyuan Huang¹, Yilin Liu¹, Ling Zhao¹, Xiang Li³, Fanrong Liang⁴

Affiliations

¹ Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, 37 Shi-er-qiao Rd, Chengdu 610075, Sichuan, China.
² Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, No. 3, Hai yun cang Hutong, Dong cheng District, Beijing 100007, China.
³ Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, 37 Shi-er-qiao Rd, Chengdu 610075, Sichuan, China. Electronic address: lixiang@cdutcm.edu.cn.
⁴ Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, 37 Shi-er-qiao Rd, Chengdu 610075, Sichuan, China. Electronic address: acuresearch@126.com.

PMID: 35504399
DOI: 10.1016/j.jad.2022.04.155

Abstract

Background: The benefits of acupuncture on Major depressive disorder (MDD) have been well established in previous studies. However, uncertainty exists regarding the dose-effect relationship between acupuncture and MDD. This study aims to explore the association between acupuncture and its effects on MDD based on previously published data.

Methods: Nine databases were searched from inception until 10th September 2021. Randomized controlled trials that compared acupuncture with sham acupuncture, or anti-depressants, were included. The data extraction, and assessing the data quality and risk of bias completed by two researcher, respectively. A non-linear meta-regression approach with restricted cubic spline was used to investigate the dose-effect relationship between acupuncture sessions and their effects on the Hamilton rating scale for depression (HAMD) score.

Results: Of the 20,835 citations screened, 62 studies (2269 patients of MDD) were included. The dose-effect meta-analysis suggested that acupuncture session was associated with a decline in HAMD scores. Overall, an increase in the number of acupuncture sessions received was associated with symptom improvement in MDD patients. After 8 acupuncture sessions, the HAMD score decreased from 17.68 (95% CI: -11.81, -4.80) to 8.30 (95% CI: 14.23-21.13). After 24 acupuncture sessions, a decrease in HAMD scores was observed in 51% of cases (95% CI: 48% to 54%). After 36 acupuncture sessions, the effect of improvement in HAMD scores peaked at 66% of cases (95% CI: 59% to 72%).

Conclusions: A dose-effect relationship was found between the number of acupuncture sessions and HAMD scores. 36 acupuncture sessions were associated with optimal clinical response.

Systematic review registration: PROSPERO CRD42021290143.

Keywords: Acupuncture; Depression; Dose-effect; Meta-analysis.

Publication types

Meta-Analysis
Review
Research Support, Non-U.S. Gov't

MeSH terms

Acupuncture Therapy* / adverse effects
Depressive Disorder, Major* / etiology
Depressive Disorder, Major* / therapy
Humans
Randomized Controlled Trials as Topic
Treatment Outcome