The comparison of different acupuncture therapies for post stroke depression: A protocol for a Bayesian network meta-analysis

Abstract

Background: Depression is a common disease which occurs after stroke, affecting approximately one third of stroke survivors at any 1 time after stroke (compared with 5%-13% of adults without stroke), with a cumulative incidence of 55%. Acupuncture, which has a long history in China, is the generic name of different kinds of acupuncture therapies, including manual acupuncture (MA), electroacupuncture (EA), fire needle (FN), dry needling (DN), and so on. Clinical studies have shown that acupuncture has a good therapeutic effect on post stroke depression (PSD), but the evidence-based medicine of it is insufficient. The purpose of this study is to systematically evaluate the efficacy of different kinds of acupuncture therapies in the treatment of PSD, and to provide evidencebased basis for the clinical application of acupuncture in the treatment of PSD. Methods: A systematic search will be performed on English databases (PubMed, The Cochrane Library, Medline, Embase) and Chinese databases (China National Knowledge Infrastructure (CNKI), WanFang Data, VIP and Chinese biomedical databases). The retrieval time limit will be from the establishment of the database to August 2020. Two researchers will independently screen the literatures, extract data, and evaluate the quality of the included studies. Bayesian network analysis will be conducted by using STATA V.14.0 and ADDIS V.1.16.7. Results: In this study, the efficacy of different kinds of acupuncture therapies in the treatment of PSD will be evaluated by the degree of reduction in depression, total numbers of adverse events, quality of life indices, improvement of social and life functions and the expression of nerve cell factors. Conclusions: This study will provide reliable evidence-based evidence for the clinical application of acupuncture in PSD. Abbreviations: ADL = Activity of Daily Living Scale, APA = American psychiatric association, BDI = Beck Depression Inventory, CANMAT = Canadian network for mood and anxiety treatments, CCMD = Chinese Classification of Mental Disorders, CG = control group, CNKI = China National Knowledge Infrastructure, CT = computer tomography, DALYs = disability-adjusted life-years, DN = dry needling, DSM = Diagnosis and Statistical Manual of Mental Disorders, EA = electroacupuncture, EG = experiment group, FN = fire needle, GRADE = The Grades of Recommendation, Assessment, Development, and Evaluation, HAMD-17 = the 17-item Hamilton Rating Scale for Depression, ICD-10 = International Classification of Diseases-Tenth Edition, LN = laser needle, MA = manual acupuncture, MD = mean difference, MRI = magnetic resonance imaging, OR = odds ratio, PSD = post stroke depression, PSRF = Potential Scale Reduction Factor, QOL = quality of life, RCTs = randomized controlled trials, ROB 2.0 = risk of bias 2.0, SMD = standardized mean difference, SNRIs = serotonin and norepinephrine reuptake inhibitors, SSRIs = selective serotonin uptake inhibitors, WFSBP = the World federation of societies of biological psychiatry, WHOQOL = the World Health Organization Quality of Life, WHOQOL-BREF = WHO Quality of Life-BREF, YLLs = years of life lost.