Table 1.
Study characteristics of 25 included studies.
| References | Group/size | Age (year) | Depression duration (m = month, y = year) | Diagnostic system | TCM Syndrome Type | Acupuncture interventions | Acupoints | Prescription in control group (placebo or Western medication) | Outcome measure tool | Acupuncture/Acupuncture + Western medication compared with control (waitlist, placebo-/sham-acupuncture, Western medication) | Follow-up | Adverse events |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Wang et al. (35) | - MA/n = 33 - Sham-MA/n = 33 |
- MA/48.72 ± 4.21 - Sham-MA/47.82 ± 4.35 |
- MA/NR - Sham-MA/NR |
CCMD-3 | NR | 30 min/day, 3 days/week for 8 weeks | KI6, LU7, PC6, SP4 | sham-MA 30 min/day, 3 days/week for 8 weeks | (i) SDS (ii) MENQOL | (i) compared with sham-MA p < 0.05 (ii) compared with sham-MA p < 0.05 |
Lower SDS in MA in 4-week follow-up (ii) no difference in MENQOL between MA and sham-MA in 4-week follow-up |
NR |
| Li (36) | - EA/n = 30 - Sham-EA/n = 30 - Escitalopram/n = 30 |
- EA/49.80 ± 3.39 - Sham-EA/49.83 ± 4.10 - Escitalopram/49.90 ± 2.98 |
- EA/30.73 ± 18.57 m - Sham-EA/30.43 ± 22.15 m - Escitalopram/26.43 ± 17.86 m |
ICD-10 | NR | −30 min/day, 3 days/week for 12 weeks - dense-sparse waves, 10/50 Hz, 0.5–1 mA |
CV4, EX-CA1, EX-HN3, GV20, LI4, LR3, SP6, ST25 | - sham-EA 30 min/day, 3 days/week for 12 weeks - Escitalopram 10 mg/day for 12 weeks |
(i) HAMD (ii) MENQOL (iii) FSH (iv) E2 (v) LH |
(i-i) compared with sham-EA p < 0.05 (i-ii) compared with Escitalopram P > 0.05 (ii-i) compared with sham-EA p < 0.05 (ii-ii) compared with Escitalopram P > 0.05 (iii) compared with sham-EA or Escitalopram P > 0.05 (iv) compared with sham-EA or Escitalopram P > 0.05 (v) compared with sham-EA or Escitalopram P > 0.05 |
(i) Lower HAMD in EA in 4- and 12- week follow-up (ii) Lower MENQOL in acupuncture in 4-, 8-, and 12- week follow-up |
- EA/n = 2 [hematoma] - sham-EA/n = 0 - - Escitalopram/n = 25 [fatigue (17); headache (2); sleep disturbance (7); dizziness (7); palpitation (4); sweating (10); dry mouth (14); constipation (8)] |
| Li et al. (37) | - EA/n = 116 - Escitalopram/n = 105 |
- EA/49.83 ± 3.10 - Escitalopram/49.93 ± 3.10 |
- EA/20.60 ± 16.20 m - Escitalopram/20.20 ± 16.50 m |
DSM-V, ICD-10 | NR | −30 min/day, 3 days/week for 12 weeks - dilatational wave wave, 50 Hz, 0.5–1 mA |
CV4, EX-CA1, EX-HN3, GV20, LI4, LR3, SP6, ST25 | - Escitalopram 10 mg/day for 12 weeks | (i) HAMD (ii) MENQOL (iii) FSH (iv) E2 (v) LH |
(i) compared with Escitalopram P > 0.05 (ii) compared with Escitalopram P > 0.05 (iii) compared with Escitalopram P > 0.05 (iv) compared with Escitalopram P > 0.05 (v) compared with Escitalopram P > 0.05 |
(i) Lower HAMD in EA in 4- and 12- week follow-up (ii) Lower MENQOL in acupuncture in 4-, 8- and 12- week follow-up |
- EA/n = 14 [hematoma] - Escitalopram/n = 18 [dizziness, palpitation, stomachache] |
| Chi and Zou (30) | - MA/n = 30 - Fluoxetine/n = 30 |
- MA/51.63 ± 1.72 - Fluoxetine/51.43 ± 1.62 |
- MA/10.61 ± 6.10 m - Fluoxetine/11.12 ± 5.58 m |
CCMD-3 | NR | 30 min/day for 4 weeks | EX-HN1, EX-HN3, GV20, KI3, LR3, LR14, SP6, ST36 | - Fluoxetine 20 mg/day for 4 weeks | (i) HAMD | (i) compared with Fluoxetine p < 0.05 | No follow-up | - MA/n = 0 - Fluoxetine/n = 3 [dizziness (1); nausea (2)] |
| Deng (38) | - MA/n = 29 - Deanxit/n = 29 |
- MA/50.03 ± 4.43 - Deanxit/48.70 ± 4.93 |
- MA/6.25 ± 2.31 m - Deanxit/5.77 ± 3.64 m |
ICD-10 | NR | 20–30 min/day, after 3 consecutive days of treatment, once treatment every 3 days for total 4 weeks | CV3, CV4, CV6, CV10, CV12, KI17, Qipang (0.5 Cun beside CV6), Xiafengshidian (1 Cun below and beside ST26) | - Deanxit 20 mg/day for 4 weeks | (i) HAMD (ii) KI (iii) 5-HT | (i) compared with Deanxit P > 0.05 (ii) compared with Deanxit P > 0.05 (iii) compared with Deanxit P > 0.05 |
(i) Lower HAMD in MA in 2- week follow-up (ii) no difference in HAMD between MA and Deanxit in 4- week follow-up (iii) no difference in KI between MA and Deanxit in 2- and 4- week follow-up |
- MA/n = 3 [changes of character of stool (2); palpitation (1)]- Deanxit/n = 32 [changes of character of stool (6); dry mouth and halitosis (9); dysphoria (6); dreaminess (6); breast distending pain (5)] |
| Dong (39) | - MA/n = 30 - Nilestriol + Fluoxetine/n = 30 |
- MA/55.00 - Nilestriol + Fluoxetine/53.00 |
- MA/24.00 m - Nilestriol + Fluoxetine/26.00 m |
CCMD-3, CDTE-TCM | NR | 30 min/day for 30 days | BL13, BL15, BL17, BL18, BL20, BL21, BL23 | Nilestriol 2 mg/15 days for 30 days + Fluoxetine 20 mg/day for 30 days | (i) HAMD | (i) compared with Nilestriol + Fluoxetine p < 0.05 | No follow-up | NR |
| Li (40) | - MA/n = 32 - Fluoxetine/n = 32 |
- MA/50.59 ± 2.94 - Fluoxetine/50.25 ± 2.71 |
- MA/20.63 ± 7.49 m - Fluoxetine/20.31 ± 7.45 m |
CCMD-3 | Liver stagnation and Kidney deficiency | 30 min/day, 6 days/week for 12 weeks | BL15, BL18, BL23, EX-HN1, EX-HN3, GV20, GV24, PC6 | 20 mg/day for 12 weeks | (i) HAMD (ii) KI |
(i) compared with Fluoxetine p < 0.05 (ii) compared with Fluoxetine p < 0.05 |
follow-up for 12 weeks; no data of HAMD and KI total scores for follow-up | - MA/n = 0- Fluoxetine/ n = 8 [nausea or vomiting (2); dry mouth (1); indigestion (1); diarrhea (1); dizziness (1); headache (1)] |
| Ma and Liu (41) | - MA/n = 30 - Fluoxetine/n = 30 |
- MA/53.45 ± 4.82 - Fluoxetine/52.74 ± 5.17 |
- MA/8.24 ± 4.76 m - Fluoxetine/7.65 ± 4.52 m |
CCMD-3, CDTE-TCM | NR | 30 min/day, 5 days/week for 8 weeks | EX-HN1, EX-HN3, GV20, HT7, PC6, PC7, SP6, ST36 | 20 mg/day for 8 weeks | (i) HAMD | (i) compared with Fluoxetine P > 0.05 | No follow-up | - MA/n = 0- Fluoxetine/ n = 6 [nausea (2); dizziness (2)] |
| Niu and Wang (42) | - MA/n = 41 - Fluoxetine/n = 41 |
- MA/54.10 ± 2.00 - Fluoxetine/54.20 ± 2.10 |
- MA/7.70 ± 1.20 m - Fluoxetine/7.70 ± 1.30 m |
CCMD-3 | Stagnation of Liver-Qi | 30 min/day, 5 days/week for 6 weeks | BL13, BL15, BL17, BL18, BL20, BL23 | 20 mg/day for 6 weeks | (i) HAMD | (i) compared with Fluoxetine p < 0.05 | No follow-up | - MA/n = 7 [dizziness (2); palpitation (1); dry mouth (1); nausea (3)] - Fluoxetine/n = 6 [dizziness (1); palpitation (2); dry mouth (2); nausea (1)] |
| Qian et al. (43) | - MA/n = 33 - Fluoxetine/n = 30 |
- MA/54.00 - Fluoxetine/55.00 |
- MA/7.00 m - Prozac/8.00 m |
CCMD-3 | NR | 25 min/day, 5 days/week for 6 weeks | BL13, BL15, BL17, BL18, BL20, BL23 | 20 mg/day for 6 weeks | (i) HAMD | (i) compared with Fluoxetine P > 0.05 | No follow-up | - MA/n = 2 [dizziness (1); palpitation (1)] - Fluoxetine/n = 9 [insomnia (1); akathisia (1); dry mouth (1); nausea (1); palpitation (1); skin symptom (1); forexcitation and agitation (2)] |
| Qiang (44) | - MA/n = 30 - Fluoxetine/n = 30 |
- MA/54.32 ± 3.29 - Fluoxetine/54.00 ± 4.62 |
- MA/11.32 ± 6.25 m - Fluoxetine/12.12 ± 4.58 m |
CCMD-3 | NR | 25 min/day, 5 days/week for 6 weeks | BL15, BL18, BL23,EX-HN1, GB20 | 20 mg/day for 6 weeks | (i) HAMD | (i) compared with Prozac P > 0.05 | No follow-up | NR |
| Shi et al. (45) | - EA/n = 30 - Escitalopram/n = 30 |
- EA/48.70 ± 1.99 - Escitalopram/49.43 ± 1.87 |
- EA/14.17 ± 4.99 m - Escitalopram/14.23 ± 5.58 m |
DSM-V | NR | −30 min/day, 3 days/week for 12 weeks- dense-sparse waves, 10/50 Hz, 0.5–1.0 mA | CV4, EX-CA1, EX-HN3, GV20, LI4, LR3, SP6, ST25 | 10 mg/day for 12 weeks | (i) HAMD | (i) compared with Escitalopram p < 0.05 | (i) Lower HAMD in EA in 4- and 12- week follow-up | NR |
| Sun et al. (46) | - EA/n = 21 - Escitalopram/n = 21 |
- EA/50.29 ± 2.59 - Escitalopram/49.86 ± 3.83 |
- EA/1.94 ± 0.68 m - Citalopram/1.56 ± 0.94 m |
DSM-V | NR | −30 min/day, 3 days/week for 12 weeks - dense-sparse waves, 10/50 Hz, 0.5–1.0 mA |
CV4, EX-CA1, EX-HN3, GV20, LI4, LR3, SP6, ST25 | 10 mg/day for 12 weeks | (i) HAMD | (i) compared with Escitalopram p < 0.05 | No follow-up | NR |
| Wang et al. (47) | - MA/n = 21 - Deanxit/n = 21 |
- MA/49.60 ± 4.30 - Deanxit/48.30 ± 4.70 |
NR | CCMD-3 | NR | −30 min/day, after 3 consecutive days of treatment, once treatment every 3 days for total 4 weeks | CV3, CV4, CV6, CV10, CV12, KI17 | 10 mg/day for 4 weeks | (i) HAMD | (i) compared with Prozac P > 0.05 | (i) Lower HAMD in MA in 2- and 4- week follow-up | - MA/n = 3 [changes of character of stool (2); palpitation (1)] - Deanxit/n = 15 [dry mouth and halitosis (9); dysphoria, dreaminess or breast distending pain (6)] |
| Zhang (48) | - EA/n = 44 - Nilestriol+ Fluoxetine/n = 46 |
- EA/48.48 ± 5.39 - Nilestriol+ Fluoxetine/48.16 ± 4.15 |
- EA/29.15 ± 25.90 m - Nilestriol+ Fluoxetine/27.45 ± 28.83 m |
CCMD-3 | NR | −30 min/day, 5 days/week for 12 weeks - dilatational wave wave, 8–9 mA, 6 V |
BL13, BL15, BL17, BL20, BL23, GV20, KI3, LR3, PC6, SP6 | Nilestriol 2 mg/14 days for 30 days + Fluoxetine 20 mg/day for 12 weeks | (i) HAMD (ii) KI (iii) FSH (iv) E2 (v) LH |
(i) compared with Nilestriol+ Fluoxetine P > 0.05 (ii) compared with Nilestriol+ Fluoxetine P > 0.05 (iii) compared with Nilestriol+ Fluoxetine P > 0.05 (iv) compared with Nilestriol+ Fluoxetine P > 0.05 (v) compared with Nilestriol+ Fluoxetine P > 0.05 |
No follow-up | - EA/n = 5 [sweating, dizziness, vomiting] - Nilestriol+ Fluoxetine/n = 23 [dry mouth and halitosis (5); nausea (6); dysphoria (2); constipation (6); dreaminess (2); breast distending pain (2)] |
| Zhang (49) | - MA/n = 94 - Premarin + Provera + Fluoxetine/n = 94 |
- MA/50.10 ± 2.70 - Premarin + Provera + Fluoxetine/49.80 ± 2.60 |
- MA/1.40 ± 0.50y - Premarin + Provera + Fluoxetine/1.30 ± 0.40y |
CCMD-3 | NR | 30 min/day, 7 days/week for 12 weeks | EX-HN1, GB13, GV20, GV24, HT7 | Premarin 0.625 mg/day and Provera 6 mg/day + Fluoxetine 20 mg/day for 12 weeks | (i) HAMD (ii) FSH (iii) E2 (iv) LH |
(i) compared with Premarin + Provera + Fluoxetine p < 0.05 (ii) compared with Premarin + Provera + Fluoxetine P > 0.05 (iii) compared with Premarin + Provera + Fluoxetine P > 0.05 (iv) compared with Premarin + Provera + Fluoxetine P > 0.05 |
No follow-up | - MA/n = 2 [feeling pain when inserting needle] - Premarin + Provera + Fluoxetine/n = 12 [dizziness (5); nausea and vomiting (4); hypersomnia (3)] |
| Zheng et al. (50) | - MA/n = 60 - Premarin + Provera + Fluoxetine/n = 60 |
- MA/52.27 ± 3.45 - Premarin + Provera + Fluoxetine/51.98 ± 3.14 |
- MA/1.22 ± 0.87y - Premarin + Provera + Fluoxetine/1.34 ± 0.92y |
CCMD-3 | NR | 30 min/day, 7 days/week for 12 weeks (needle retaining time for 8 h in BL8, GV19, GV21 per session) | BL8, BL18, BL23, GV19, GV21, KI3, LR3, SP6 | Premarin 0.625 mg/day for 20 days + and Provera 6 mg/day + Fluoxetine 20 mg/day for 12 weeks | (i) HAMD (ii) KI (iii) FSH (iv) E2 (v) LH |
(i) compared with Premarin + Provera + Fluoxetine P > 0.05(ii) compared with Premarin + Provera + Fluoxetine P > 0.05 (iii) compared with Premarin + Provera + Fluoxetine P > 0.05 (iv) compared with Premarin + Provera + Fluoxetine p < 0.05 (v) compared with Premarin + Provera + Fluoxetine P > 0.05 |
(i) Lower HAMD and KI in MA in 24- week follow-up | - MA/n = 2 [feeling pain when inserting needle] - Premarin + Provera + Fluoxetine/n = 18 [loss of appetite (5); dizziness (4); diarrhea (3); breast distending pain (3); leukorrhagia (2); spasmus (1)] |
| Ding and Liu (51) | - MA/n = 39 - Fluoxetine/n = 39 |
- MA/49.68 ± 3.90 - Fluoxetine/49.50 ± 3.51 |
NR | CCMD-2-R | NR | 30 min/day, 6 days/week for 4 weeks | BL15, BL18, BL20, BL23, GV20, HT7, LR3, SP6 | 20 mg/day for 4 weeks | (i) HAMD (ii) KI | (i) compared with Fluoxetine P > 0.05 (ii) compared with Fluoxetine p < 0.05 |
No follow-up | NR |
| Li and Dai (52) | - EA/n = 30 - Fluoxetine/n = 30 |
NR | NR | CDTE-TCM | NR | −25 min/day, 3 days/week for 6 weeks - dilatational wave, 15 Hz, 1 mA |
EX-HN1, EX-HN3, GV20, HT7, LI4, PC6, SP6, ST36 | 20 mg/day for 6 weeks | (i) HAMD (ii) HAMA |
(i) compared with Fluoxetine P > 0.05 (ii) compared with Fluoxetine p < 0.05 |
No follow-up | NR |
| Zhang (53) | - MA/n = 29 - Deanxit/n = 29 |
NR | NR | CCMD-3 | NR | 30 min/day, after 3 consecutive days of treatment, once treatment every 3 days for total 4 weeks | CV3, CV4, CV6, CV10, CV12, KI17 | 20 mg/day for 4 weeks | (i) HAMD | (i) compared with Deanxit P > 0.05 | (i) Lower HAMD in MA in 2- and 4- week follow-up | NR |
| Xing (54) | - MA/n = 120 - Fluoxetine/n = 120 |
- MA/51.20 ± 5.40 - Fluoxetine/49.50 ± 6.80 |
- MA/11.60 ± 7.30 m - Fluoxetine/10.50 ± 8.60 m |
CCMD-3 | Stagnation of Liver-Qi, Heart and Spleen deficiency; Liver depression and phlegm-heat | 20 min/day, 7 days/week for 6 weeks | GV26, PC5 | 20 mg/day for 6 weeks | (i) HAMD | (i) compared with Fluoxetine P > 0.05 | No follow-up | NR |
| Zhou and Wu (31) | - MA/n = 30 - Fluoxetine/n = 28 |
- MA/51.80 ± 4.20 - Fluoxetine/48.90 ± 3.80 |
- MA/30.63 ± 10.12 m - Prozac/26.33 ± 9.65 m |
CCMD-3 | Liver and kidney Yin deficiency, Spleen and Kidney Yang deficiency, stagnated Qi transforming into fire, stagnation of phlegm and Qi | 30 min/day, 6 days/week for 6 weeks | BL15, BL18, BL23, EX-HN1, GB13, GV24, SP6, ST36 | 20 mg/day for 6 weeks | (i) HAMD (ii) 5-HIAA (iii) NE (iv) DA |
(i) compared with Fluoxetine p < 0.05 (ii) compared with Fluoxetine P > 0.05 (iii) compared with Fluoxetine P > 0.05 (iv) compared with Fluoxetine p < 0.05 |
No follow-up | NR |
| Ma et al. (55) | - EA + Paroxetine/n = 55 - Paroxetine/n = 50 |
- EA + Paroxetine /52.95 ± 5.86 - Paroxetine /51.49 ± 6.03 |
- EA + Paroxetine/5.49 ± 4.86 m - Paroxetine/4.98 ± 4.75 m |
CCMD-3 | NR | −45 min/day, 7 days/week for 6 weeks - dilatational wave wave, 8–9 mA |
EX-HN3, GV20, LI4, PC6, ST36 | −10 mg/day for 6 weeks | (i) HAMD | (i) compared with Paroxetine P > 0.05 | No follow-up | - EA + Paroxetine/n = 2 [dizziness (1); nausea (1)] - Paroxetine/n = 3 [dizziness (1); elevated blood pressure (2)] |
| Liu and Chen (56) | - MA + Sertraline/n = 40 - Sertraline/n = 40 |
- MA + Sertraline/51.50 ± 3.40 - Sertraline/52.10 ± 3.30 |
- MA + Sertraline/2.58 ± 2.18y - Sertraline/2.67 ± 1.73y |
- CCMD-3, - ICD-10 |
NR | 30 min/day, 3 days/week for 12 weeks | BL23, CV4, HT7, KI3, LI4, LR3, SP6 | 50 mg/day for 6 weeks |
(i) HAMD (ii) FSH (iii) E2 (iv) 5-HT (v) GABA |
(i) compared with Sertraline p < 0.05 (ii) compared with Sertraline p < 0.05 (iii) compared with Sertraline p < 0.05 (iv) compared with Sertraline p < 0.05 (v) compared with Sertraline p < 0.05 |
No follow-up | NR |
| Ning (57) | - MA + Nilestriol + Fluoxetine/n = 45 - Nilestriol + Fluoxetine/n = 45 |
NR | NR | Psychiatry textbook | NR | 30 min/day, 7 days/week for 12 weeks | BL13, BL15, BL18, BL20, BL23, GV20, HT7, KI3, LI4, LR3 | Nilestriol 2 mg/15 days + Fluoxetine 20 mg/day for 12 weeks | (i) HAMD (ii) TESS | (i) compared with Nilestriol + Fluoxetine p < 0.05 (ii) compared with Nilestriol + Fluoxetine p < 0.05 |
No follow-up | NR |