Journal of Traditional Chinese Medicine ›› 2023, Vol. 43 ›› Issue (2): 239-251.DOI: 10.19852/j.cnki.jtcm.20221226.001
• Meta Analysis • Previous Articles Next Articles
Effectiveness of acupuncture-related therapies on schizophrenia: a Bayesian network Meta-analysis
HUANG Zhaohan1, FANG Yuan1,2, WANG Xiaolu1, HAN Yue1, YU Qi1, WANG Tong1(
)
- 1 School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Institute of traditional Chinese medicine, Beijing 102488, China
2 Maternal and women’s health department, Shanghai Center for Women and Children’s Health, Shanghai 200062, China
-
Received:2022-01-11Accepted:2022-04-26Online:2023-04-15Published:2023-03-14 -
Contact:Prof. WANG Tong, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China. tongwang@bucm.edu.cn. Telephone: +86-10-64286640 -
Supported by:Research Development Fund of Beijing University of Chinese Medicine: Research on the genesis and data mining of "Chronic Illness and Kidney" theory(2180072120090);Key Discipline Projects of the National Administration of Traditional Chinese Medicine: Preparation and Revision Project of TCM "Prevention of Disease" Standard(20170709)
Cite this article
HUANG Zhaohan, FANG Yuan, WANG Xiaolu, HAN Yue, YU Qi, WANG Tong. Effectiveness of acupuncture-related therapies on schizophrenia: a Bayesian network Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2023, 43(2): 239-251.
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Figure 1 Flow diagram of study selection CNKI: China National Knowledge Infrastructure Database; VIP: China Science and Technology Journal Database.
Figure 1 Flow diagram of study selection CNKI: China National Knowledge Infrastructure Database; VIP: China Science and Technology Journal Database.
Table 1 Characteristic of the included studies
| Study | Sample size (O/C) | Age (O/C) | Observation intervention | Control intervention | Duration of treatment (d) | Outcome | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Liu XC et al 2011 | 30/32 | 40±8/44±10 | EA 20 min qd+CIN | Clozapine standard dose | 28 | ④⑤⑥ | |||||||||
| Sun ZL et al 2016 | 31/32 | 37.2±10.6 /34.9±7.8 | 3 times per week+ CIN | Clozapine 350-600 ng/mL, Risperidone 20-60 ng/mL | 28 | ②③④⑤ | |||||||||
| Chen J et al 2016 | 62/62 | 26.1±8.2 /27.8±9.1 | EA 30 min bid+CIN | Risperidone 1 mg, +Haloperido 5-20 mg, intramuscular injection | 7 | ①④ | |||||||||
| Chen MM et al 2015 | 31/31 | 23.3±7.4 /25.14±6.7 | EA 60 min qd+CIN | Olanzapine 10-20 mg | 7 | ①④ | |||||||||
| Long HW et al 2015 | 30/30 | 28.0±6.0 /27±7.0 | EA 20 min qd+CIN | Haloperidol injection 5 mg bid ＋Scopolamine 0.3 mg intramuscular injection bid | 7 | ①③ | |||||||||
| Yang SQ et al 2014 | 40/40 | 42.3/45.2 | EA 30 min qd+CIN | Olanzapine 10 mg qd, | 27 | ③ | |||||||||
| Chen K et al 2008 | 30/30 | 27±13 /28±15 | EA 45 min 5 times per week+CIN | Aripiprazole, started at 5 mg/d and gradually increased to 10-30 mg/d within two weeks | 84 | ②④⑤ | |||||||||
| Cheng LX et al 2020 | 100/ 100 | 1.2±2.2 /1.3±2.1 | EA+CIN | Haloperidol 5-10 mg bid + Risperidone 2-3 mg bid | 9 | ① | |||||||||
| Yao JF et al 2006 | 45/45 | 31±12 /29±13 | EA 30 min qd+CIN | Clozapine 100-150 mg bid | 56 | ③ | |||||||||
| Cheng J et al 2009 | 30/30 | 31.2±5.79 /28.97±5.49 | EA 20 min 5 times per week+WM Standard dose | Sham EA 20 min + WM Standard dose | 42 | ②③④⑤ | |||||||||
| Ding GY et al 2005 | 25/25 | 57.4±5.71 /57.4± 5.71 | EA 5 min once every two days+CIN | WM Standard dose | 60 | ②⑥ | |||||||||
| Li J et al 2020 | 59/58 | 30±9.1 /27±8.6 | EA 30 min 6 times per week+CIN | Risperidone 3-6 mg qd | 42 | ⑨ | |||||||||
| Yang YT et al 2016 | 50/50 | 35±11 /35±11 | BA 30 min 6 times per week+CIN | Risperidone 5-10 mg qd | 84 | ③⑨ | |||||||||
| Luo C et al 2006 | 30/30 | 26.81±7.43 /27.47±6.78 | BA 30 min qd+CIN | Risperidone, started at 1 mg/d, increased to 4-6 mg/d within 10 d | 90 | ①⑤⑥ | |||||||||
| Ma L et al 2008 | 30/30 | 29.2±6.2 /30.6± 3.6 | BA 30 min qd+CIN | Risperidone, started at 1 mg/d, increased to 2-4 mg/d within 14 d | 36 | ①③⑨ | |||||||||
| Li H et al 2020 | 40/40 | 27.25±1.15 /27.35±1.28 | BA 30 min qd+CIN | Risperidone 1-2 mg bid or tid | 72 | ③⑤⑥ | |||||||||
| Liu XF 2010 | 50/50 | 34.05±8.35 /35.12±7.57 | BA 30 min 4-5 times per week+CIN | Risperidone, started at 1 mg/d, increased to 2-6 mg/d within 14 d, average dose (2.3± 0.8) mg/d | 90 | ①⑥⑨ | |||||||||
| Wang ZZ et al 2013 | 47/49 | 34.05±8.35 /35.12±7.57 | BA 30 min 4-5 times per week+CIN | Risperidone, started at 1 mg/d, increased to 2-6 mg/d within 14 d, average dose (2.3±0.8) mg/d | 90 | ①⑥⑨ | |||||||||
| Yi CG et al 2017 | 36/36 | 41.7±5.1/ 43.3±4.3 | BA qd+CIN | Aripiprazole, started at 20 mg each time qd, decreased to 10 mg/d. Adjusted to 40 mg after 2 weeks | 56 | ②③⑧ | |||||||||
| Li H 2013 | 30/30 | 39. 84±10. 59 | BA qd+CIN | Aripiprazole, started at 5 mg/d, increased to 10 mg/d after one week, and 10-30 mg/d in the third week, bid | 90 | ④⑤⑥⑨ | |||||||||
| Chen J 2017 | 48/48 | 38.2±7.6/ 39.7±8.1 | BA qd+CIN | Aripiprazole, started at 20 mg/d, gradually increased by 10 mg/d every week, and maintained at 40 mg/time after 2 weeks | 56 | ②③⑧ | |||||||||
| Du YJ 2011 | 30/30 | 26.81±7.43/27.47±6.78 | BA 30 min qd+CIN | Sulpiride 100 mg/d，bid | 90 | ③⑤⑥ | |||||||||
| Zhao GM et al 2014 | 94/86 | 51.63±5.11 /51.57±5.03 | BA 30 min qd+CIN | Chlorpromazine, started at 150 mg/d, increased to 500 mg/d after one week | 30 | ③⑥ | |||||||||
| Dang YM et al 2016 | 43/26 | NA | BA 30 min 5 times per week+CIN | WM Standard dose | 84 | ④⑤⑥ | |||||||||
| Song LX et al 2019 | 38/38 | 35.4±3.5/ 35.1±3.7 | SA+EA 3-4 s once 8-10 times a day, 3 times per week+CIN | Clozapine, started at 50-100 mg/d, increased to 200-500 mg/d in one week | 56 | ①③ | |||||||||
| Li GH et al 2012 | 60/60 | 32.30±9.41/31.30±10.03 | SA+EA 60 min 5 times per week+CIN | Risperidone, started at 1 mg/d, increased to normal dose in 14 d, average dose (2.3±0.8) mg/d | 56 | ①⑥ | |||||||||
| Study | Sample size (O/C) | Age (O/C) | Observation intervention | Control intervention | Duration of treatment (days) | Outcome | |||||||||
| Lu HP et al 2020 | 30/30 | 29.6±11.2/ 31.2±12.33 | SA+EA 30 min, Once every two days, 3 times per week+CIN | WM Standard dose | 42 | ② | |||||||||
| Zhang YD et al 2001 | 22/20 | 32.19±9.13 | SA+EA 45 min, qd 4 times per week+CIN | WM Standard dose | 42 | ⑧ | |||||||||
| Yue HF et al 2020 | 30/30 | 36.1±7.8 /35.1±7.9 | SA+EA 45 min 5 times per week+CIN | Ziprasidone 10-20 mg qd or bid | 14 | ① | |||||||||
| Li Q et al 2020 | 30/30 | 39.2±7.1 /38.3±6.8 | SA+EA once every two days+CIN | Risperidone 1-6 mg bid | 74 | ③ | |||||||||
| Lin F et al 2018 | 30/30 | 37.4±5.8 | SA+EA 40 min 5 times per week+IN | Olanzapine 10 mg qd | 30 | ①③⑤ | |||||||||
| Fan HF 2015 | 43/43 | 41.2±11.4 /41.3 ± 11.3 | SA+EA 30 min 5 times per week qd+CIN | Risperidone, started at 1 mg/d, increased to 3-6 mg/d within 1 week | 42 | ②③④⑤ | |||||||||
| Jiang PR et al 2011 | 39/39 | 41.6±9.2/ 42.2±8.3 | SA+EA 20 min qd+CIN | Quetiapine, the initial dose is 0.2-0.4 mg, the maximum is 0.8 mg | 56 | ①②③④⑤ | |||||||||
| Gao L et al 2014 | 31/31 | 36.2±7.2/ 37.9±8.5 | SA+EA 20 min qd+IN | Alprazolam 0.4-0.8 mg qd, average dose (0.6±0.2) mg Risperidone 2-6 mg qd+ health education 30 min once a week | 28 | ⑥ | |||||||||
| Lu HP et al 2018 | 28/27 | 29.6±11.2/ 29.2±10.5 | SA+EA 30 min once two days 3 times per week+CIN | WM Standard dose | 42 | ⑧ | |||||||||
| Chen ZM et al 2006 | 33/34 | 30.2±11.0/ 2.9±10.7 | SA+EA 50 min qd+IN | WM Standard dose | 42 | ①⑧ | |||||||||
| Xiong DZ et al 2010 | 40/40 | 29.4±11.3/ 28.1±12.2 | SA+EA 3 times per week+CIN | Clozapine, started at 50-100 mg/d, increased to 200-500 mg/d in one week | 56 | ①②③④⑤⑨ | |||||||||
| Shen HB et al 2017 | 35/35 | 35.46±5.97/ 34.97±6.13 | SA+EA 30 min once two days, 3 times per week+CIN | WM Standard dose | 28 | ⑧⑨ | |||||||||
| Pan LY et al 2020 | 50/51 | 37.56±9.72 /36.91±9.23 | SA 30 min qd+CIN | Risperidone 2 mg bid+ Benhexol 2 mg bid, | 84 | ①②③⑦ | |||||||||
| Dong HS et al 2018 | 36/36 | 28.3±2.6 /29.6±1.9 | SA qd+CIN | Quetiapine 450-750 mg/d, average dose 600 mg | 56 | ③ | |||||||||
| Ren WW 1999 | 50/30 | 32.2±18.8 /31.3±18.7 | AA 1-2min qd+CIN | WM Standard dose | 90 | ① | |||||||||
| Yang J et al 2015 | 43/43 | 35.4±11.5 /34.7±12.5 | AA 3 min tid+CIN | Olanzapine 1.25 mg qd | 84 | ②⑧ | |||||||||
| Lin Q et al 2012 | 15/15 | 33.02±11.42/30.36±13.72 | AA 15 times per point each time, 6 times a day+CIN | WM Standard dose | 36 | ①⑥ | |||||||||
| Gimelfarb Y et al 2016 | 22/14 | 28±9.2/ 32.50±5.5 | AA 20-40 min, 4-6 times a day+CIN | WM Standard dose | 35 | ⑦ | |||||||||
| Liu QP 2019 | 37/33 | 45.5±6.8/ 43.6±8.9 | Mo 30 min qd+CIN | Aripiprazole, started at 5 mg/d, increased to 20-30 mg/d in two weeks | 84 | ①②③④⑤ | |||||||||
| Yang YH et al 2017 | 11/12 | 47.42±9.76/47.52±9.3 | Mo 120 min qd+CIN | WM Standard dose | 56 | ① | |||||||||
| Xu TC et al 2010 | 30/30 | 25.67±8.12 /26.33±7.52 | LA 30 min qd 5 times per week+Risperidone 2 mg/d | WM Total dose 3-6mg/d | 56 | ② | |||||||||
| Xu TC et al 2004 | 40/40 | 31.74±10.23 /30.12±8.06 | LA 30 min qd gradually increased to 3 times per week +WM dosage < 0.2 g/d | WM maximum dosage 0.2-0.79g/d | 80 | ⑤⑥⑨ | |||||||||
| Wang L et al 2006 | 16/16 | 15.87±2.45 /15.74±2.89 | LA 45 min qd+WM dosage < 0.29 g/d | WM Standard dose | 30 | ①④⑤⑥⑨ | |||||||||
| Wang W et al 2013 | 30/30 | 48.15±1.13 | LA Acupoint prick once every two days+CIN | Sulpiride, started at 200 mg/d, increased to 600 mg/d tid + Benhexol 2 mg bid | 20 | ④⑤⑨ | |||||||||
| Study | Sample size (O/C) | Age (O/C) | Observation intervention | Control intervention | Duration of treatment (days) | Outcome | |||||||||
| Zhao LJ 2018 | 100/99 | 32.6±2.3 /32.4±2.2 | LA 30 min qd+Risperidone, started at 1 mg/d, gradually increased to 4 mg/d | Risperidone, started at 1 mg/d, once every two days, increased to 4-6 mg/d in two weeks, maximum dose 10 mg/d | 30 | ① | |||||||||
| Wang GP et al 2000 | 45/45 | 39.54±10.93 /38.27±9.78 | AI (clonazepam injection 1 mg once every two days, 7 times total)+CIN | WM Standard dose | 14 | ⑥ | |||||||||
| Wu CF et al 2004 | 100/60 | 32.24±10.40 /32.07±10.17 | AI (Danshen injection 6 mL qd)+CIN | Hibernating, average dose (462.59±72.92) mg/d | 44 | ⑥⑨ | |||||||||
| Ma C 2006 | 60/60 | 25.35±7.31 /25.75±7.46 | AI (Clonazepam injection 1 mg once every two days, 14 times total)+CIN | WM Standard dose | 28 | ⑥⑨ | |||||||||
| Jiang WC et al 1998 | 34/30 | 30.7±10.3 /28.8±12.4 | AI (Perphenazine injection 5 mg qd)+CIN | WM Standard dose | 180 | ①⑥ | |||||||||
| Pan YF et al 2003 | 100/60 | 32.24±10.40 /32.07±10.17 | AI (Danshen injection 6 mL qd)+CIN | WM Standard dose | 44 | ⑥⑨ | |||||||||
| Xiao HQ et al 2020 | 30/30 | 31.43±4.51 /29.03±3.66 | ACE+CIN | Clozapine 50-100 mg | 42 | ③⑦ | |||||||||
| Zhang W et al 2015 | 35/35 | 43.2±3.2 /45±4 | ACE once a week+CIN | Chlorpromazine, started at 25 mg/d, once every two days, increased to 200 mg/d in one weeks, bid | 180 | ⑥ | |||||||||
| Zhang YK et al 2007 | 30/30 | 28.2±7.9/ 27.8±11.1 | MOT+CIN | WM Standard dose | 84 | ①⑤⑥ | |||||||||
| Liu ZL et al 2010 | 31/29 | 46±10/ 44±9 | MOT+CIN | Risperidone, started at 1 mg/d, increased to 4-6 mg/d dose in 14 d, average dose (4.0±1.8) mg/d | 84 | ②③④⑤ | |||||||||
Table 1 Characteristic of the included studies
| Study | Sample size (O/C) | Age (O/C) | Observation intervention | Control intervention | Duration of treatment (d) | Outcome | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Liu XC et al 2011 | 30/32 | 40±8/44±10 | EA 20 min qd+CIN | Clozapine standard dose | 28 | ④⑤⑥ | |||||||||
| Sun ZL et al 2016 | 31/32 | 37.2±10.6 /34.9±7.8 | 3 times per week+ CIN | Clozapine 350-600 ng/mL, Risperidone 20-60 ng/mL | 28 | ②③④⑤ | |||||||||
| Chen J et al 2016 | 62/62 | 26.1±8.2 /27.8±9.1 | EA 30 min bid+CIN | Risperidone 1 mg, +Haloperido 5-20 mg, intramuscular injection | 7 | ①④ | |||||||||
| Chen MM et al 2015 | 31/31 | 23.3±7.4 /25.14±6.7 | EA 60 min qd+CIN | Olanzapine 10-20 mg | 7 | ①④ | |||||||||
| Long HW et al 2015 | 30/30 | 28.0±6.0 /27±7.0 | EA 20 min qd+CIN | Haloperidol injection 5 mg bid ＋Scopolamine 0.3 mg intramuscular injection bid | 7 | ①③ | |||||||||
| Yang SQ et al 2014 | 40/40 | 42.3/45.2 | EA 30 min qd+CIN | Olanzapine 10 mg qd, | 27 | ③ | |||||||||
| Chen K et al 2008 | 30/30 | 27±13 /28±15 | EA 45 min 5 times per week+CIN | Aripiprazole, started at 5 mg/d and gradually increased to 10-30 mg/d within two weeks | 84 | ②④⑤ | |||||||||
| Cheng LX et al 2020 | 100/ 100 | 1.2±2.2 /1.3±2.1 | EA+CIN | Haloperidol 5-10 mg bid + Risperidone 2-3 mg bid | 9 | ① | |||||||||
| Yao JF et al 2006 | 45/45 | 31±12 /29±13 | EA 30 min qd+CIN | Clozapine 100-150 mg bid | 56 | ③ | |||||||||
| Cheng J et al 2009 | 30/30 | 31.2±5.79 /28.97±5.49 | EA 20 min 5 times per week+WM Standard dose | Sham EA 20 min + WM Standard dose | 42 | ②③④⑤ | |||||||||
| Ding GY et al 2005 | 25/25 | 57.4±5.71 /57.4± 5.71 | EA 5 min once every two days+CIN | WM Standard dose | 60 | ②⑥ | |||||||||
| Li J et al 2020 | 59/58 | 30±9.1 /27±8.6 | EA 30 min 6 times per week+CIN | Risperidone 3-6 mg qd | 42 | ⑨ | |||||||||
| Yang YT et al 2016 | 50/50 | 35±11 /35±11 | BA 30 min 6 times per week+CIN | Risperidone 5-10 mg qd | 84 | ③⑨ | |||||||||
| Luo C et al 2006 | 30/30 | 26.81±7.43 /27.47±6.78 | BA 30 min qd+CIN | Risperidone, started at 1 mg/d, increased to 4-6 mg/d within 10 d | 90 | ①⑤⑥ | |||||||||
| Ma L et al 2008 | 30/30 | 29.2±6.2 /30.6± 3.6 | BA 30 min qd+CIN | Risperidone, started at 1 mg/d, increased to 2-4 mg/d within 14 d | 36 | ①③⑨ | |||||||||
| Li H et al 2020 | 40/40 | 27.25±1.15 /27.35±1.28 | BA 30 min qd+CIN | Risperidone 1-2 mg bid or tid | 72 | ③⑤⑥ | |||||||||
| Liu XF 2010 | 50/50 | 34.05±8.35 /35.12±7.57 | BA 30 min 4-5 times per week+CIN | Risperidone, started at 1 mg/d, increased to 2-6 mg/d within 14 d, average dose (2.3± 0.8) mg/d | 90 | ①⑥⑨ | |||||||||
| Wang ZZ et al 2013 | 47/49 | 34.05±8.35 /35.12±7.57 | BA 30 min 4-5 times per week+CIN | Risperidone, started at 1 mg/d, increased to 2-6 mg/d within 14 d, average dose (2.3±0.8) mg/d | 90 | ①⑥⑨ | |||||||||
| Yi CG et al 2017 | 36/36 | 41.7±5.1/ 43.3±4.3 | BA qd+CIN | Aripiprazole, started at 20 mg each time qd, decreased to 10 mg/d. Adjusted to 40 mg after 2 weeks | 56 | ②③⑧ | |||||||||
| Li H 2013 | 30/30 | 39. 84±10. 59 | BA qd+CIN | Aripiprazole, started at 5 mg/d, increased to 10 mg/d after one week, and 10-30 mg/d in the third week, bid | 90 | ④⑤⑥⑨ | |||||||||
| Chen J 2017 | 48/48 | 38.2±7.6/ 39.7±8.1 | BA qd+CIN | Aripiprazole, started at 20 mg/d, gradually increased by 10 mg/d every week, and maintained at 40 mg/time after 2 weeks | 56 | ②③⑧ | |||||||||
| Du YJ 2011 | 30/30 | 26.81±7.43/27.47±6.78 | BA 30 min qd+CIN | Sulpiride 100 mg/d，bid | 90 | ③⑤⑥ | |||||||||
| Zhao GM et al 2014 | 94/86 | 51.63±5.11 /51.57±5.03 | BA 30 min qd+CIN | Chlorpromazine, started at 150 mg/d, increased to 500 mg/d after one week | 30 | ③⑥ | |||||||||
| Dang YM et al 2016 | 43/26 | NA | BA 30 min 5 times per week+CIN | WM Standard dose | 84 | ④⑤⑥ | |||||||||
| Song LX et al 2019 | 38/38 | 35.4±3.5/ 35.1±3.7 | SA+EA 3-4 s once 8-10 times a day, 3 times per week+CIN | Clozapine, started at 50-100 mg/d, increased to 200-500 mg/d in one week | 56 | ①③ | |||||||||
| Li GH et al 2012 | 60/60 | 32.30±9.41/31.30±10.03 | SA+EA 60 min 5 times per week+CIN | Risperidone, started at 1 mg/d, increased to normal dose in 14 d, average dose (2.3±0.8) mg/d | 56 | ①⑥ | |||||||||
| Study | Sample size (O/C) | Age (O/C) | Observation intervention | Control intervention | Duration of treatment (days) | Outcome | |||||||||
| Lu HP et al 2020 | 30/30 | 29.6±11.2/ 31.2±12.33 | SA+EA 30 min, Once every two days, 3 times per week+CIN | WM Standard dose | 42 | ② | |||||||||
| Zhang YD et al 2001 | 22/20 | 32.19±9.13 | SA+EA 45 min, qd 4 times per week+CIN | WM Standard dose | 42 | ⑧ | |||||||||
| Yue HF et al 2020 | 30/30 | 36.1±7.8 /35.1±7.9 | SA+EA 45 min 5 times per week+CIN | Ziprasidone 10-20 mg qd or bid | 14 | ① | |||||||||
| Li Q et al 2020 | 30/30 | 39.2±7.1 /38.3±6.8 | SA+EA once every two days+CIN | Risperidone 1-6 mg bid | 74 | ③ | |||||||||
| Lin F et al 2018 | 30/30 | 37.4±5.8 | SA+EA 40 min 5 times per week+IN | Olanzapine 10 mg qd | 30 | ①③⑤ | |||||||||
| Fan HF 2015 | 43/43 | 41.2±11.4 /41.3 ± 11.3 | SA+EA 30 min 5 times per week qd+CIN | Risperidone, started at 1 mg/d, increased to 3-6 mg/d within 1 week | 42 | ②③④⑤ | |||||||||
| Jiang PR et al 2011 | 39/39 | 41.6±9.2/ 42.2±8.3 | SA+EA 20 min qd+CIN | Quetiapine, the initial dose is 0.2-0.4 mg, the maximum is 0.8 mg | 56 | ①②③④⑤ | |||||||||
| Gao L et al 2014 | 31/31 | 36.2±7.2/ 37.9±8.5 | SA+EA 20 min qd+IN | Alprazolam 0.4-0.8 mg qd, average dose (0.6±0.2) mg Risperidone 2-6 mg qd+ health education 30 min once a week | 28 | ⑥ | |||||||||
| Lu HP et al 2018 | 28/27 | 29.6±11.2/ 29.2±10.5 | SA+EA 30 min once two days 3 times per week+CIN | WM Standard dose | 42 | ⑧ | |||||||||
| Chen ZM et al 2006 | 33/34 | 30.2±11.0/ 2.9±10.7 | SA+EA 50 min qd+IN | WM Standard dose | 42 | ①⑧ | |||||||||
| Xiong DZ et al 2010 | 40/40 | 29.4±11.3/ 28.1±12.2 | SA+EA 3 times per week+CIN | Clozapine, started at 50-100 mg/d, increased to 200-500 mg/d in one week | 56 | ①②③④⑤⑨ | |||||||||
| Shen HB et al 2017 | 35/35 | 35.46±5.97/ 34.97±6.13 | SA+EA 30 min once two days, 3 times per week+CIN | WM Standard dose | 28 | ⑧⑨ | |||||||||
| Pan LY et al 2020 | 50/51 | 37.56±9.72 /36.91±9.23 | SA 30 min qd+CIN | Risperidone 2 mg bid+ Benhexol 2 mg bid, | 84 | ①②③⑦ | |||||||||
| Dong HS et al 2018 | 36/36 | 28.3±2.6 /29.6±1.9 | SA qd+CIN | Quetiapine 450-750 mg/d, average dose 600 mg | 56 | ③ | |||||||||
| Ren WW 1999 | 50/30 | 32.2±18.8 /31.3±18.7 | AA 1-2min qd+CIN | WM Standard dose | 90 | ① | |||||||||
| Yang J et al 2015 | 43/43 | 35.4±11.5 /34.7±12.5 | AA 3 min tid+CIN | Olanzapine 1.25 mg qd | 84 | ②⑧ | |||||||||
| Lin Q et al 2012 | 15/15 | 33.02±11.42/30.36±13.72 | AA 15 times per point each time, 6 times a day+CIN | WM Standard dose | 36 | ①⑥ | |||||||||
| Gimelfarb Y et al 2016 | 22/14 | 28±9.2/ 32.50±5.5 | AA 20-40 min, 4-6 times a day+CIN | WM Standard dose | 35 | ⑦ | |||||||||
| Liu QP 2019 | 37/33 | 45.5±6.8/ 43.6±8.9 | Mo 30 min qd+CIN | Aripiprazole, started at 5 mg/d, increased to 20-30 mg/d in two weeks | 84 | ①②③④⑤ | |||||||||
| Yang YH et al 2017 | 11/12 | 47.42±9.76/47.52±9.3 | Mo 120 min qd+CIN | WM Standard dose | 56 | ① | |||||||||
| Xu TC et al 2010 | 30/30 | 25.67±8.12 /26.33±7.52 | LA 30 min qd 5 times per week+Risperidone 2 mg/d | WM Total dose 3-6mg/d | 56 | ② | |||||||||
| Xu TC et al 2004 | 40/40 | 31.74±10.23 /30.12±8.06 | LA 30 min qd gradually increased to 3 times per week +WM dosage < 0.2 g/d | WM maximum dosage 0.2-0.79g/d | 80 | ⑤⑥⑨ | |||||||||
| Wang L et al 2006 | 16/16 | 15.87±2.45 /15.74±2.89 | LA 45 min qd+WM dosage < 0.29 g/d | WM Standard dose | 30 | ①④⑤⑥⑨ | |||||||||
| Wang W et al 2013 | 30/30 | 48.15±1.13 | LA Acupoint prick once every two days+CIN | Sulpiride, started at 200 mg/d, increased to 600 mg/d tid + Benhexol 2 mg bid | 20 | ④⑤⑨ | |||||||||
| Study | Sample size (O/C) | Age (O/C) | Observation intervention | Control intervention | Duration of treatment (days) | Outcome | |||||||||
| Zhao LJ 2018 | 100/99 | 32.6±2.3 /32.4±2.2 | LA 30 min qd+Risperidone, started at 1 mg/d, gradually increased to 4 mg/d | Risperidone, started at 1 mg/d, once every two days, increased to 4-6 mg/d in two weeks, maximum dose 10 mg/d | 30 | ① | |||||||||
| Wang GP et al 2000 | 45/45 | 39.54±10.93 /38.27±9.78 | AI (clonazepam injection 1 mg once every two days, 7 times total)+CIN | WM Standard dose | 14 | ⑥ | |||||||||
| Wu CF et al 2004 | 100/60 | 32.24±10.40 /32.07±10.17 | AI (Danshen injection 6 mL qd)+CIN | Hibernating, average dose (462.59±72.92) mg/d | 44 | ⑥⑨ | |||||||||
| Ma C 2006 | 60/60 | 25.35±7.31 /25.75±7.46 | AI (Clonazepam injection 1 mg once every two days, 14 times total)+CIN | WM Standard dose | 28 | ⑥⑨ | |||||||||
| Jiang WC et al 1998 | 34/30 | 30.7±10.3 /28.8±12.4 | AI (Perphenazine injection 5 mg qd)+CIN | WM Standard dose | 180 | ①⑥ | |||||||||
| Pan YF et al 2003 | 100/60 | 32.24±10.40 /32.07±10.17 | AI (Danshen injection 6 mL qd)+CIN | WM Standard dose | 44 | ⑥⑨ | |||||||||
| Xiao HQ et al 2020 | 30/30 | 31.43±4.51 /29.03±3.66 | ACE+CIN | Clozapine 50-100 mg | 42 | ③⑦ | |||||||||
| Zhang W et al 2015 | 35/35 | 43.2±3.2 /45±4 | ACE once a week+CIN | Chlorpromazine, started at 25 mg/d, once every two days, increased to 200 mg/d in one weeks, bid | 180 | ⑥ | |||||||||
| Zhang YK et al 2007 | 30/30 | 28.2±7.9/ 27.8±11.1 | MOT+CIN | WM Standard dose | 84 | ①⑤⑥ | |||||||||
| Liu ZL et al 2010 | 31/29 | 46±10/ 44±9 | MOT+CIN | Risperidone, started at 1 mg/d, increased to 4-6 mg/d dose in 14 d, average dose (4.0±1.8) mg/d | 84 | ②③④⑤ | |||||||||
Figure 2 Network graph for primary outcomes A: clinical efficacy rate; B: BPRS score; C: PANSS general score; D: PANSS total score; E: SANS score; F: SAPS score; G: CGI score; H: HAMD score; I: TESS score. BPRS: the Brief Psychiatric Rating Scale; PANSS: Positive and Negative Syndrome Scale; SANS: Scale for Assessment of Negative Symptoms; SAPS: Scale for Assessment of Positive Symptoms; CGI: Clinical Global Impression; HAMD: Hamilton Depression Scale; TESS: Treatment Emergent Symptom Scale; WM: Western Medicine; EA: Electric Acupuncture; BA: Body Acupuncture; SA: Scalp Acupuncture; AA: Auricular Acupuncture; Mo: Moxibustion; LA: Low-dose medication and Acupuncture; AI: Acupoint Injection; ACE: Acupoint Catgut Embedding; MOT: Meridian Oxygen Therapy.
Figure 2 Network graph for primary outcomes A: clinical efficacy rate; B: BPRS score; C: PANSS general score; D: PANSS total score; E: SANS score; F: SAPS score; G: CGI score; H: HAMD score; I: TESS score. BPRS: the Brief Psychiatric Rating Scale; PANSS: Positive and Negative Syndrome Scale; SANS: Scale for Assessment of Negative Symptoms; SAPS: Scale for Assessment of Positive Symptoms; CGI: Clinical Global Impression; HAMD: Hamilton Depression Scale; TESS: Treatment Emergent Symptom Scale; WM: Western Medicine; EA: Electric Acupuncture; BA: Body Acupuncture; SA: Scalp Acupuncture; AA: Auricular Acupuncture; Mo: Moxibustion; LA: Low-dose medication and Acupuncture; AI: Acupoint Injection; ACE: Acupoint Catgut Embedding; MOT: Meridian Oxygen Therapy.
Figure 3 Risk of bias graph
Figure 3 Risk of bias graph
Figure 4 Network Meta-analysis comprising the effects of all treatment interventions on various outcome measures A: clinical efficacy rate; B: BPRS score; C: PANSS total score; D: PANSS general score; E: SAPS score; F: SANS score; G: CGI score; H: HAMD score; I: TESS score. BPRS: the Brief Psychiatric Rating Scale; PANSS: Positive and Negative Syndrome Scale; SAPS: Scale for Assessment of Positive Symptoms; SANS: Scale for Assessment of Negative Symptoms; CGI: Clinical Global Impression; HAMD: Hamilton Depression Scale; TESS: Treatment Emergent Symptom Scale. The numbers in red are statistically significant.
Figure 4 Network Meta-analysis comprising the effects of all treatment interventions on various outcome measures A: clinical efficacy rate; B: BPRS score; C: PANSS total score; D: PANSS general score; E: SAPS score; F: SANS score; G: CGI score; H: HAMD score; I: TESS score. BPRS: the Brief Psychiatric Rating Scale; PANSS: Positive and Negative Syndrome Scale; SAPS: Scale for Assessment of Positive Symptoms; SANS: Scale for Assessment of Negative Symptoms; CGI: Clinical Global Impression; HAMD: Hamilton Depression Scale; TESS: Treatment Emergent Symptom Scale. The numbers in red are statistically significant.
Table 2 Rank probability of each therapeutic intervention for the listed outcomes
| A | B | C | D | E | F | G | H | I | |
|---|---|---|---|---|---|---|---|---|---|
| WM | 10 | 9 | 9 | 5 | 5 | 7 | 3 | 4 | 4 |
| BA+EA | 5 | 3 | 4 | 4 | 3 | 6 | - | - | 3 |
| BA | 6 | 6 | 2 | 1 | 1 | 1 | - | 2 | - |
| SA+EA | 4 | 7 | 3 | 3 | 4 | 4 | - | 3 | 1 |
| SA | 3 | 5 | 6 | 2 | - | - | 1 | 5 | - |
| AA | 1 | 4 | 1 | - | - | - | 4 | 1 | - |
| Mo | 7 | - | 7 | 7 | 7 | 3 | - | - | - |
| LA | 2 | 2 | 10 | - | 2 | 2 | - | - | 2 |
| AI | 8 | 8 | - | - | - | - | - | - | 5 |
| ACE | - | 1 | 5 | - | - | - | 2 | - | - |
| MOT | 9 | 10 | 8 | 6 | 6 | 5 | - | - | - |
Table 2 Rank probability of each therapeutic intervention for the listed outcomes
| A | B | C | D | E | F | G | H | I | |
|---|---|---|---|---|---|---|---|---|---|
| WM | 10 | 9 | 9 | 5 | 5 | 7 | 3 | 4 | 4 |
| BA+EA | 5 | 3 | 4 | 4 | 3 | 6 | - | - | 3 |
| BA | 6 | 6 | 2 | 1 | 1 | 1 | - | 2 | - |
| SA+EA | 4 | 7 | 3 | 3 | 4 | 4 | - | 3 | 1 |
| SA | 3 | 5 | 6 | 2 | - | - | 1 | 5 | - |
| AA | 1 | 4 | 1 | - | - | - | 4 | 1 | - |
| Mo | 7 | - | 7 | 7 | 7 | 3 | - | - | - |
| LA | 2 | 2 | 10 | - | 2 | 2 | - | - | 2 |
| AI | 8 | 8 | - | - | - | - | - | - | 5 |
| ACE | - | 1 | 5 | - | - | - | 2 | - | - |
| MOT | 9 | 10 | 8 | 6 | 6 | 5 | - | - | - |
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