針灸改善海洛因成癮者之焦慮：系統性文獻回顧與統合分析

Acupuncture to alleviate anxiety in patients with heroin addiction: A systematic review and meta-analysis

蕭坤元(Kun-Yuan Hsiao)；李俞生(Yu-Sheng Li)

海洛因 ； 針灸 ； 焦慮 ； 統合分析 ； 成癮 ； heroin ； acupuncture ； anxiety ； meta-analysis ； addiction

北台灣中醫醫學雜誌

14卷2期（2022 / 09 / 01）

1 - 15

繁體中文

本研究目的是欲探討針灸對海洛因戒癮者的焦慮緩解效果。我們從資料庫檢索，包括MEDLINE、EMBASE、Cochrane Central Register of Controlled Trials（CENTRAL）、華藝中文期刊資料庫與中國期刊網等，中文資料庫的搜尋關鍵字為成癮與針灸，西文資料庫的關鍵字為addiction and acupuncture。關於搜尋結果的篩選。納入條件為隨機分派臨床試驗及觀察型研究、對象是海洛因戒癮者、具針灸處置與無處置相比或針灸加一般處置與一般處置比較、具焦慮程評估、中英文撰寫的研究。排除條件包括沒有評估療效、比較不同針灸方法、比較不同介入、不充足資訊或無法獲得評估結果，同時排除非人體試驗等。結果經刪除重複文獻、由標題或摘要刪除明顯不符文獻，仍餘57篇。57篇中，有2篇研究數據重複、6篇討論多種類型成癮症、6篇不是單純針灸組與對照組相比較、2篇屬針灸加其他治療與無處置比較、37篇沒有可用的焦慮評估結果，只餘4篇納入本分析，結果顯示針灸組與控制組之間達統計顯著差異（SMD＝-1.71，95％ CI：-2.52～-0.91），支持針灸有效緩解海洛因戒癮患者的焦慮程度。

The purpose of this study is to explore the anxiety-relieving effect of acupuncture on heroin addicts. We searched from databases, including MEDLINE, EMBASE, CENTRAL, Airiti Library and CNKI. The search keywords in the Chinese database were addiction and acupuncture in Chinese. The keywords in Western language database are addiction and acupuncture. About the screening of search results. The inclusion conditions include randomized clinical trials, observational studies, subjects being heroin addicts, comparison of acupuncture and moxibustion treatment with no treatment, or comparison of acupuncture and moxibustion plus general treatment and general treatment, an anxiety course assessment, and a study written in Chinese and English. Exclusion conditions include failure to evaluate efficacy, comparison of different acupuncture methods, comparison of different interventions, insufficient information or inability to obtain evaluation results, and the exclusion of non-human trials. As a result, after deleting duplicate documents and deleting obviously inconsistent documents from titles or abstracts, there are still 57 articles. Among the 57 articles, there are 2 articles with duplication of research data, 6 articles discussing multiple types of addictions, 6 articles that are not pure acupuncture and moxibustion compared with the control group, 2 articles are acupuncture plus other treatments and no treatment comparison, 37 articles have no available anxiety As a result of the evaluation, only 4 articles were included in this analysis. The results showed that there was a statistically significant difference between the acupuncture group and the control group (SMD=-1.71, 95% CI:-2.52~-0.91), which supports that acupuncture can effectively alleviate the anxiety of heroin addiction patients' degree.

1. Baker, TE,Chang, G(2016).The use of auricular acupuncture in opioid use disorder: A systematic literature review.The American journal on addictions,25(8),592-602.
2. Carter, K,Olshan-Perlmutter, M(2014).NADA protocol: Integrative acupuncture in addictions.Journal of addictions nursing,25(4),182-187.
3. Fatséas, M,Denis, C,Lavie, E,Auriacombe, M(2010).Relationship between anxiety disorders and opiate dependence–a systematic review of the literature: Implications for diagnosis and treatment.Journal of Substance Abuse Treatment,38(3),220-230.
4. Grant, S,Kandrack, R,Motala, A,Shanman, R,Booth, M,Miles, J,Sorbero, M,Hempel, S(2016).Acupuncture for substance use disorders: a systematic review and meta-analysis.Drug and Alcohol Dependence,163,1-15.
5. Guo, J,Huang, W,Tang, C-y,Wang, G-L,Zhang, F,Wang, L-p(2016).Effect of acupuncture on sleep quality and hyperarousal state in patients with primary insomnia: study protocol for a randomised controlled trial.BMJ open,6(3)
6. Higgins, JP,Altman, DG,Gøtzsche, PC,Jüni, P,Moher, D,Oxman, AD,Savović, J,Schulz, KF,Weeks, L,Sterne, JAC(2011).The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials.BMJ,342,d5928.
7. Jones, CM,Logan, J,Gladden, RM,Bohm, MK(2015).Vital signs: demographic and substance use trends among heroin users-United States.MMWR Morb Mortal Wkly Rep,64(26),719-725.
8. Kallen, V,Tulen, J,Utens, E,Treffers, PD,De Jong, F,Ferdinand, R(2008).Associations between HPA axis functioning and level of anxiety in children and adolescents with an anxiety disorder.Depression and anxiety,25(2),131-141.
9. Lee, MY,Lee, BH,Kim, HY,Yang, CH(2021).Bidirectional role of acupuncture in the treatment of drug addiction.Neuroscience & Biobehavioral Reviews,126,382-397.
10. Ma, D,Han, JS,Diao, QH,Deng, GF,Ping, XJ,Jin, WJ,Wu, LZ,Cui, CL,Li, XD(2015).Transcutaneous electrical acupoint stimulation for the treatment of withdrawal syndrome in heroin addicts.Pain Med,16(5),839-848.
11. Mu, J-p,Liu, L,Cheng, J-m,Zhou, L-z,Ao, J-b,Wang, J,Fang, W,Hu, J(2009).Clinical study on electroacupuncture for post-withdrawal anxiety-depression mood in heroin addicts.Journal of acupuncture and tuina science,7(4),203-206.
12. Pilkington, K,Kirkwood, G,Rampes, H,Cummings, M,Richardson, J(2007).Acupuncture for anxiety and anxiety disorders–a systematic literature review.Acupuncture in Medicine,25(1-2),1-10.
13. Pirnia, B,Najafi, E,Soleimani, AA,Malekanmehr, P,Pirnia, K(2018).The Effectiveness of Acupuncture on Addiction Severity Index, a single case experimental design in a Case of Methamphetamine Abuser Patient with Trismus Syndrome.Crescent J Med Biol Sci,5(3),265-267.
14. Riordan, C,Frances, R,Isbell, P,Khantzian, E,Kosten, T,Meyer, R,Cabaj, R,Blume, S,Fullilove, M,Greenfield, S(1994).Position statement on methadone maintenance treatment.American Journal of Psychiatry,151(5),792-794.
15. Roh, HS,Park, BR,Jang, EY,Kim, JS,Gwak, YS(2018).Acupuncture on the stress-related drug relapse to seeking.Evidence-Based Complementary and Alternative Medicine,2018,5367864.
16. Zeng, X,Lei, L,Lu, Y,Wang, Z(2005).Treatment of heroinism with acupuncture at points of the Du Channel.Journal of traditional Chinese medicine,25(3),166-170.
17. 李揚帆,徐平,李煜(2008)。海洛因成癮中醫分型及針灸療法。遼寧中醫雜誌，35(1)，114-116。
18. 張本國,羅非,劉崇悅,韓濟生(2000)。單獨應用韓式戒毒儀治療海洛因成癮 121 例報告。中國中西醫結合雜誌，20(8)，593-595。

1. (2024)。臺灣中醫戒治海洛因成癮進展。中醫藥雜誌，35(1)，1-15。