[Clinical evidence of acupuncture and moxibustion for depressive disorder: controversy, reflection and prospect].

Abstract

To clarify the clinical evidence required for integrating acupuncture and moxibustion treatment for depressive disorder into the mainstream psychiatric diagnostic and therapeutic system, as well as the existing deficiencies, this paper summarizes the current state of evidence for acupuncture and moxibustion treatment for depressive disorder from three perspectives: clinical guidelines, systematic reviews, and clinical trials. The differentiation of recommendations of different guidelines and its causes are analyzed, and the key issues such as the design and implementation of clinical research, efficacy evaluation, the integration of mechanisms with clinical practice, and the heterogeneity of acupuncture and moxibustion techniques and protocols are discussed. On this basis, the paper proposes that by conducting high-quality clinical research, constructing a multidimensional efficacy evaluation system, promoting the integration of mechanistic studies with clinical practice, and strengthening interdisciplinary collaboration and the translation of research outcomes, the therapeutic characteristics, target populations, and clinical value of acupuncture and moxibustion treatment for depressive disorder can be further clarified. This will provide a reference for improving the relevant clinical evidence system and promoting standardized application. 为厘清针灸治疗抑郁障碍融入主流精神医学诊疗体系所需的临床证据及其现存不足，本文从临床指南、系统评价和临床试验3个层面总结针灸治疗抑郁障碍的证据现状，分析不同指南推荐意见分化及其原因，并围绕临床研究设计与实施、疗效评价、机制与临床衔接、针灸技术与方案异质性等关键问题展开反思。在此基础上，提出通过开展高质量临床研究、构建多维度疗效评价体系、促进机制研究与临床实践融合以及加强跨学科协作和成果转化，进一步明确针灸治疗抑郁障碍的疗效特点、适用人群及临床价值，为完善相关临床证据体系和推动规范化应用提供参考。.