Acupuncture Combined with Traditional Chinese Medicine Integrative Interventions for Depression: A Systematic Review and Meta-Analysis

Objective To systematically evaluate the efficacy and safety of acupuncture (AC) combined with traditional Chinese medicine (TCM) integrative interventions for depression. Methods We searched China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang Data Knowledge Service Platform, PubMed, Embase, and Web of Science from inception to 30 April 2026. Meta-analysis was performed using Stata 18.0 and R 4.5. Results A total of 12 studies (848 patients) were included. The pooled analysis revealed a statistically significant reduction in Hamilton Depression Rating Scale (HAMD) scores favoring the experimental group over the control group, with a standardized mean difference (SMD) of −0.77 (95% confidence interval (CI): −1.17 to −0.37), but the heterogeneity was high (I 2 = 85.8%). A significantly improved clinical effective rate (CER) was observed in the experimental group relative to the control group, with a risk ratio (RR) of 1.23 (95% CI: 1.06 to 1.42, P = 0.01). The severity of adverse events (AEs) was lower in the experimental group (SMD = −2.64, 95% CI: −3.81 to −1.47, P < 0.001), but only four studies were reported and the heterogeneity was extremely high (I 2 = 92.75%). Certainty of evidence was moderate for HAMD scores and CER and very low for AEs. Conclusion AC combined with TCM integrative interventions may improve depressive symptoms. However, the included studies have high heterogeneity, lack of blinding, and low evidence quality limit the certainty of this conclusion. In the future, large-sample, strictly blinded, standardized intervention protocols and high-quality RCTs should be conducted to verify this.