摘要
目的:系统评价逍遥散治疗卒中后抑郁的疗效和安全性。方法:计算机检索CNKI、万方、维普、CMB、PubMed、Embase数据库中有关逍遥散治疗卒中后抑郁的随机对照试验。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan5.3软件进行Meta分析。结果:共纳入20篇文献,共1489例患者(治疗组759例,对照组730例),Meta分析显示:逍遥散联合抗抑郁药物治疗有效率优于对照组(RR=1.27,95%CI[1.20,1.35],P<0.00001),HAMD评分改善优于对照组(MD=-3.15,95%CI[-4.24,-2.05],P<0.00001),单用逍遥散HAMD评分与对照组无显著差异(MD=-2.21,95%CI[-3.70,1.29],P>0.05),逍遥散联合组日常生活活动能力(Barthel Index)改善优于对照组(MD=17.42,95%CI[15.62,19.22],P<0.00001)、神经功能缺损评分(SSS)优于对照组(MD=-8.24,95%CI[-8.87,-7.61],P<0.00001)、不良反应发生率低于对照组(RR=0.51,95%CI[0.33,0.79],P<0.05)。结论:逍遥散单用可以改善卒中后抑郁情况,联合抗抑郁药物可以提高疗效,并且可以改善卒中后日常生活活动能力、神经功能,安全性方面,逍遥散联合抗抑郁药能降低不良反应,证据更充分,更安全,单用逍遥散安全性有待进一步验证。
Objective:To systematically evaluate the efficacy and safety of Xiaoyao Powder in the treatment of post-stroke depression.Methods:Randomized controlled trial of Xiaoyao Powder for the treatment of post-stroke depression in CNKI,Wanfang,Weipu,CMB,PubMed and Embase database were retrieved by computer.Two researchers screened the literature,extracted the data and evaluated the bias risk of the included study independently.RevMan5.3 software was used for Meta analysis.Results:A total of 20 references and 1489 patients were included(759 in the treatment group and 730 in the control group).Meta analysis showed that:The effective rate in Xiaoyao powder combined with antidepressants group was better than that in the control group(RR=1.27,95%CI[1.20,1.35],P<0.00001),and the improvement of HAMD score was better than that in the control group(MD=-3.15,95%CI[-4.24,-2.05],P<0.00001).There was no significant difference between the Xiaoyao powder single use group and the control group on HAMD score(MD=-2.21,95%CI[-3.70,1.29],P>0.05).Compared with the control group,the Barthel Index(MD=17.42,95%CI[15.62,19.22],P<0.00001)and neurological impairment score(SSS)MD=-8.24,95%CI[-8.87,-7.61],P<0.00001)in the combination drug group were significantly improved,the adverse reaction incidence was significantly lower(RR=0.51,95%CI[0.33,0.79],P<0.05).Conclusion:Single Xiaoyao Powder can improve the situation of post-stroke depression.Xiaoyao Powder combined with antidepressant drugs can increase its efficacy,and improve the ability of daily life activities and neurological function.In terms of safety,Xiaoyao Powder combined with antidepressants can reduce adverse reactions,which has more sufficient evidence and is safer,while the safety of Single Xiaoyao Powder remains to be further verified.
作者
赵佳源
王小方
袁荣荣
钱仁义
Zhao Jiayuan;Wang Xiaofang;Yuan Rongrong;Qian Renyi(Henan University of TCM,Zhengzhou 450000;First Affiliated Hospital of Henan University of TCM,Zhengzhou 450000)
出处
《中药药理与临床》
CAS
CSCD
北大核心
2020年第5期173-179,共7页
Pharmacology and Clinics of Chinese Materia Medica
基金
河南省中医药管理局项目(编号:2018ZY2073)
河南省中医药管理局项目(编号:2019ZY2135)。
关键词
逍遥散
卒中后抑郁
META分析
Xiaoyao Powder
Post stroke depression
Meta analysis
