中药制剂治疗抑郁症的Meta分析

Chinese Medicinal Herbs for Depression:A Meta-analysis

目的:评价中药制剂治疗抑郁症患者的有效性和安全性。方法:检索国内外有关中药制剂治疗抑郁症的病例对照研究文献并进行Meta分析。结果:符合入选标准的研究共8个,共计受试者1 340例。总有效率方面:4个与氟西汀比较的研究结果显示,两组总有效率的差异无统计学意义(OR=1.04,95%CI=0.74～1.46,P=0.84)。2个与帕罗西汀比较的研究显示,两组差异无统计学意义(OR=0.57,95%CI=0.16～2.08,P=0.40)。1个与文拉法辛比较的研究显示,两组差异无统计学意义(OR=0.57,95%CI=0.22～1.50,P=0.26)。1个与麦普替林比较的研究显示,两组差异无统计学意义(OR=0.23,95%CI=0.02～2.22,P=0.21)。HAM-D评分方面:用药6周时HAM-D评分6个研究显示,两组差异无统计学意义(MD=0.18,95%CI=-0.89～1.24,P=0.74)。用药12周时HAM-D评分1个研究的两组差异无统计学意义(MD=0.75,95%CI=-0.56～2.06,P=0.26)。中药组不良反应发生率低于对照组,两组均未见明显实验室检查异常。结论:中药制剂治疗抑郁症有效,但由于本系统评价纳入研究的方法学质量较低,尚需开展更多设计合理、执行严格,随访时间足够长的多中心大样本随机对照试验验证其疗效及安全性。

Objective： To assess the efficacy and safety of Chinese herbal medicines for patients with depression. Method： A recta-analysis was performed to identify case-control studies of Chinese herbal medicines for patients with depression from the literatures. Result： Eight studies involving 1 340 participants were included. As for the total effective rate, there is no statistical difference between treatment group and control group in the 4 trials comparing with Fluoxetine （ OR = 1.04, 95% CI = 0.74-1.46, P = 0.84）, in the 2 trials comparing with Paroxetine （ OR = 0.57, 95% CI = 0. 16-2.08, P = 0.40）, in the 1 trial comparing with Venlafaxine （ OR = 0.57, 95% CI =0.22-1.50, P = 0.26） , and in the 1 trial comparing with Maprotiline （OR = 0.23, 95% CI = 0.02- 2.22, P = 0.21 ）. As for HAM-D scaling rate, neither 6 trials with treatment for 6 weeks nor 1 trial for 12 weeks appear statistical differences between treatment group and control group （MD = 0. 18, 95% CI = - 0. 89-1.24, P =0.74; MD =0.75, 95% CI = -0.56-2.06, P =0.26）. Conclusion： Based on the existing evidence, some Chinese herbal medicines for treating depression appeared efficacious. However, due to the lack of stronger evidence, we cannot recommend any kind of Chinese medical herbal formulation as an effective remedy for depression.