中医联合疗法治疗卒中后抑郁的网状Meta分析

The Network Meta-analysis of Traditional Chinese Medicine Combined Therapy in the Treatment of Post-stroke Depression

目的运用网状Meta分析的方法,以SSRIs药物为共同对照,评价中医联合疗法治疗脑卒中后抑郁(PSD)的有效性。方法检索Pub Med、The Cochrane Library、EMbase、CBM、CNKI、维普及万方数据库中有关中医联合疗法、SSRIs之间比较治疗PSD有效性的临床随机对照试验。以治疗总有效率为结局指标,运用Stata 14.0和Gemtc 0.14.3软件进行统计分析。结果纳入23个RCT,共有PSD患者1895例,涉及中医联合疗法、SSRIs等13种治疗措施。各比较组构成星型网络,网状Meta分析结果显示:在治疗有效率方面,针刺+内服中药、耳穴压豆+内服中药、耳穴压豆+针刺、电针+内服中药、灸法+内服中药与SSRIs相比差异有统计学意义,其余疗法与其比较无明显差异,疗效最好的为电针+内服中药[OR=0.1,95%CI(0,0.79)]。结论电针+内服中药整体疗效最优于SSR Is。但本研究结论仍需开展更多临床试验予以证实。

Objective Using the method of reticular meta-analysis, SSRIs were used as common control to evaluate the effectiveness of traditional Chinese medicine combined therapy for PSD. Methods A randomized controlled trial comparing the efficacy of traditional Chinese medicine combined therapy and SSRIs in the treatment of PSD efficacy between Pub Med, The Cochrane Library, EMbase,CBM, CNKI, Vip and Wanfangdatabase was made. The total effective rate was used as the outcome indexes. The data were analyzed by Stata14.0, and Gemtc 0.14.3 software. Results A total of 23 RCT patients were included, and there were 1895 cases of PSD patients, involving 13 treatment measures such as combined therapy of traditional Chinese medicine and SSRIs. The comparative groups formed a star network, and the mesh Meta-analysis showed： in the treatment of efficiency, acupuncture and oral administration of traditional Chinese medicine, ear acupressure beans and traditional Chinese medicine, ear acupressure beans and acupuncture,electroacupuncture and traditional Chinese medicine, moxibustion and oral administration of traditional Chinese medicine was compared with SSRIs, the difference was statistically significant, and the other treatments were compared with it, and there had no obvious difference. The best curative effect was electroacupuncture and Chinese medicine OR =0.1, OR =0.1, 95% CI（ 0, 0.79）.Conclusion The comprehensive evidence showed that the overall curative effect of electroacupuncture and oral Chinese medicine is better than that of SSRIs. But the conclusions of this study still need to carry out more clinical trials to be confirmed.