温胆汤加减治疗卒中后抑郁的Meta分析

Meta Analysis of Wendan Decoction(温胆汤)in the Treatment of Post-Stroke Depression

目的:系统评价温胆汤加减治疗卒中后抑郁的临床疗效和安全性。方法:检索中国知网、万方数据库、维普数据库、Web of Science、PubMed、Embase、Cochrane Library等数据库,筛选温胆汤加减治疗卒中后抑郁的随机对照试验文献,检索时间从建库至2019年11月30日,纳入文献采用Jadad评分表评价文献质量,采用RevMan5.3软件进行Meta分析。结果:共纳入10篇文献,725例患者,文献质量普遍偏低。与对照组比较,治疗组能显著提高患者痊愈率[OR=1.63,95%CI(1.15,2.31),P=0.006]和有效率[OR=2.96,95%CI(1.90,4.61),P<0.000,01],缓解抑郁症状[MD=-3.30,95%CI(-4.43,-2.17),P<0.000,01],恢复神经功能[MD=-2.39,95%CI(-3.34,-1.44),P<0.000,01],提高日常生活能力[MD=-4.53,95%CI(-5.83,-3.23),P <0.000,01],改善精神状态[MD=3.16,95%CI(1.05,5.27),P=0.003],不良反应少[OR=0.28,95%CI(0.18,0.43),P<0.000,01],差异均有统计学意义。结论:温胆汤加减治疗卒中后抑郁疗效显著,安全性高,但需高质量的随机对照试验进一步验证。

Objective: To systematically evaluate the clinical efficacy and safety of Wendan decoction in the treatment of post-stroke depression. Methods: Chinese and English databases such as CNKI, Wanfang database,VIP, Web of Science, PubMed, Embase and Cochrane Library were searched. The randomized controlled trial literatures of Wendan Decoction for the treatment of post-stroke depression were screened. The retrieval time was from the establishment of the database to November 30, 2019. The included literature was evaluated using the Jadad score table Quality, and Meta analysis was performed using RevMan5.3 software. Results: A total of10 articles were included in 725 patients. The quality of the articles was generally low. Compared with the control group, the treatment group can significantly improve the cure rate of patients [OR=1.63, 95%CI(1.15, 2.31),P=0.006] and effective rate [OR=2.96, 95%CI(1.90, 4.61), P<0.000,01], relieve depression symptoms [MD=-3.30,95% CI(-4.43,-2.17), P<0.000,01], restore nerve function [MD=-2.39, 95%CI(-3.34,-1.44), P<0.000,01], improve daily living ability [MD =-4.53, 95% CI(-5.83,-3.23), P <0.000,01] and improve mental state [MD =3.16, 95%CI(1.05,5.27), P =0.003]. Compared with the control group, the adverse reactions were small in treatment group[OR=0.28, 95%CI(0.18, 0.43), P<0.000,01]. Conclusion: Wendan decoction has significant curative effect and high safety in treating post-stroke depression, but it needs to be further verified by high-quality randomized controlled trials.