柴胡加龙骨牡蛎汤治疗肿瘤相关性抑郁的有效性及安全性系统评价与Meta分析

Efficacy and Safety of Chaihu Jia Longgu Muli Decoction in the Treatment of Tumor Associated Depression:A Systematic Review and Meta Analysis

目的:对柴胡加龙骨牡蛎汤治疗肿瘤相关性抑郁的有效性与安全性进行评价。方法:检索CNKI、VIP、PubMed等数据库筛选出柴胡加龙骨牡蛎汤治疗肿瘤相关性抑郁的随机对照试验,运用RevMan5.3软件进行分析。结果:总有效率方面,柴胡加龙骨牡蛎汤优于草酸艾司西酞普兰片[RR=1.23,95%CI(1.22,1.36),P<0.0001];柴胡加龙骨牡蛎汤+草酸艾司西酞普兰片优于草酸艾司西酞普兰片[RR=1.24,95%CI(1.10,1.40),P=0.0005];柴胡加龙骨牡蛎汤优于氟西汀[RR=1.15,95%CI(1.07,1.23),P<0.0001];柴胡加龙骨牡蛎汤优于盐酸帕罗西汀片[RR=1.10,95%CI(1.01,1.21),P=0.004]。HAMD评分方面,柴胡加龙骨牡蛎汤优于草酸艾司西酞普兰片[MD=-6.01,95%CI(-7.04,-4.97),P<0.00001];柴胡加龙骨牡蛎汤+草酸艾司西酞普兰片优于草酸艾司西酞普兰片[MD=-5.44,95%CI(-9.75,-1.12),P=0.01];柴胡加龙骨牡蛎汤+氟西汀优于氟西汀[MD=-6.13,95%CI(-9.45,-2.81),P=0.0003]。不良反应率方面,柴胡加龙骨牡蛎汤优于草酸艾司西酞普兰片[RR=0.19,95%CI(0.10,0.35),P<0.00001];柴胡加龙骨牡蛎汤优于氟西汀[RR=0.19,95%CI(0.10,0.35),P<0.00001];柴胡加龙骨牡蛎汤+草酸艾司西酞普兰片优于草酸艾司西酞普兰片[RR=0.21,95%CI(0.08,0.52),P=0.0008];柴胡加龙骨牡蛎汤+氟西汀优于氟西汀[RR=0.21,95%CI(0.08,0.59),P=0.003]。结论:柴胡加龙骨牡蛎汤或联合西药治疗肿瘤相关性抑郁可提高总有效率,降低HAMD评分,减少不良反应发生率。因纳入研究的质量不高,仅作临床参考。

Objective: To evaluate the effectiveness and safety of Chaihu plus Longgu Muli Decoction in the treatment of tumor-related depression. Methods: Search CNKI, VIP, PubMed and other databases, screen out the randomized controlled trials of Chaihu plus Longgu Muli Decoction in the treatment of tumor-related depression, and use RevMan5.3 software to analyze. Results: In terms of total effective rate: Chaihu plus Longgu Muli Decoction is better than escitalopram oxalate tablets(RR=1.23, 95% CI [1.22, 1.36], P<0.0001);Chaihu plus Longgu Muli Decoction + escitalopram oxalate tablets are better than escitalopram oxalate tablets(RR=1.24, 95% CI[1.10, 1.40], P=0.0005);Chaihu plus Longgu Muli Decoction is better than fluoxetine(RR=1.15, 95 % CI [1.07, 1.23], P<0.0001);Chaihu plus Longgu Muli Decoction is better than paroxetine hydrochloride tablets(RR=1.10, 95% CI[1.01, 1.21], P=0.004). In terms of HAMD score: Chaihu plus Longgu Muli Decoction is better than escitalopram oxalate tablets(MD=-6.01, 95% CI[-7.04,-4.97], P<0.00001);Chaihu plus Longgu Muli Decoction + escitalopram oxalate tablets are better than escitalopram oxalate tablets(MD=-5.44, 95% CI[-9.75,-1.12], P=0.01);Chaihu plus Longgu Muli Decoction + Fluoxetine is better than Fluoxetine(MD=-6.13, 95% CI[-9.45,-2.81], P=0.0003). Adverse reaction rate: Chaihu plus Longgu Muli Decoction is better than escitalopram oxalate tablets(RR=0.19, 95% CI[0.10, 0.35], P<0.00001);Chaihu plus Longgu Muli Decoction is better than fluoxetine(RR=0.19, 95% CI [0.10, 0.35], P<0.00001);Chaihu plus Longgu Muli Decoction + escitalopram oxalate tablets are better than escitalopram oxalate tablets(RR=0.21, 95% CI [0.08, 0.52], P=0.0008);Chaihu plus Longgu Muli Decoction+ fluoxetine is better than fluoxetine(RR=0.21, 95% CI[0.08,0.59], P=0.003). Conclusion: Chaihu plus Longgu Muli Decoction or combined with western medicine in the treatment of tumor-related depression can increase the total effective rate, reduce the HAMD score, and reduce the incidence of adverse reactions. Because the quality of the included studies is not high, it is only for clinical reference.