柴胡类方对比选择性五羟色胺再摄取抑制剂治疗肿瘤相关抑郁Meta分析

Efficacy and Safety of Bupleurum Analogous Decoctions Versus Selective Serotonin Reuptake Inhibitors in Cancer-related Depression:a Meta-analysis

目的系统评价柴胡类方对比选择性五羟色胺再摄取抑制剂(SSRIs)治疗肿瘤相关抑郁的疗效及安全性。方法计算机检索CNKI、Wanfang、VIP、PubMed、Cochrane Library等数据库,检索时间截至2020年6月,采用RevMan 5.3软件进行Meta分析。结果柴胡类方对比SSRI组可提高对肿瘤合并抑郁治疗有效率,RR=1.13,95%CI[1.06,1.19],P<0.0001;减低治疗后HAMD抑郁量表评分,SMD=-0.71,95%CI[-1.14,-0.28],P=0.001;在提高治疗后生活质量上两组疗效相当,SMD=0.12,95%CI[-0.78,1.02],P=0.79。安全性方面,柴胡类方不良反应总体发生率低于SSRIs组RR=0.29,95%CI[0.15,0.54],P=0.0001。结论在肿瘤合并抑郁的治疗上,柴胡类方疗效优于SSRIs,且安全性高。但纳入研究数量较少,质量较低,有待今后开展更多高质量研究验证。

Objective To compare the efficacy and safety between bupleurum analogous decoctions and selective serotonin reuptake inhibitors for cancer-related depression.Methods Literature of randomized controlled trials(RCT)about bupleurum analogous decoctions versus selective serotonin reuptake inhibitors in cancer-related depression in CNKI,Wanfang,VIP,SinoMed,PubMed,Cochrane Library,EMBase databases from the establishment to June 2020 are retrieved by computer.Meta-analysis is conducted by RevMan5.3 software.Results Meta-analysis results show that bupleurum analogous decoctions group compared with the SSRIs group can improve the efficiency of treatment of tumor-related depression,RR=1.13,95%CI[1.06,1.19],P<0.0001,and reduce the HAMD depression scale score,SMD=-0.71,95%CI[-1.14,-0.28],P=0.001,the two groups have comparable efficacy in improving the quality of life after treatment,SMD=0.12,95%CI[-0.78,1.02],P=0.79.In terms of safety,the overall incidence of adverse reactions of bupleurum analogous decoctions group is much lower than that in the SSRIs group,RR=0.29,95%CI[0.15,0.54],P=0.0001.Conclusion In the treatment of cancer-related depression,the bupleurum analogous decoctions is superior to SSRIs and has high safety.However,the number of studies included in this article is relatively small and the quality is low.Care should be taken in applying this conclusion.More high-quality studies are needed to further verify this conclusion.