含栀子治疗抑郁方剂的疗效及安全性Meta分析

Meta-analysis on the efficacy and safety of antidepressantprescriptions containing Gardeniae Fructus

为了系统评价含栀子治疗抑郁症方剂(简称含栀子方)的临床疗效及安全性。采用电子数据库检索研究含栀子方临床随机对照试验的中文文献。按照文献纳入标准进行文献整合和初步筛选;对初筛后获得的文献按提取标准进行资料提取与文献的进一步筛选。应用Revman 5.3软件进行研究文献的质量评价,并对所提取数据进行Meta分析。以“栀子”“中药”和“抑郁症”等关键词在电子数据库检索且按标准筛选文献后,最终纳入38篇文献,试验组与对照组涉及总样本量为3 960例。Meta分析结果显示:1)单用含栀子方[相对危险度(RR)=1.15,95%置信区间(CI)(1.10,1.21);P<0.000 01]及含栀子方联用西药[RR=1.23,95%CI(1.18,1.28);P<0.000 01]治疗抑郁症的有效率高于单用西药治疗抑郁症的有效率;2)单用含栀子方[均差(MD)=-1.79,95%CI(-2.84,-0.74);P=0.000 8]及含栀子方联用西药治疗抑郁症[MD=-5.14,95%CI(-6.57,-3.70);P<0.000 01]的汉密尔顿抑郁量表评分(HAMD)降低HAMD分值优于单用西药治疗抑郁症;3)单用含栀子方[RR=0.12,95%CI(0.07,0.23);P<0.000 01]及含栀子方联用西药治疗抑郁症[RR=0.47,95%CI(0.32,0.69);P=0.000 1]的不良反应发生率低于单用西药治疗抑郁症的发生率。因此,含栀子方对于抑郁症治疗具有显著的临床疗效与安全性。

The clinical trial data of prescriptions containing Gardeniae Fructus were collected from Chinese literature regarding the treatment of depression.Upon the exclusion of duplicate documents from electronic database,we utilized Revman 5.3 software to evaluate the quality of research papers,then extracted the corresponding data for Meta-analysis,aiming to assess the clinical safety and efficacy of antidepressant prescriptions containing Gardeniae Fructus.Three keywords including“Gardeniae Fructus”,“Chinese medicine”,and“depression”appeared in 38 articles from the total of 3960 publications,and the Meta-analysis demonstrated:a)the prescriptions,either containing Gardeniae Fructus alone[RR=1.15,95%CI(1.10,1.21);P<0.00001]or with combination with antidepressants[RR=1.23,95%CI(1.18,1.28);P<0.00001]showed higher effective rate than antidepressants with regard to clinical efficiency.b)In terms of HAMD scaling rate,the prescriptions,either containing Gardeniae Fructus alone or in combination with antidepressants could reduce HAMD more significantly than antidepressants alone.c)Regarding adverse effects,the prescriptions,either containing Gardeniae Fructus alone[RR=0.12,95%CI(0.07,0.23);P<0.00001]or with the combination with antidepressants[RR=0.47,95%CI(0.32,0.69);P=0.0001],proved to be safer than antidepressants.In conclusion,the prescriptions containing Gardeniae Fructus would offer a better option for patients with depressive disorder.