目的:系统评价中药对卒中后抑郁(PSD)患者炎性因子影响及中药对卒中后抑郁的疗效。方法:对中文数据库(SinoMed、CNKI、VIP、万方数据库)和PubMed、Cochrane图书馆、Web of science进行检索,纳入用中药治疗卒中后抑郁患者的临床随机对照...目的:系统评价中药对卒中后抑郁(PSD)患者炎性因子影响及中药对卒中后抑郁的疗效。方法:对中文数据库(SinoMed、CNKI、VIP、万方数据库)和PubMed、Cochrane图书馆、Web of science进行检索,纳入用中药治疗卒中后抑郁患者的临床随机对照试验,进行质量评价并且用软件RevMan 5.4进行Meta分析。结果:最后纳入文献6篇,接受试验者共有636例。中药疗法在降低PSD患者的静脉血TNF-α[MD=-4.13,95%CI(-4.75,-3.51),P<0.00001]、IL-6[MD=-3.39,95%CI(-3.90,-2.88),P<0.00001]、IL-8[MD=-2.12,95%CI(-2.49,-1.75),P<0.00001]水平方面优于西药治疗,并且在降低HAMD[MD=-4.22,95%CI(-5.37,-3.07),P<0.00001]、NIHSS[MD=-2.33,95%CI(-3.43,-1.23),P<0.0001]评分方面优于西药治疗;中药与西药合用在降低卒中后抑郁患者的静脉血TNF-α[MD=-10.61,95%CI(-15.30,-5.91),P<0.00001]、IL-1[MD=-3.75,95%CI(-4.51,-2.99),P<0.00001]、IL-6[MD=-3.83,95%CI(-4.49,-3.16),P<0.00001]、IL-8[MD=-9.41,95%CI(-14.89,-3.92),P<0.00001]、Hcy[MD=-3.81,95%CI(-4.62,-2.99),P<0.00001]水平方面优于西药治疗,并且在降低HAMD[MD=-3.06,95%CI(-3.39,-2.73),P<0.00001]、NIHSS[MD=-4.47,95%CI(-7.55,-1.39),P=0.004]、HAMA[MD=-2.83,95%CI(-3.47,-2.19),P<0.00001]评分,提高BI指数[MD=-12.30,95%CI(-22.66,-1.93),P=0.02]方面优于西药治疗。有3项研究没有提到不良反应,其余3项研究中有37例有皮疹、震颤、头晕等不良反应,试验组不良反应发生率低于对照组,且无严重不良反应。结论:中药可以在一定程度上降低卒中后抑郁患者部分炎性因子水平,且在疗效方面优于单纯应用西药,但研究存在着一定的局限性,未来随着相关试验的增加,所得结论需加入更多高质量的RCT研究进行深入探讨。展开更多
Objective:To systematically evaluate the effect of traditional Chinese medicine on inflammatory factors in patients with post-stroke depression(PSD)and the efficacy of traditional Chinese medicine on PSD.Methods:Chine...Objective:To systematically evaluate the effect of traditional Chinese medicine on inflammatory factors in patients with post-stroke depression(PSD)and the efficacy of traditional Chinese medicine on PSD.Methods:Chinese databases(Sinomed,CNKI,VIP,Wanfang),PubMed,Cochrane Library,and Web of Science were searched.Randomized controlled trials of patients with PSD treated with traditional Chinese medicine were included.Quality evaluation was performed and Meta-analysis was performed using RevMan 5.4 software.Results:The results show that TCM therapy is superior to western medicine in reducing the level of TNF-α[MD=-4.13,95%CI(-4.75,-3.51),P<0.00001],IL-6[MD=-3.39,95%CI(-3.90,-2.88),P<0.00001]and IL-8[MD=-2.12,95%CI(-2.49,-1.75),P<0.00001]in venous blood of PSD patients,and is superior to western medicine in reducing the score of HAMD[MD=-4.22,95%CI(-5.37,-3.07),P<0.00001]and NIHSS[MD=-2.33,95%CI(-3.43,-1.23),P<0.0001].The combination of Chinese medicine and western medicine is superior to western medicine in reducing the level of TNF-α[MD=-10.61,95%CI(-15.30,-5.91),P<0.00001]、IL-1[MD=-3.75,95%CI(-4.51,-2.99),P<0.00001]、IL-6[MD=-3.83,95%CI(-4.49,-3.16),P<0.0001]、IL-8[MD=-9.41,95%CI(-14.89,-3.92),P<0.00001]and Hcy[MD=-3.81,95%CI(-4.62,-2.99),P<0.00001]in venous blood of patients with PSD,and is superior to western medicine in reducing the score of HAMD[MD=-3.06,95%CI(-3.39,-2.73),P<0.00001]、NIHSS[MD=-4.47,95%CI(-7.55,-1.39),P=0.004]and HAMA[MD=-2.83,95%CI(-3.47,-2.19),P<0.00001]and improving BI index.Three studies do not mention adverse reactions,and 37 cases in the remaining three studies show rash,tremor,dizziness and other adverse reactions.The incidence of adverse reactions in the experimental group was lower than that in the control group,and there were no serious adverse reactions.Conclusion:The results suggest that traditional Chinese medicine can reduce the level of some inflammatory factors in patients with PSD to a certain extent,and its efficacy is better than that of western medicine alone.Nevertheless,this study has some limitations,and with the increase of related trials in the future,the conclusions of the study need to be further discussed by adding more high-quality RCT studies.展开更多
系统评价参松养心胶囊治疗缓慢性心律失常合并早搏的疗效和安全性的Meta分析。计算机检索中国知网数据库(CNKI)、万方数据资源系统、维普中文科技期刊全文数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed和Cochrane图书馆、Cli...系统评价参松养心胶囊治疗缓慢性心律失常合并早搏的疗效和安全性的Meta分析。计算机检索中国知网数据库(CNKI)、万方数据资源系统、维普中文科技期刊全文数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed和Cochrane图书馆、ClinicalTrials数据库,收集参松养心胶囊治疗缓慢性心律失常合并早搏的随机对照试验。由2名研究者独立根据纳排标准筛选文献、资料提取并核对结果,采用Risk of Bias工具进行方法学质量评估,采用RevMan 5.3进行Meta分析。共纳入9篇随机对照试验,包含受试者706名,干预措施为单独使用参松养心胶囊,对照措施为空白对照。结果显示,参松养心胶囊对平均心率(MD=6.59,95%CI[3.87,9.31],I^2=90%)、早搏有效率(RR=1.72,95%CI[1.53,1.93],I^2=0%)、心动过缓有效率(RR=1.74,95%CI[1.40,2.17],I^2=47%)、临床有效率(RR=1.50,95%CI[1.31,1.70],I^2=31%)均有一定疗效。8项研究报告安全性事件,未发现明显不良反应。该研究发现,单独使用参松养心胶囊对缓慢性心律失常合并早搏在提高心率,控制早搏及改善临床症状方面可能具有一定疗效,未发现明显不良反应,临床可考虑使用。该结论仍需开展高质量的临床试验进一步加以证实。展开更多
系统评价复方苁蓉益智胶囊治疗血管性认知障碍的疗效和安全性的Meta分析。计算机检索中国知网数据库(CNKI)、万方数据资源系统、维普中文科技期刊全文数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Cochrane图书馆、Clinica...系统评价复方苁蓉益智胶囊治疗血管性认知障碍的疗效和安全性的Meta分析。计算机检索中国知网数据库(CNKI)、万方数据资源系统、维普中文科技期刊全文数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Cochrane图书馆、ClinicalTrials数据库,收集复方苁蓉益智胶囊治疗血管性认知障碍的随机对照试验。由2名研究者独立根据纳排标准筛选文献、资料提取并核对结果,采用Risk of Bias工具进行方法学质量评估,采用RevMan 5.3进行Meta分析。共纳入12篇文献,包含受试者1 279名,治疗组干预措施为单独使用复方苁蓉益智胶囊或联合西药,对照组为西药或空白对照。结果显示,对轻度血管性认知障碍患者,复方苁蓉益智胶囊在改善MoCA量表评分、提高血清NO水平、降低血清ET-1水平方面优于空白对照;对血管性痴呆患者,复方苁蓉益智胶囊联合西药在改善MMSE,MoCA量表评分方面优于单用西药治疗。5项研究报告不良事件,未发现明显不良反应。该研究发现,单独使用复方苁蓉益智胶囊可改善轻度血管性认知障碍患者的早期认知功能损害,联合使用复方苁蓉益智胶囊和西药改善血管性痴呆患者的认知功能损害效果优于单用西药治疗,未见明显不良反应,临床可考虑使用。该结论仍需开展高质量的临床试验进一步加以证实。展开更多
文摘目的:系统评价中药对卒中后抑郁(PSD)患者炎性因子影响及中药对卒中后抑郁的疗效。方法:对中文数据库(SinoMed、CNKI、VIP、万方数据库)和PubMed、Cochrane图书馆、Web of science进行检索,纳入用中药治疗卒中后抑郁患者的临床随机对照试验,进行质量评价并且用软件RevMan 5.4进行Meta分析。结果:最后纳入文献6篇,接受试验者共有636例。中药疗法在降低PSD患者的静脉血TNF-α[MD=-4.13,95%CI(-4.75,-3.51),P<0.00001]、IL-6[MD=-3.39,95%CI(-3.90,-2.88),P<0.00001]、IL-8[MD=-2.12,95%CI(-2.49,-1.75),P<0.00001]水平方面优于西药治疗,并且在降低HAMD[MD=-4.22,95%CI(-5.37,-3.07),P<0.00001]、NIHSS[MD=-2.33,95%CI(-3.43,-1.23),P<0.0001]评分方面优于西药治疗;中药与西药合用在降低卒中后抑郁患者的静脉血TNF-α[MD=-10.61,95%CI(-15.30,-5.91),P<0.00001]、IL-1[MD=-3.75,95%CI(-4.51,-2.99),P<0.00001]、IL-6[MD=-3.83,95%CI(-4.49,-3.16),P<0.00001]、IL-8[MD=-9.41,95%CI(-14.89,-3.92),P<0.00001]、Hcy[MD=-3.81,95%CI(-4.62,-2.99),P<0.00001]水平方面优于西药治疗,并且在降低HAMD[MD=-3.06,95%CI(-3.39,-2.73),P<0.00001]、NIHSS[MD=-4.47,95%CI(-7.55,-1.39),P=0.004]、HAMA[MD=-2.83,95%CI(-3.47,-2.19),P<0.00001]评分,提高BI指数[MD=-12.30,95%CI(-22.66,-1.93),P=0.02]方面优于西药治疗。有3项研究没有提到不良反应,其余3项研究中有37例有皮疹、震颤、头晕等不良反应,试验组不良反应发生率低于对照组,且无严重不良反应。结论:中药可以在一定程度上降低卒中后抑郁患者部分炎性因子水平,且在疗效方面优于单纯应用西药,但研究存在着一定的局限性,未来随着相关试验的增加,所得结论需加入更多高质量的RCT研究进行深入探讨。
基金supported by Key Research Project of the University(No.2020-JYB-ZDGG-121)the National Natural Science Foundation of China(No.81874422)the Natural Science Foundation of Beijing,China(No.7202120)。
文摘Objective:To systematically evaluate the effect of traditional Chinese medicine on inflammatory factors in patients with post-stroke depression(PSD)and the efficacy of traditional Chinese medicine on PSD.Methods:Chinese databases(Sinomed,CNKI,VIP,Wanfang),PubMed,Cochrane Library,and Web of Science were searched.Randomized controlled trials of patients with PSD treated with traditional Chinese medicine were included.Quality evaluation was performed and Meta-analysis was performed using RevMan 5.4 software.Results:The results show that TCM therapy is superior to western medicine in reducing the level of TNF-α[MD=-4.13,95%CI(-4.75,-3.51),P<0.00001],IL-6[MD=-3.39,95%CI(-3.90,-2.88),P<0.00001]and IL-8[MD=-2.12,95%CI(-2.49,-1.75),P<0.00001]in venous blood of PSD patients,and is superior to western medicine in reducing the score of HAMD[MD=-4.22,95%CI(-5.37,-3.07),P<0.00001]and NIHSS[MD=-2.33,95%CI(-3.43,-1.23),P<0.0001].The combination of Chinese medicine and western medicine is superior to western medicine in reducing the level of TNF-α[MD=-10.61,95%CI(-15.30,-5.91),P<0.00001]、IL-1[MD=-3.75,95%CI(-4.51,-2.99),P<0.00001]、IL-6[MD=-3.83,95%CI(-4.49,-3.16),P<0.0001]、IL-8[MD=-9.41,95%CI(-14.89,-3.92),P<0.00001]and Hcy[MD=-3.81,95%CI(-4.62,-2.99),P<0.00001]in venous blood of patients with PSD,and is superior to western medicine in reducing the score of HAMD[MD=-3.06,95%CI(-3.39,-2.73),P<0.00001]、NIHSS[MD=-4.47,95%CI(-7.55,-1.39),P=0.004]and HAMA[MD=-2.83,95%CI(-3.47,-2.19),P<0.00001]and improving BI index.Three studies do not mention adverse reactions,and 37 cases in the remaining three studies show rash,tremor,dizziness and other adverse reactions.The incidence of adverse reactions in the experimental group was lower than that in the control group,and there were no serious adverse reactions.Conclusion:The results suggest that traditional Chinese medicine can reduce the level of some inflammatory factors in patients with PSD to a certain extent,and its efficacy is better than that of western medicine alone.Nevertheless,this study has some limitations,and with the increase of related trials in the future,the conclusions of the study need to be further discussed by adding more high-quality RCT studies.
文摘系统评价参松养心胶囊治疗缓慢性心律失常合并早搏的疗效和安全性的Meta分析。计算机检索中国知网数据库(CNKI)、万方数据资源系统、维普中文科技期刊全文数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed和Cochrane图书馆、ClinicalTrials数据库,收集参松养心胶囊治疗缓慢性心律失常合并早搏的随机对照试验。由2名研究者独立根据纳排标准筛选文献、资料提取并核对结果,采用Risk of Bias工具进行方法学质量评估,采用RevMan 5.3进行Meta分析。共纳入9篇随机对照试验,包含受试者706名,干预措施为单独使用参松养心胶囊,对照措施为空白对照。结果显示,参松养心胶囊对平均心率(MD=6.59,95%CI[3.87,9.31],I^2=90%)、早搏有效率(RR=1.72,95%CI[1.53,1.93],I^2=0%)、心动过缓有效率(RR=1.74,95%CI[1.40,2.17],I^2=47%)、临床有效率(RR=1.50,95%CI[1.31,1.70],I^2=31%)均有一定疗效。8项研究报告安全性事件,未发现明显不良反应。该研究发现,单独使用参松养心胶囊对缓慢性心律失常合并早搏在提高心率,控制早搏及改善临床症状方面可能具有一定疗效,未发现明显不良反应,临床可考虑使用。该结论仍需开展高质量的临床试验进一步加以证实。
文摘系统评价复方苁蓉益智胶囊治疗血管性认知障碍的疗效和安全性的Meta分析。计算机检索中国知网数据库(CNKI)、万方数据资源系统、维普中文科技期刊全文数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Cochrane图书馆、ClinicalTrials数据库,收集复方苁蓉益智胶囊治疗血管性认知障碍的随机对照试验。由2名研究者独立根据纳排标准筛选文献、资料提取并核对结果,采用Risk of Bias工具进行方法学质量评估,采用RevMan 5.3进行Meta分析。共纳入12篇文献,包含受试者1 279名,治疗组干预措施为单独使用复方苁蓉益智胶囊或联合西药,对照组为西药或空白对照。结果显示,对轻度血管性认知障碍患者,复方苁蓉益智胶囊在改善MoCA量表评分、提高血清NO水平、降低血清ET-1水平方面优于空白对照;对血管性痴呆患者,复方苁蓉益智胶囊联合西药在改善MMSE,MoCA量表评分方面优于单用西药治疗。5项研究报告不良事件,未发现明显不良反应。该研究发现,单独使用复方苁蓉益智胶囊可改善轻度血管性认知障碍患者的早期认知功能损害,联合使用复方苁蓉益智胶囊和西药改善血管性痴呆患者的认知功能损害效果优于单用西药治疗,未见明显不良反应,临床可考虑使用。该结论仍需开展高质量的临床试验进一步加以证实。