Early screening for post-stroke depression and its effect on functional outcomes, quality of life, and mortality: A meta-analysis

BACKGROUND Post-stroke depression(PSD)is a common and debilitating condition affecting stroke survivors,significantly impacting their recovery and overall quality of life.AIM To assess the effects of early PSD screening on functional outcomes,quality of life,and mortality.METHODS From an initial pool of 1065 articles,6 studies met the inclusion criteria and were selected for analysis.Functional outcomes were measured using the functional independence measure(FIM).RESULTS The analysis revealed a significant improvement in FIM scores for a PSD scree-ning group compared to controls[standardized mean difference(SMD)=8.90,95%confidence interval(CI):4.65-13.15,P<0.01].Quality of life was assessed using the Stroke-Specific Quality of Life Scale,with the screening group showing significantly higher scores(SMD=20.83,95%CI:15.27-26.38,P<0.01).Mortality analysis indicated a reduction in five-year mortality rates for the PSD screening group.CONCLUSION Early PSD screening enhances functional recovery,improves quality of life,and reduces mortality rates in stroke survivors.Thus,integrating PSD screening into routine stroke care improves long-term outcomes for patients.

Logistic Regression Analysis on the Correlation between Physical Diseases and Life Events and Depression in the Elderly

[Objectives]This study was conducted to explore the effects of physical diseases and life events on depression among urban elderly people.[Methods]Five hundred urban elderly people in Shiyan City were selected using a convenient sampling method to investigate and diagnose depression using the Geriatric Mental State Schedule and its accompanying computer diagnostic system.The Minimum Data Set(MDS)and related factor survey form were used to investigate physical diseases and life events,and statistical analysis was conducted using methods such as logistic regression analysis and factor analysis.[Results]The prevalence rates of angina,stroke,or partial paralysis,migraine,vision problems,hyperthyroidism or hypothyroidism,as well as the number of physical diseases were significantly higher in elderly depression patients than in objects free of depression.Stroke or partial paralysis[OR(95%CI)=6.389(1.684,24.237)],emotional trauma events[OR(95%CI)=1.438(1.069,1.934)]and adverse health and economic events[OR(95%CI)=1.652(1.099,2.483)]were risk factors for late life depression(LLD).[Conclusions]Some physical diseases and life events may affect the onset process of depression in urban elderly people,and various measures need to be taken to reduce the risk of physical diseases and life events on depression.

An Interpretable Depression Prediction Model for the Elderly Based on ISSA Optimized LightGBM

Depression is one of the most severe mental health illnesses among senior citizens.Aiming at the low accuracy and poor interpretability of traditional prediction models,a novel interpretable depression predictive model for the elderly based on the improved sparrow search algorithm(ISSA)optimized light gradient boosting machine(LightGBM)and Shapley Additive exPlainations(SHAP)is proposed.First of all,to achieve better optimization ability and convergence speed,various strategies are used to improve SSA,including initialization population by Halton sequence,generating elite population by reverse learning and multi-sample learning strategy with linear control of step size.Then,the ISSA is applied to optimize the hyper-parameters of light gradient boosting machine(LightGBM)to improve the prediction accuracy when facing massive high-dimensional data.Finally,SHAP is used to provide global and local interpretation of the prediction model.The effectiveness of the proposed method is validated by a series of comparative experiments based on a real-world dataset.

Clinical Study of Acupuncture Combined with Emotional Intervention in Patients with Post-Stroke Depression

Objective:To investigate the clinical efficacy of acupuncture combined with emotional intervention in patients with post-stroke depression(PSD).Methods:A total of 100 patients with PSD who met the inclusion criteria were randomly divided into an experimental group(50 cases)and a control group(50 cases)using the random number table method,and the enrollment was in order of admission time.The control group used conventional treatment of oral antidepressant Deanxit tablets(0.5 mg flupenthixol+10 mg melitracen)with the dose appropriately adjusted according to the patient’s medication effect,and modern rehabilitation treatment given selectively according to the patient’s condition.The experimental group had similar treatment as the control group with the addition of traditional Chinese medicine(TCM)acupuncture combined with emotional intervention.The application effects of both groups before and after treatment were verified using the Hamilton Depression Rating Scale(Ham-D),National Institutes of Health Stroke Scale(NIHSS),and Activities of Daily Living(ADL),serotonin levels were measured,and statistical analyses were carried out.Results:The total effective rate of patients in the experimental group was significantly higher than that in the control group,and the Ham-D score,NIHSS score,ADL score,and serotonin level after treatment were significantly higher than those in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:For patients with PSD,adding TCM acupuncture with emotional intervention on top of conventional treatment significantly improve the clinical efficacy and better improve the daily life ability of patients.

CLINICAL STUDY ON THE TREATMENT OF POST-STROKE DEPRESSION WITH ELECTROACUPUNCTURE OF “NIWAN BAZHEN” POINTS

Objective To observe the therapeutic effect of electroacupuncture （EA） of ＂Niwan Bazhen＂ points in the treatment of post-stroke depression. Methods A total of 66 post-stroke depression patients were randomized into treatment group （EA＋oral administration of Prozac-20, n =31 ） and control group （o- ral administration of Prozac-20, 20 mg/d, 28 days altogether, n =30）. For patients of treatment group, EA （2/100 Hz, a tolerable stimulation strength） was applied to ＂Niwan Bazhen＂ points [Baihui （百会 GV20）, etc. ] for 30 min, once daily, （except weekends） continuously for one month. Halmiton Rating Scale （HAMD） for Depression and Chinese Scale for Stroke （CSS） were used to evaluate the therapeutic effect. Results After the treatment, of the 30 and 31 cases in control and treatment groups, 4 and 6 were cured, 10 and 14 experienced marked improvement.in their symptoms, 6 and 7 had an improvement, 6 and 4 failed, with the cure＋ markedly effective rates being 46.7% and 64.5% respectively. The therapeutic effect of treatment group was significantly superior to that of control group （ P〈0.05）. The decreased values of both HAMD and C,,SS of treatment group were remarkably lower than those of control group （P〈0.01,0.05） . Conclusion EA of ＂Niwan Bazhen＂ points is an effective remedy for post-stroke depression.

Depression and chronic heart failure in the elderly： an intriguing relationship

Chronic heart failure and depressive disorders have a high prevalence and incidence in the elderly. Several studies have shown how depression tends to exacerbate coexisting chronic heart failure and its clinical outcomes and vice versa, especially in the elderly. The negative synergism between chronic heart failure and depression in the elderly may be approached only taking into account the multifaceted pathophysiological characteristics underlying both these conditions, such as behavioural factors, neurohormonal activation, inflammatory mediators, hypercoagulability and vascular damage. Nevertheless, the pathophysiological link between these two conditions is not well established yet. Despite the high prevalence of depression in chronic heart failure elderly patients and its negative prognostic value, it is often unrecognized especially because of shared symptoms. So the screening of mood disorders, using reliable questionnaires, is recommended in elderly patients with chronic heart failure, even if cannot substitute a diagnostic interview by mental health professionals. In this setting, treatment of depression requires a multidisciplinary approach including： psychotherapy, antidepressants, exercise training and electroconvulsive therapy. Pharmacological therapy with selective serotonin reuptake inhibitors, despite conflicting results, improves quality of life but does not guarantee better outcomes. Exercise training is effective in improving quality of life and prognosis but at the same time cardiac rehabilitation services are vastly underutilized.

The effects of Xingnao Jieyu capsules on post-stroke depression are similar to those of fluoxetine

The Xingnao Jieyu capsule has been shown to effectively relieve neurologic impairments and les- sen depression. It remains poorly understood whether this capsule can be used to treat post-stroke depression. Thus, in the present study, we established a rat model of post-stroke depression using left middle cerebral artery occlusions in combination of chronic unpredictable stress and solitary housing during development. Experimental rats received intragastric perfusion with 0.82, 0.41, and 0.20 g/kg Xingnao Jieyu capsules separately dissolved in 2 mL distilled water. Fluoxetine served as a positive control. The treatment was conducted over 28 days. Sugar water consumption test, open-field test, real-time fluorescent quantitative PCR and immunohistochemical staining results demonstrated that intragastric perfusion with various doses of Xingnao Jieyu capsules increased sugar water consumption, voluntary behaviors and synaptotagmin mRNA and protein expression in rats with post-stroke depression. These therapeutic effects were similar to those of fluoxetine. These results indicate that Xingnao Jieyu capsules upregulate synaptotagmin expression in hip pocampi of rats with post-stroke depression, and exert antidepressant effects.

Apolipoprotein E polymorphisms increase the risk of post-stroke depression

Recent reports have shown that apolipoprotein E （APOE） polymorphisms are involved in neurodegenerative disease. However, it is unclear whether APOE affects post-stroke depression. Accordingly, we hypothesized that APOE polymorphisms modify the risk of post-stroke depression. Here, we performed a hospital-based case-control study （including 76 cerebral infarction cases with post-stroke depression, 88 cerebral infarction cases without post-stroke depression, and 109 controls without any evidence of post-stroke depression or cerebral infarction） to determine possible association between APOE rs429358 and rs7412 polymorphisms and risk of post-stroke depression. Our findings show no difference among the groups with regards genotype distribution of the rs7412 polymorphism. In contrast, APOE genotypes with rs429358-C alleles increased the risk of post-stroke depression. Further, the rs429358 polymorphism was associated with significantly decreased regional cerebral blood flow values in the left temporal lobe of post-stroke depression cases. Additionally, the rs429358 polymorphism was not only associated with depression severity, but with increasing serum levels of total cholesterol. These resuits suggest that the APOE rs429358 polymorphism is associated with increased risk of developing post-stroke depression, and that APOE rs429358-C allele genotypes may be detrimental to recovery of nerve function after stoke. Indeed, these findings provide clinical data for future post-stroke depression gene interventions.

miR-137, a new target for post-stroke depression?

Expression of miR-137 is downregulated in brain tissue from patients with depression and suicidal behavior, and is also downregulated in peripheral blood from stroke patients. However, it is not yet known if miR-137 acts as a bridge between stroke and depression. To test this, we used middle cerebral artery occlusion and chronic mild stress to establish a post-stroke depression model in rats. Compared with controls, we found significantly lower miR-137 levels in the brain and peripheral blood from post-stroke depression rats. Injection of a miR-137 antagonist into the brain ventricles upregulated miR-137 levels, and improved behavioral changes in post-stroke depression rats. Luciferase assays showed miR-137 bound to the 3＇UTR of Grin2A, regulating Grin2A expression in a neuronal cell line. Grin2A gene overexpression in the brain of post-stroke depression rats, no- ticeably suppressed the inhibitory effect of miR-137 on post-stroke depression. Overall, our results show that miR-137 suppresses Grin2A protein expression through binding to Grin2A mRNA, thereby exerting an inhibitory effect on post-stroke depression. Our results offer a new therapeutic direction for post-stroke depression.

Electroacupuncture at the Wangu (GB 12) acupoint suppresses expression of inflammatory factors in the hippocampus and frontal lobe of rats with post-stroke depression

Electroacupuncture was performed at the Wangu （GB 12） acupoint, whose position is similar to the cerebellar fastigial nucleus in rats with post-stroke depression. Results showed that the expression of nuclear factor-κB and the levels of tumor necrosis factor-α and interleukin-1β decreased. Simultaneously, the extent of edema in the hippocampus and frontal lobe decreased, and the morphology of the nerve cells recovered to near normal. In addition, fluoxetine treatment displayed a similar effect on post-stroke depression as electroacupuncture at GB 12 acupoint. The results indicate that electroacupuncture at GB 12 acupoint can reduce the levels of cytokines in the hippocampus and frontal lobe of rats with post-stroke depression, and thus provide a neuroprotective effect on post-stroke depression.

Metabolic changes of prefrontal cerebral lobe,white matter and cerebellum in patients with post-stroke depression A proton magnetic resonance spectroscopy study

BACKGROUND： Proton magnetic resonance spectroscopy （IH-MRS） non-invasively detects changes in chemical substances in the brain, which reflects the pathological metabolism.OBJECTIVE： To investigate changes in N-acetyl-aspartate （NAA）, choline （Cho）, creatine （Cr）, and myoinositol （MI） in the gray and white matter of cerebral prefrontal lobe and cerebellum of patients with differential degrees of post-stroke depression （PSD） using ^1H-MRS. DESIGN： A case control study. SETTING： The First Affiliated Hospital of the Dalian Medical University. PARTICIPANTS： A total of 38 patients with stroke （28 male and l0 female patients, aged 40 to 79 years） were selected from the Department of Neurology, 1st Affiliated Hospital, Dalian Medical University, from February to October in 2004. All subjects met the DSM-IV criteria for cerebrovascular disease and depression. The degree of depression was defined according to Hamilton criteria. 38 patients with PSD were divided into two groups according to the time after ischemia, 20 patients in the acute group with less than 10 days after ischemic attack （mild： 16 patients, moderate/severe： 4 patients） and 18 patients in the chronic group with more than l l days after ischemic attack （mild： 15 patients, moderate/severe： 3 patients）. Seventeen healthy volunteers with matching age from 41 to 80 years were examined as a control group. The study was approved by the Medical Ethics Committee of the University Medical Center Utrecht, and each participant signed an informed consent form. METHODS： Spectra were acquired by multi-voxel point-resolved spectroscopy （PRESS） sequence with GE signal.5T MR/i, localized in prefrontal cerebral lobe and cerebellum. Values of NAA, Cho, MI, and Cr ere compared between different graded PSD patients and control subjects with one-way analysis of variance in software SPSS 11.5. MAIN OUTCOME MEASURES： Metabolite concentration in different brain regions of interest. Difference in metabolites between distinctly graded PSD patients and control subjects. Exclusion of age-effects on metabolites. RESULTS： Metabolite concentrations of different brain regions： A significant rise in the Cho/Cr ratio was detected in the acute and chronic group compared to the control group. The ratio change was more significant in the acute group （P 〈 0.05）. There was no significant difference between these three groups for other metabolites detected by IH-MRS in the right frontal white matter, bilateral frontal grey matter, and cerebellum （P 〉 0.05）. Comparison of metabolite levels among differently graded PSD patients and control subjects： a significant increase in the Cho/Cr ratio was detected in the left frontal white matter compared to the control group （P 〈 0.05）. There was no significant difference in age between patients in the stroke groups and the control group （P 〉 0.05）, and similarly, there was no significant correlation between age and absolute or relative values in the control group （P 〉 0.05）. CONCLUSION： Abnormalities of frontal lobe in PSD were located in the white matter. There was early abnormality of metabolic substance in PSD.

The power of informal institutions:The impact of clan culture on the depression of the elderly in rural China

Exploration of ways to improve the subjective welfare of residents is an important area of current academic research.Using data from the China Family Panel Studies survey conducted in 2010,this paper investigated the impact of clan culture on the mental health of elderly people in rural China.The results demonstrated that clan culture can significantly decrease the depression score of the rural elderly.Further,there was no gender difference with respect to the impact of clan culture on the depression score of the elderly.At the same time,the positive effects of clan culture on the depression score of the elderly have gradually weakened with economic development.Exploration of the mechanisms involved indicated that in areas with stronger clan culture,older people receive more social support.This study enriches our understanding of the impact of informal institutions on the welfare of rural residents.At the same time,it can also provide a certain decisionmaking reference for the government to formulate relative poverty relief strategies in a new stage of poverty alleviation.

Clinical Observation of Huatanjieyu Granule in the Treatment of Post-stroke Depression

[Objectives]To observe the clinical effect of Huatanjieyu granule on patients with post-stroke depression.[Methods]Total 76 patients with confirmed post-stroke depression were randomly divided into two groups(treatment group and control group)according to the double-blind principle.The treatment group(38 cases)was treated with Huatanjieyu granule combined with escitalopram,and the control group(38 cases)was treated with escitalopram alone.The course of treatment was 6 weeks.Through clinical efficacy,Hamilton Depression Scale(HAMD)and Treatment Emergent Symptom Scale(TESS)scores were compared,and blood,liver function,renal function and electrocardiogram were examined.[Results]The scores of HAMD and TESS in patients with post-stroke depression were significantly decreased by Huatanjieyu granule,and there were no obvious side effects.The total effective rate was 92.1%in the treatment group and 76.3%in the control group.There was significant difference between the two groups(P<0.01).[Conclusions]Huatanjieyu granule was effective in the treatment of post-stroke depression with little side effects and was easy to be accepted by patients.

CLINICAL STUDY ON ACUPUNCTURE IN THE TREATMENT OF POST-STROKE DEPRESSION WITH THE METHOD OF ACTIVATING THE DU MERIDIAN AND CLEARING THE MIND

Objective: To observe the therapeutic effect of acupuncture in the treatment of post-stroke depression (PSD) with the method of activating the Du Meridian and clearing the mind. Methods: Two hundred and thirty one cases of PSD were randomly divided into two groups, acupuncture and control groups. In acupuncture group, Baihui (百会 GV 20), Dazhui (大椎 GV 14), Neiguan (内关 PC 6), Taichong (太冲 LR 3) and Shenmen (神门 HT 7) were selected as the main points to invigorate flow of qi in the Du Meridian and clear the mind. Patients in the control group received Fluoxetine orally, 20 mg once per-day. In addition, the same routine treatments were given to both groups, strengthened with rehabilitation exercises as early as possible; 8 weeks constituted one therapeutic course. HAMD and severity of neuro-functional defect of each case were evaluated before and 8-week after the treatment. Results: The total effective rate of acupuncture group was 92.37%, the control group, 72.88%. According to χ2 test, the difference between the two groups was remarkably significant (P<0.05). Conclusion: Acupuncture therapy of activating the Du Meridian and clearing the mind in the treatment of PSD was safe and effective.

Effects of group reminiscence on elderly depression: A meta-analysis

Background/purpose:The present meta-analysis was performed to evaluate the effectiveness of group reminiscence on depression in elderly patients.Methods:Published and unpublished randomised controlled trials that assessed the effects of group reminiscence on depression in elderly patients were systematically reviewed using multiple electronic databases.Relative risks for dichotomous data and weighted mean differences for continuous data were calculated with 95%confidence intervals.Results:Ten trials were evaluated.Group reminiscence provided significantly greater relief of depressive symptoms than did the control intervention immediately after and 3 months after the intervention(p<0.00001).However,this advantage disappeared 6 months after the intervention(p?0.14).Group reminiscence significantly improved self-esteem and life satisfaction(p<0.01).Conclusion:Group reminiscence was associated with short-term depression relief among elderly patients with depression and effectively improved self-esteem and life satisfaction.Higher-quality large-scale randomised controlled trials are needed to confirm these findings.

Role of Transcranial Direct Current Stimulation in the Management of Post-Stroke Depression

Study Objectives: Stroke is a major neurological disease significantly threatening the human health and life with a high morbidity, disability, and mortality. Post-stroke depression (PSD) is one of the common complications of stroke. PSD has been a major factor hindering the recovery of neurological functions and daily activities in stroke patients and is closely related to the social avoidance and increased mortality of stroke patients. Although antidepressant drug treatment has improved during the last decades, symptoms in about 20% of the patients are not in remission two years after initiation of pharmacological intervention. Nowadays, non-invasive brain stimulation;techniques;transcranial direct current stimulation (tCDS) has gained an important interest in the treatment of many neuropsychiatric disorders which might be of some help in treatment of PSD. The goal of the current study is to evaluate the beneficial short term role of tDCS on post-stroke depression. Study Design: This was a randomized double blind placebo-controlled clinical trial included forty hemiparetic patients with post-stroke depression from outpatient clinic of Faculty of Physical Therapy, Cairo University, in the period between June 2018 to June 2019. All patients diagnosed as having a PSD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Depression was evaluated by Hamilton Depression Rating Scale (HAM-D) pre and post treatment and quality of life was evaluated by the Stroke Specific Quality Of Life scale (SS-QOL). Patients were assigned randomly into two groups: the study group A and the control group B. Both groups received antidepressant medication in addition to physical therapy program. Group A received tCDS for 30 minutes, three times per week for one month, while the group B received sham transcranial direct current stimulation. Results: Active tDCS was significantly superior to sham with significant improvement in depression and Stroke Specific Quality Of Life in treated group in comparison to group B, p = 0.000. Conclusion: tDCS was effective for post- stroke depression and might be a favorable option for treating post-stroke patients.

Depression among elderly living in Briddashram (old age home)

Introduction: Depression is a common public health issue with the increasing life expectancy worldwide and depression is associated with morbidity as well as disability among the elderly. There are very few studies related with depression among elderly from developing countries. Objective: The purpose of this study was to assess the prevalence of depression and its correlates among the elderly living in Briddashram (old age home). Methods: This is a cross-sectional study carried out in 2012. Data were collected by face-to-face interview using short version of Geriatric Depression Scale. The data were analyzed using percentage, mean, simple correlation and regression. Results: The subjects (N = 185) were elderly aged 60 years and above living in Devghat area, Nepal. Mean age of the subjects was 73.67 (±3.23) years old and 51% were male. 94% elderly belong to Khas ethnicity. Nearly one third (31%) elderly were from nuclear family back ground, 25% were married, and only 18% elderly were literate. Majority of the elderly (93%) had health problems and self reported health shows 86% elderly reported their health fair. This study shows mean functional disability score was 2.53 (±2.05). Finding shows the prevalence of depression was 57.8%. Among them 46.7% had mild, 8.9% had moderate and 2.2% had severe depression. A statistically significant correlation was found between feelings of depression and age, sex, previous family type, ethnicity, feeling of loneliness and instrumental activities of daily living. Regression analysis shows that being women, feeling of loneliness and higher the dependency in IADL were predictors of depression. Conclusion: This study indicates that many elderly living in the Briddashram are suffering from depression. There should be some interruption from the concerned authorities so that depression can be reduced which will support to the well-being and quality of life of elderly.

Research Progress in the Pathogenesis of Post-stroke Depression

Post-stroke depression is an affective disorder that occurs after stroke.Its pathogenesis has not yet been fully understood,and it mainly involves neurobiology,neuroanatomy,and psychology.This paper provides an overview on the neurobiological mechanism of post-stroke depression to further understand post-stroke depression and to provide references for further research.

Post-stroke seizures in consecutive elderly stroke patients

This prospective study sought to investigate the clinical, radiological and electroencephalographic （EEG） characteristics of seizures in elderly stroke patients, and their outcomes. Over a 2-year study period, 158 consecutive elderly patients with stroke were examined and followed up. Of these patients, 32 （20%） developed seizures, primarily related to stroke, within a follow up period between 5 months and 2 years. Of these 32 cases, 20 experienced infarctions, and 12 experienced hemorrhages. Involvement of cortical regions was detected in most of the patients exhibiting seizures. In these patients, 44% of the lesions involved cortical areas exclusively or in addition to subcortical areas observed on computed tomography （CT） images. Twenty-five patients （78%） developed early seizures （within 2 weeks after stroke）, and half exhibited immediate post-stroke seizures. None of the patients exhibiting early onset seizures developed recurrent seizures or epilepsy, while 57% of late onset seizures （four cases） developed epilepsy. No specific EEG pattems were apparent in those who later developed epilepsy. Overall, early onset seizures after stroke were found to be relatively common, and did not affect outcome. Late onset seizures were less common, but were associated with chronic epilepsy.

Systematic review and meta-analysis on efficacy of traditional Chinese medicine in treatment of inflammatory factors in patients with post-stroke depression

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.