中国中药杂志

2019, v.44(23) 5217-5224

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中成药辅助治疗肝郁脾虚型抑郁症的网状Meta分析
Network Meta-analysis of Chinese patent medicines in treatment of liver stagnation and spleen deficiency of depression

于莹;张功;韩涛;李洁;黄海量;
YU Ying;ZHANG Gong;HAN Tao;LI Jie;HUANG Hai-liang;College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine;

摘要(Abstract):

该研究系统评价舒肝解郁胶囊、解郁丸、逍遥丸3种中成药辅助治疗肝郁脾虚型抑郁症的临床疗效与安全性,全面检索CNKI,VIP,Wan Fang Data,CBM中文数据库及the Cochrane Library,PubMed,EMbase,Web of Science外文数据库,搜索公开发表此3种中成药辅助治疗的临床随机对照试验,检索时间均为自建库至2018年10月30日,筛选出符合纳入标准的研究,按照Cochrane 5. 1手册标准对纳入的研究进行文献质量评价与偏倚风险评估,采用ADDIS软件进行数据合并及网状Meta分析。纳入37项RCT共计3 105例患者,网状Meta分析结果显示:临床有效率方面,3种中成药辅助治疗均能提高临床疗效,以解郁丸辅助治疗效果最显著(OR=4. 59,95%CI[1. 94,12. 71],P<0. 05); HAMD评分方面,舒肝解郁胶囊(MD=3. 22,95%CI[2. 07,4. 39],P<0. 05)与逍遥丸(MD=2. 23,95%CI[0. 41,4. 03],P<0. 05)辅助治疗均能有效降低抑郁量表指标;不良反应发生率方面,3种中成药辅助治疗肝郁脾虚型抑郁症均可有效降低不良反应发生率。因此治疗肝郁脾虚型抑郁症时3种中成药的作用机制互有优势,临床疗效与安全性方面,中成药具有较好的临床辅助治疗表现,尽管该研究得出解郁丸辅助治疗为临床首选推荐用药,但明确的结论仍需要更多高质量随机对照文献予以验证,临床中可根据病人的具体特征进行准确选择应用。
To evaluate the clinical efficacy and safety of Shugan Jieyu Capsules,Jieyu Pills and Xiaoyao Pills in the treatment of liver-stagnation and spleen-deficiency depression by the network Meta-analysis( NMA),so as to provide evidence-based clinical practice. Chinese databases,including CNKI,VIP,Wan Fang Data,CBM as well as English databases including the Cochrane Library,PubMed,EMbase and Web of Science were retrieved from inception to October 30,2018,to collect randomized controlled trials( RCTs) about clinical study of the three kinds of Chinese patent medicines. The quality and bias risk of the included studies were assessed by 5. 1 standard in Cochrane Handbook,ADDIS software was applied in the statistical analysis,and the result were compared by NMA. A total of 37 studies involving 3 105 patients were included. The results of NMA showed that the adjuvant therapy with the three kinds of traditional Chinese patent medicines could improve the clinical efficacy. Jieyu Pills had the most significant effect( OR = 4. 59,95%CI[1. 94,12. 71],P<0. 05). In HAMD,Shugan Jieyu Capsules( MD = 3. 22,95%CI[2. 07,4. 39],P< 0. 05) and Xiaoyao Pills( MD= 2. 23,95%CI[0. 41,4. 03],P<0. 05) can effectively reduce the depression scale indicators. In the incidence of adverse reactions,the three kinds of Chinese patent medicines can reduce the incidence of adverse reactions. The three kinds of Chinese patent medicines can be combined with auxiliary Western medicine to treat liver-stagnation and spleen-deficiency depression,with complementary advantages in action mechanisms. In the clinical efficacy and safety,the Chinese patent medicines had good clinical manifestations. Although this study showed that Jieyu Pills may be the referred medicine for depression,this conclusion is still immature and needs to be further verified by high-quality RCTs studies,and the application shall be selective based on specific characteristics in clinic.

关键词(KeyWords): 中成药;辅助治疗;抑郁症;肝郁脾虚型;网状Meta分析
Chinese patent medicine;adjuvant therapy;depression;liver-stagnation and spleen-deficiency;network Meta-analysis

Abstract:

Keywords:

基金项目(Foundation): 2016年度山东省重点研发计划项目(2016CYJS08A01-6);; 经方治疗重大疾病作用机理与疗效评价科研创新团队项目(220316);; 山东省2017—2018年度中医药科技发展计划项目(2017-018);; 山东省2015—2016年度中医药科技发展计划项目(2015-030);; 山东省名老中医药专家刘昭纯传承工作室建设项目(鲁卫中发展字[2018]1);; 2018年度山东省高等学校科研发展计划项目(J18KB130)

作者(Author): 于莹;张功;韩涛;李洁;黄海量;
YU Ying;ZHANG Gong;HAN Tao;LI Jie;HUANG Hai-liang;College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine;

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