Institute of Integrated Traditional Medicine and Western Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.
J Ethnopharmacol. 2012 Jun 1;141(2):571-7. doi: 10.1016/j.jep.2011.08.079. Epub 2011 Sep 12.
Depression is a psychiatric disorder. Chaihu-Shugan-San (CSS) is a traditional Chinese medicine formula suggested in the treatment of depression, but its effectiveness and safety are not well defined. This meta-analysis aimed to assess the effectiveness and safety of CSS in depression therapy.
The databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CNKI database, Wanfang Data and VIP Information were searched. Papers were reviewed systematically by two researchers and were analyzed using Cochrane software Revman 5.0.
Ten randomized controlled trials comparing 835 subjects were included. Of these studies, seven studies used fluoxetine (20 mg, once a day), two used paroxetine (20 mg, once a day) and one used doxepin (25 mg, two times a day) as the antidepressant drugs. Meta-analyses revealed that CSS in combination with antidepressant drugs treatment significantly improved depressive symptoms (WMD=-3.56; 95% CI -5.09 to -2.03) and significantly increased effective rate (OR=3.31; 95% CI 1.80-6.10) and recovery rate (OR=2.32; 95% CI 1.61-3.34) compared with antidepressant drugs therapy. In addition, the efficacy of CSS as monotherapy was significantly better than antidepressants in improving depressive symptoms (WMD=-3.09; 95% CI -5.13 to -1.06) and in creasing effective rate (OR=2.61; 95% CI 1.23-5.53). CSS was comparable to antidepressants in increasing recovery rate (OR=1.83; 95% CI 0.84-3.98). No serious adverse events were reported in any of the included trials.
The present work supported that CSS was effective and safe in treating depressed patients. More full-scale randomized clinical trials with reliable designs are recommended to further evaluate the clinical benefit and long-term effectiveness of CSS for the treatment of depression.
抑郁症是一种精神疾病。柴胡疏肝散（CSS）是一种被建议用于治疗抑郁症的中药方剂，但它的疗效和安全性尚未得到明确界定。本荟萃分析旨在评估 CSS 在抑郁症治疗中的疗效和安全性。
检索了 MEDLINE、EMBASE、Cochrane 中央对照试验注册库、中国知网（CNKI）数据库、万方数据和 VIP 信息等数据库。由两名研究人员系统地对文献进行了审查，并使用 Cochrane 软件 Revman 5.0 进行了分析。
共纳入 10 项比较 835 例受试者的随机对照试验。其中 7 项研究使用氟西汀（20mg，每天 1 次），2 项研究使用帕罗西汀（20mg，每天 1 次），1 项研究使用多塞平（25mg，每天 2 次）作为抗抑郁药物。荟萃分析显示，CSS 联合抗抑郁药物治疗可显著改善抑郁症状（WMD=-3.56；95%CI-5.09 至-2.03），显著提高有效率（OR=3.31；95%CI1.80-6.10）和恢复率（OR=2.32；95%CI1.61-3.34），与抗抑郁药物治疗相比。此外，CSS 作为单一疗法的疗效明显优于抗抑郁药，可显著改善抑郁症状（WMD=-3.09；95%CI-5.13 至-1.06）和提高有效率（OR=2.61；95%CI1.23-5.53）。CSS 增加恢复率的效果与抗抑郁药相当（OR=1.83；95%CI0.84-3.98）。在纳入的所有试验中均未报告严重不良事件。
本研究支持 CSS 治疗抑郁患者有效且安全。建议开展更多设计可靠的大规模随机临床试验，以进一步评估 CSS 治疗抑郁症的临床获益和长期疗效。
