Zeng Ling-Feng, Cao Ye, Wang Lu, Dai Yun-Kai, Hu Ling, Wang Qi, Zhu Li-Ting, Bao Wen-Hu, Zou Yuan-Ping, Chen Yun-Bo, Xu Wei-Hua, Liang Wei-Xiong, Wang Ning-Sheng
Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, 510405, PR China.
Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, PR China.
Phytother Res. 2017 Jan;31(1):40-52. doi: 10.1002/ptr.5740. Epub 2016 Oct 20.
Current evidence demonstrated certain beneficial effects of medicinal herbs as an adjuvant therapy for post-stroke depression (PSD) in China; Chai-hu (Chinese Thorowax Root, Radix Bupleuri) is an example of a medicinal plant for Liver-Qi regulation (MPLR) in the treatment of PSD. Despite several narrative reports on the antidepressant properties of MPLR, it appears that there are no systematic reviews to summarize its outcome effects. Therefore, the aim of this review was to assess the effectiveness and safety of MPLR adjuvant therapy in patients with PSD. Seven databases were extensively searched from January 2000 until July 2016. Randomized control trials (RCTs) involving patients with PSD that compared treatment with and without MPLR were taken into account. The pooled effect estimates were calculated based on Cochrane Collaboration's software RevMan 5.3. Finally, 42 eligible studies with 3612 participants were included. Overall, MPLR adjuvant therapy showed a significantly higher effective rate (RR = 1.23; 95% CI = 1.19, 1.27; p < 0.00001) compared to those without. Moreover, the administration of MPLR was superior to abstainers regarding Hamilton Depression Scale (HAMD) score changes after 3 weeks (WMD = -4.83; 95% CI = -6.82, -2.83; p < 0.00001), 4 weeks (WMD = -3.25; 95% CI = -4.10, -2.40; p < 0.00001), 6 weeks (WMD = -4.04; 95% CI = -5.24, -2.84; p < 0.00001), 8 weeks (WMD = -4.72; 95% CI = -5.57, -3.87; p < 0.00001), and 12 weeks (WMD = -3.07; 95% CI = -4.05, -2.09; p < 0.00001). In addition, there were additive benefits in terms of response changes for the National Institutes of Health Stroke Scale (NIHSS) and other self-rating scores. No frequently occurring or serious adverse events were reported. We concluded that there is supporting evidence that adjuvant therapy with MPLR is effective in reducing the depressive symptoms and enhancing quality of life for patients with PSD. More well-designed RCTs are necessary to explore the role of MPLR in the treatment of PSD. Copyright © 2016 John Wiley & Sons, Ltd.
目前的证据表明，在中国，草药作为中风后抑郁症（PSD）的辅助治疗具有一定的有益效果；柴胡是一种用于调节肝气的药用植物，可用于治疗PSD。尽管有几篇关于调节肝气的抗抑郁特性的叙述性报告，但似乎没有系统评价来总结其疗效。因此，本综述的目的是评估调节肝气辅助治疗PSD患者的有效性和安全性。从2000年1月至2016年7月广泛检索了7个数据库。纳入了涉及PSD患者的随机对照试验（RCT），这些试验比较了使用和不使用调节肝气治疗的情况。基于Cochrane协作网的RevMan 5.3软件计算合并效应估计值。最后，纳入了42项符合条件的研究，共3612名参与者。总体而言，与未使用调节肝气治疗的患者相比，调节肝气辅助治疗的有效率显著更高（RR = 1.23；95%CI = 1.19，1.27；p < 0.00001）。此外，在3周（WMD = -4.83；95%CI = -6.82，-2.83；p < 0.00001）、4周（WMD = -3.25；95%CI = -4.10，-2.40；p < 0.00001）、6周（WMD = -4.04；95%CI = -5.24，-2.84；p < 0.00001）、8周（WMD = -4.72；95%CI = -5.57，-3.87；p < 0.00001）和12周（WMD = -3.07；95%CI = -4.05，-2.09；p < 0.00001）后，调节肝气治疗在汉密尔顿抑郁量表（HAMD）评分变化方面优于未使用者。此外，在国立卫生研究院卒中量表（NIHSS）和其他自评评分的反应变化方面有附加益处。未报告频繁发生或严重的不良事件。我们得出结论，有支持性证据表明，调节肝气辅助治疗可有效减轻PSD患者的抑郁症状并提高生活质量。需要更多设计良好的RCT来探索调节肝气在PSD治疗中的作用。版权所有© 2016约翰威立父子有限公司。
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