Huang Wanlin, Liao Xiaoqin, Tian Jinhui, Wu Jing, Shan Yawei, Zhou Weini
Shanghai University of Traditional Chinese Medicine, Shanghai.
Lanzhou University, Centre of Evidence Based Medicine, Lanzhou City, Gansu, China.
Medicine (Baltimore). 2018 Dec;97(52):e13840. doi: 10.1097/MD.0000000000013840.
Post-stroke depression (PSD) is common in stroke survivors, with significantly negative effects and serious impairments in terms of personal and social functioning. While both pharmacological and traditional Chinese medicine (TCM) interventions have been administered for PSD, there is still uncertainty about the balance between these and what treatment strategy should be preferred in clinical practice. Therefore, we aim to compare and rank, describing the protocol of a systematic review and network meta-analysis (NMA), the commonly used TCM interventions for PSD.
We will search CENTRAL (the Cochrane Central Register of Controlled Trials), CINAHL, Embase, PubMed, CBM and PsycINFO, the US National Institutes of Health and the World Health Organisation International Trials Registry Platform search portal from inception to November 2018. There will be no restrictions on language, publication year or publication type. Only randomized clinical trials (RCTs) accessing any TCM treatments against active comparator or other controls for PSD will be included. The primary outcomes will be efficacy (the total number of participants, declining more than 50% on the total score between baseline) and acceptability of treatment (dropout rate due to any cause). A Bayesian NMA will be performed to compare all relative outcome of different TCM interventions. we will conduct the network meta-regression meta-analyses of data on the sex ratio, the types of stroke and the treatment duration of TCM interventions. Potential explanations in extra subgroup analyses according to the results of heterogeneity and inconsistency will be explored, and sensitivity analyses will be conducted to assess the robustness of the findings.
PROSPERO CRD42018082400.
Our study will generate evidence for TCM in the treatment of PSD and help to reduce the uncertainty about the effectiveness of PSD management, which will encourage further suggestions for TCM clinical practice or guideline.
中风后抑郁（PSD）在中风幸存者中很常见，对个人和社会功能有显著负面影响和严重损害。虽然药物和中医（TCM）干预都已用于PSD，但在这些干预措施之间的平衡以及临床实践中应优先选择何种治疗策略仍存在不确定性。因此，我们旨在比较并排序，描述系统评价和网络荟萃分析（NMA）的方案，即PSD常用的中医干预措施。
我们将检索CENTRAL（Cochrane对照试验中央注册库）、CINAHL、Embase、PubMed、CBM和PsycINFO、美国国立卫生研究院和世界卫生组织国际临床试验注册平台搜索门户，检索时间从数据库建立至2018年11月。对语言、出版年份或出版类型不设限制。仅纳入针对PSD使用任何中医治疗方法与活性对照或其他对照进行比较的随机临床试验（RCT）。主要结局将是疗效（参与者总数，基线总分下降超过50%）和治疗可接受性（因任何原因导致的脱落率）。将进行贝叶斯NMA以比较不同中医干预措施的所有相对结局。我们将对中医干预措施的性别比例、中风类型和治疗持续时间的数据进行网络荟萃回归分析。将根据异质性和不一致性结果进行额外亚组分析，探索潜在解释，并进行敏感性分析以评估研究结果的稳健性。
PROSPERO CRD42018082400。
我们的研究将为中医治疗PSD提供证据，并有助于减少PSD管理有效性方面的不确定性，这将为中医临床实践或指南提供进一步建议。
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