Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, P.R. China.
The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.
J Altern Complement Med. 2020 Jan;26(1):8-24. doi: 10.1089/acm.2019.0105. Epub 2019 Jul 19.
(BC; Radix Bupleuri) formulae are widely used in herbal medicine clinical practice for major depressive disorder (MDD). This study provides an up-to-date and comprehensive systematic review and meta-analysis of BC formula for MDD. Randomized controlled trials were retrieved from English and Chinese databases, from their inceptions to March 2019. Included studies compared BC formula alone or as integrative medicine to selective serotonin reuptake inhibitor (SSRI) antidepressants. Studies included adults 18-65 years of age. People with other types of depression or physical comorbidities, such as poststroke depression, bipolar, and other mental or physical disorders, were excluded. Meta-analysis was performed using STATA software. Grading of Recommendations Assessment, Development, and Evaluation was also conducted to assess the quality of evidence. Thirty studies compared BC formula to antidepressants and 25 studies compared BC formula plus antidepressants to antidepressants alone. BC formula was more effective than antidepressants at improving depression severity measured on the Hamilton Rating Scale for Depression (HRSD) (standardized mean difference [SMD] -0.35, 95% confidence interval [CI] -0.52 to -0.18, = 81.2%). Integrative use of BC formula plus SSRIs was also superior to SSRIs alone at improving HRSD scores (SMD -1.03, 95% CI -1.43 to -0.62, = 94.2%). However, heterogeneity of the included studies was high and quality was low. The total number and severity of adverse events in the BC formula groups were less than that in the antidepressant groups. BC formula alone or given as integrative medicine with antidepressants reduced depression severity. However, the evidence is low quality and at risk of bias. Well-designed studies are needed to validate the results we identified in this review.
（柴胡）方剂广泛应用于草药医学临床实践中，用于治疗重度抑郁症（MDD）。本研究对柴胡方剂治疗 MDD 进行了最新和全面的系统评价和荟萃分析。从英语和中文数据库中检索到随机对照试验，从其成立到 2019 年 3 月。纳入的研究比较了柴胡方剂单独使用或作为综合医学与选择性 5-羟色胺再摄取抑制剂（SSRI）抗抑郁药的效果。研究纳入年龄在 18-65 岁之间的成年人。排除其他类型的抑郁症或身体合并症患者，如中风后抑郁症、双相情感障碍和其他精神或身体障碍。使用 STATA 软件进行荟萃分析。还进行了推荐评估、制定和评估分级以评估证据质量。30 项研究比较了柴胡方剂与抗抑郁药，25 项研究比较了柴胡方剂加抗抑郁药与单独使用抗抑郁药。柴胡方剂在改善汉密尔顿抑郁量表（HRSD）上的抑郁严重程度方面比抗抑郁药更有效（标准化均数差 [SMD] -0.35，95%置信区间 [CI] -0.52 至 -0.18， = 81.2%）。柴胡方剂加 SSRI 的综合使用在改善 HRSD 评分方面也优于 SSRI 单独使用（SMD -1.03，95% CI -1.43 至 -0.62， = 94.2%）。然而，纳入研究的异质性较高，质量较低。柴胡方剂组的总不良事件数量和严重程度低于抗抑郁药组。柴胡方剂单独使用或作为综合医学与抗抑郁药联合使用可降低抑郁严重程度。然而，证据质量低，存在偏倚风险。需要设计良好的研究来验证我们在本综述中确定的结果。
