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治疗抑郁症的经典中药方剂丹栀逍遥散:一项系统评价与Meta分析

Canonical Chinese medicine formula Danzhi-Xiaoyao-San for treating depression: A systematic review and meta-analysis.

作者信息

Wang Xiao-Le, Feng Si-Tong, Wang Ya-Ting, Zhang Ning-Ning, Wang Zhen-Zhen, Zhang Yi

机构信息

Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, China.

State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China.

出版信息

J Ethnopharmacol. 2022 Apr 6;287:114960. doi: 10.1016/j.jep.2021.114960. Epub 2021 Dec 28.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

Danzhi-Xiaoyao-San (DXS), as a canonical Chinese medicine formula, possessing the functions of the soothing liver, invigorating spleen, clearing heat, and cooling blood, has been widely used for the treatment of depression.

AIM OF THE STUDY

This systematic review and meta-analysis of randomized controlled trials aimed to examine the efficacy of DXS in depression.

MATERIALS AND METHODS

We performed a literature search in several databases, e.g., PUBMED, until August 2021 and conducted the meta-analysis using Review Manager 5.3 software. The random-effects model and fixed-effects model were used to synthetize extracted data.

RESULTS

Finally, this meta-analysis showed that comparing with antidepressants, DXS exhibited similar effect to antidepressants in the clinical comprehensive effect [RR = 1.04, 95% CI (0.77, 1.40); P = 0.81] and decrease in Self-Rating Depression Scale scores [WMD = 0.89, 95% CI (-6.33, 8.11); P = 0.81], while lower effect in Hamilton Depression Scale scores [SMD = -0.29, 95% CI (-0.55, -0.03); P = 0.03]; Furthermore, DXS plus antidepressants can significantly improve the clinical comprehensive effect [RR = 1.23, 95% CI (1.17, 1.29); P < 0.00001] and decrease the Hamilton Depression Scale scores [SMD = 1.04, 95% CI (0.51, 1.58); P = 0.0001] than pure antidepressants.

CONCLUSION

This systematic review and meta-analysis approved an efficient role of DXS in improving depression in clinical randomized controlled trials. However, further evidence from large samples and high-quality randomized controlled trials is needed to be investigated for a reliable conclusion about DXS in the treatment of depression.

摘要

民族药理学相关性

丹栀逍遥散(DXS)作为一种经典的中药方剂,具有疏肝、健脾、清热、凉血的功效,已被广泛用于治疗抑郁症。

研究目的

本随机对照试验的系统评价和荟萃分析旨在探讨丹栀逍遥散治疗抑郁症的疗效。

材料与方法

我们在多个数据库(如PUBMED)中进行文献检索,截止到2021年8月,并使用Review Manager 5.3软件进行荟萃分析。采用随机效应模型和固定效应模型对提取的数据进行综合分析。

结果

最终,该荟萃分析表明,与抗抑郁药相比,丹栀逍遥散在临床综合疗效[RR = 1.04,95% CI(0.77,1.40);P = 0.81]和自评抑郁量表评分降低方面[WMD = 0.89,95% CI(-6.33,8.11);P = 0.81]与抗抑郁药效果相似,而在汉密尔顿抑郁量表评分方面效果较低[SMD = -0.29,95% CI(-0.55,-0.03);P = 0.03];此外,丹栀逍遥散联合抗抑郁药在临床综合疗效[RR = 1.23,95% CI(1.17,1.29);P < 0.00001]和降低汉密尔顿抑郁量表评分方面[SMD = 1.04,95% CI(0.51,1.58);P = 0.0001]比单纯抗抑郁药更显著。

结论

本系统评价和荟萃分析证实了丹栀逍遥散在临床随机对照试验中对改善抑郁症有有效作用。然而,需要来自大样本和高质量随机对照试验的进一步证据,以得出关于丹栀逍遥散治疗抑郁症的可靠结论。

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