Wang Lingning, Fan Yan, He Jiangmen, Liu Heng, Chen Feng, Dan Hongying, Zhao Juan, Zhang Jiao, Wang Tao, Liu Xinru
Department of Obstetrics and Gynecology Clinics, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China.
Evid Based Complement Alternat Med. 2022 Jul 7;2022:5260235. doi: 10.1155/2022/5260235. eCollection 2022.
To evaluate the efficacy and safety of Shuganjieyu capsule alone or in combination with other antidepressants in the treatment of postpartum depression.
Related control and randomized studies till August 1, 2021, were retrieved from the following databases: PubMed, Cochrane, CNKI, CMB, Wan-Fang, and VIP. Outcomes included HAMD reduction from baseline, response rate, and adverse events rate. Review Manager 5.3 was used in the present meta-analysis.
16 studies including 1409 participants were included in the present study. In comparison of single Shuganjieyu capsule versus regular antidepressant, 8, 6, and 4-week HAMD reduction of the Shuganjieyu group were significantly higher (8-week MD: 3.1 (1.54, 4.66), < 0.0001; 6-week MD: 0.71 (0.10, 1.31), =0.02; and 4-week MD: 0.82 (0.34, 1.30), =0.0008), response rates were comparable for the two groups (OR: 1.51 (0.87, 2.63), =0.014), and the adverse event rate of the Shuganjieyu group was significantly lower (OR: 0.22 (0.15, 0.32), < 0.00001). In comparison of combination of Shuganjieyu capsule with regular antidepressant versus regular antidepressant alone, the 8, 6, 4, 2, and 1-week HAMD reduction and response rate of combination of Shuganjieyu with the regular antidepressant group were significantly larger (8-week MD: 3.2 (1.34, 5.06), =0.0007; 6-week MD: 4.00 (2.72, 5.28), < 0.00001; 4-week MD: 3.33 (1.94,4.73), < 0.00001; 2-week MD: 2.69 (1.34, 4.03), < 0.0001; 1-week MD: 2.27 (0.69, 3.86), =0.005; and response rate OR: 4.69 (2.27, 9.68), < 0.0001) and the adverse event rate was comparable for the two groups (OR: 1.26 (0.73, 2.17), =0.41).
Compared with regular antidepressants, single Shuganjieyu capsule has similar efficacy and better safety profile; when Shuganjieyu capsule is combined with regular antidepressants, the efficacy is improved significantly without increasing adverse events. Therefore, Shuganjieyu capsule was effective and safe for postpartum, making it worth further investigation and popularization.
评估疏肝解郁胶囊单独或联合其他抗抑郁药治疗产后抑郁症的疗效和安全性。
检索截至2021年8月1日的PubMed、Cochrane、中国知网（CNKI）、中国生物医学文献数据库（CMB）、万方和维普等数据库中的相关对照和随机研究。结局指标包括汉密尔顿抑郁量表（HAMD）较基线的减分、有效率和不良事件发生率。本荟萃分析采用Review Manager 5.3软件。
本研究纳入16项研究，共1409例参与者。比较疏肝解郁胶囊单药与常规抗抑郁药，疏肝解郁组治疗8周、6周和4周时HAMD减分显著更高（8周：MD = 3.1（1.54，4.66），P < 0.0001；6周：MD = 0.71（0.10，1.31），P = 0.02；4周：MD = 0.82（0.34，1.30），P = 0.0008），两组有效率相当（OR = 1.51（0.87，2.63），P = 0.014），疏肝解郁组不良事件发生率显著更低（OR = 0.22（0.15，0.32），P < 0.00001）。比较疏肝解郁胶囊联合常规抗抑郁药与常规抗抑郁药单药，疏肝解郁联合常规抗抑郁药组治疗8周、6周、4周、2周和1周时HAMD减分及有效率显著更高（8周：MD = 3.2（1.34，5.06），P = 0.0007；6周：MD = 4.00（2.72，5.28），P < 0.00001；4周：MD = 3.33（1.94，4.73），P < 0.00001；2周：MD = 2.69（1.34，4.03），P < 0.0001；1周：MD = 2.27（0.69，3.86），P = 0.005；有效率OR = 4.69（2.27，9.68），P < 0.0001），两组不良事件发生率相当（OR = 1.26（0.73，2.17），P = 0.41）。
与常规抗抑郁药相比，疏肝解郁胶囊单药疗效相当但安全性更好；疏肝解郁胶囊联合常规抗抑郁药时疗效显著提高且不增加不良事件。因此，疏肝解郁胶囊治疗产后抑郁症有效且安全，值得进一步研究和推广。
