School of Traditional Chinese Medicine, Jinan University, Guangzhou, China.
School of Medicine, Xiamen University, Xiamen, Fujian, China.
Medicine (Baltimore). 2024 Sep 6;103(36):e39489. doi: 10.1097/MD.0000000000039489.
In patients with schizophrenia, Diankuang Mengxing Decoction with antipsychotics is one of the treatments for it. However, little information is available regarding the difference between the therapeutic effect of Diankuang Mengxing Decoction with antipsychotics and other treatments. Systematic evaluation is conducted to assess the efficacy and safety of Diankuang Mengxing Decoction and other antipsychotics, which are used to treat schizophrenia.
We performed a systematic review (PROSPERO ID: CRD42023414603). This entailed a computerized search of several research databases from their respective dates of establishment until April 11, 2023, which collected clinical randomized controlled trials of Diankuang Mengxing Decoction combined with antipsychotics. The databases that contributed to this study were PubMed, Web of Science, Embase, EBSCOhost, Cochrane, Scopus, and Google Scholar. Each publication was screened according to defined inclusion and exclusion criteria, and appropriate literature was extracted and evaluated for quality, for which meta-analysis was performed using RevMan 5.4.
A literature review of 456 publications resulted in the inclusion of 18 randomized controlled trials with data collected from a total of 1636 patients. Meta-analytical results showed combination with risperidone, olanzapine, chlorpromazine, clozapine, ziprasidone, or aripiprazole increased the overall effectiveness of Diankuang Mengxing Decoction when treating schizophrenia (P < . 00001), among whom olanzapine demonstrated the greatest enhancement (Z = 3.65, odds ratio = 4.26, 95% CI: 1.96-9.28, P = .0003). The 4-week/30-day treatment (P = .0003) and a dosage of 400 mL/d of Diankuang Mengxing Decoction (P = .0004) were more effective. Also, there were widespread reductions to the Positive And Negative Syndrome Scale (PANSS) total scores, PANSS-positive symptom scores, PANSS-negative symptom scores, general psychopathology scores (P < .05 for all), as well as the incidence of adverse effects (Z = 2.79, odds ratio = 0.34, 95% CI: 0.16-0.73, P = .005) in patients with schizophrenia.
The combination of Diankuang Mengxing Decoction with different antipsychotics can improve the overall prognosis of patients with schizophrenia; Diankuang Mengxing Decoction combined olanzapine, a dosage of 400 mL/d and a duration of 4 weeks/30 days being the best in this regard, by alleviating the symptoms and diminishing the disorder's adverse effects. To build on this work, more large-sample, multi-center, and high-quality clinical studies in the future would help to further validate our findings.
在精神分裂症患者中，癫狂梦醒汤联合抗精神病药是其治疗方法之一。然而，关于癫狂梦醒汤联合抗精神病药与其他治疗方法的疗效差异，相关信息较少。本系统评价旨在评估癫狂梦醒汤联合其他抗精神病药治疗精神分裂症的疗效和安全性。
我们进行了系统评价（PROSPERO 注册号：CRD42023414603）。这包括对几个研究数据库进行计算机检索，检索时间从各自的建立日期到 2023 年 4 月 11 日，检索内容为癫狂梦醒汤联合抗精神病药治疗精神分裂症的临床随机对照试验。纳入研究的数据库包括 PubMed、Web of Science、Embase、EBSCOhost、Cochrane、Scopus 和 Google Scholar。根据既定的纳入和排除标准筛选每个出版物，并提取和评估适当的文献质量，使用 RevMan 5.4 进行荟萃分析。
对 456 篇文献进行综述，纳入了 18 项随机对照试验，共纳入了 1636 名患者的数据。荟萃分析结果表明，与利培酮、奥氮平、氯丙嗪、氯氮平、齐拉西酮或阿立哌唑联合使用时，癫狂梦醒汤治疗精神分裂症的总体疗效提高（P<0.00001），其中奥氮平的疗效提高最大（Z=3.65，优势比=4.26，95%CI：1.96-9.28，P=0.0003）。4 周/30 天治疗（P=0.0003）和 400 mL/d 的癫狂梦醒汤剂量（P=0.0004）更有效。此外，阳性和阴性综合征量表（PANSS）总分、PANSS 阳性症状评分、PANSS 阴性症状评分、一般精神病学评分（所有 P<0.05）以及精神分裂症患者不良反应发生率（Z=2.79，优势比=0.34，95%CI：0.16-0.73，P=0.005）均有显著降低。
癫狂梦醒汤联合不同抗精神病药可改善精神分裂症患者的整体预后；其中，癫狂梦醒汤联合奥氮平、400 mL/d 剂量和 4 周/30 天治疗方案最佳，可改善症状，减少不良反应。为了进一步验证我们的研究结果，未来需要更多的大样本、多中心、高质量的临床研究。
