归脾汤治疗抑郁症疗效与安全性的系统评价(1)

http://www.100md.com 2016年4月1日 中国中医药信息 2016年第4期

     摘要：目的 系统评价归脾汤与抗抑郁药比较的治疗抑郁症临床疗效和安全性。方法 计算机检索中国知识资源总库(CNKI)、中文科技期刊数据库(VIP)、中国学术期刊数据库(万方数据)、中国生物医学文献数据库(CBM)、Embase、PubMed、Cochrane Library中归脾汤治疗抑郁症临床随机对照试验相关文献。2名研究者独立筛选文献、提取资料及质量评价后，采用RevMan 5.2软件进行Meta分析。结果 共纳入9篇文献，共计受试者893例。Meta分析结果显示：归脾汤联合抗抑郁药物较单独使用抗抑郁药能显著降低HAMD评分(MD=-4.63，95%CI[-5.95，-3.32]；P<0.001)，归脾汤降低HAMD评分与抗抑郁药相当(MD=-0.30，95%CI[-4.22，3.62]；P=0.88)；归脾汤总有效率与抗抑郁药相当(RR=1.09，95%CI[0.82，1.44]；P=0.54)，归脾汤联合抗抑郁药物较单独使用抗抑郁药物总有效率明显升高(RR=1.26，95%CI[1.14，1.38]；P<0.001)。纳入研究中未见严重不良反应报告。Meta分析显示归脾汤(RR=0.48，95%CI[0.40，0.58]；P<0.001)及归脾汤联合抗抑郁药(RR=0.51，95%CI[0.30，0.85]；P=0.010)不良反应发生率低于单独使用抗抑郁药。结论 归脾汤治疗抑郁症有一定的疗效，且相对安全。但纳入研究质量普遍较低，尚需更多大样本、多中心、高质量的临床随机对照试验进一步验证。

    关键词：归脾汤；抗抑郁药物；抑郁症；系统评价；Meta分析

    DOI：10.3969/j.issn.1005-5304.2016.04.010

    中图分类号：R2-05；R277.794 文献标识码：A 文章编号：1005-5304(2016)04-0036-05

    Systematic Review of Efficacy and Safety of the Treatment of Guipi Decoction for Depression TIAN Jing-ping1， WEN Ze-huai2，3， GUO Xin-feng2， LI Yan4， LV Zhi-ping1 (1. School of Traditional Chinese Medicine， Southern Medical University， Guangzhou 510515， China； 2. Key Unit of Methodology in Clinical Research， Guangdong Provincial Hospital of Chinese Medicine， Guangzhou 510120， China； 3. National Center for Design Measurement and Evaluation in Clinical Research， Guangzhou University of Chinese Medicine， Guangzhou 510405， China； 4. Department of Psychology， Guangdong Provincial Hospital of Chinese Medicine， Guangzhou 510120， China)

    Abstract： Objective To evaluate the efficacy and safety of Guipi Decoction vs. antidepressants for depression. Methods Articles about the randomized controlled trials (RCTs) of Guipi Decoction for depression were searched in the databases of CNKI， VIP， Wanfang Data， CMB， Embase， PubMed， and Cochrane Library. Two researchers independently screened the articles， extracted the data， and evaluated the methodological quality. Meta-analyses were performed by using RevMan 5.2 software. Results A total of 9 RCTs articles involving 893 cases were included. Meta-analysis results suggested that as compared with antidepressants only， Guipi Decoction together with antidepressants was associated with a significantly greater reduction in HAMD scores (MD=-4.63， 95%CI [-5.95， -3.32]； P<0.001). There was no significant difference in HAMD scores between Guipi Decoction used alone and antidepressants (MD=-0.30， 95%CI [-4.22， 3.62]； P=0.88). As compared with antidepressants， Guipi Decoction together with antidepressants increased in the rates of total effective events (RR=1.26， 95%CI [1.14， 1.38]； P<0.001). No serious adverse reactions were reported. Meta-analysis results suggested that the incidence of adverse reactions of Guipi Decoction (RR=0.48， 95%CI [0.40， 0.58]； P<0.001) and Guipi Decoction together with antidepressants (RR=0.51， 95%CI [0.30， 0.85]； P=0.010) were lower than that of antidepressants alone. Conclusion The present(田景平 温泽淮 郭新峰 等)

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