中西医结合护理 (Nov 2021)
A Meta analysis on effect of Traditional Chinese Medicine prescription in the treatment of postpartum depression (中药方剂治疗产后抑郁临床疗效的Meta分析)
Abstract
Objective To systematically review the effect of Traditional Chinese Medicine (TCM) prescription in the treatment of postpartum depression. Methods Use of computer to search Cochrane, PubMed, China Knowledge Network Full Text Database (CNKI), VIP Database and Wanfang Database, to collect Randomized Controlled Trials (RCTs) about Traditional Chinese Medicine prescription in the treatment of postpartum depression. The methodological quality of included trials was assessed using the Jadad Scale, and data of included studies was statistically analyzed and processed by Revman 5. 3 software. Results A total of 8 articles were included in the literature, with a total of 683 patients. According to the meta-analysis, better outcomes of HMAD scale were found in patients received TCM prescription compared with those in patients received basic treatment or psychological interventions(MD=-6. 61, 95%CI［-7. 54, -4. 78］, Z=8. 74, P＜0. 00001); better outcomes of SAS scale were found in patients received TCM prescription compared with those in patients received basic treatment (MD=-9. 56 95%CI［-10. 31, -8. 819］, Z=35. 55, P＜0. 00001); better outcomes of MADRS scale were found in patients received TCM prescription compared with those in patients received basic treatment (MD=-0. 74, 95%CI［-0. 86, -0. 61］, Z=11. 47, P＜0. 00001); better outcomes of TCM syndrome integral were found in patients received TCM prescription compared with those in patients received basic treatment (MD=-0. 43, 95%CI［-0. 45, -0. 41］, Z=39. 25, P＜0. 00001); better improvement of serum sex hormone level was found in patients received TCM prescription compared with that in patients received basic treatment (MD=-11. 88, 95%CI［-12. 21, -11. 56］, Z=72. 44, P＜0. 00001); TCM prescription was associated a better effect on Inhibition of 5-HT and NE compared with basic treatment(MD=52. 12, 95%CI［47. 52, 56. 72］, Z=22. 22, P＜0. 00001). Conclusion The TCM prescription shows a superior effect in treatment of postpartum depression compared to the single therapy. The mechanism of specific prescriptions remains uncertain and more effort should be paid on the clinical research. (目的 评价中药方剂治疗产后抑郁的临床效果。方法 通过计算机检索中国知网(CNKI)、维普数据库(VIP)、万方数据库(Wanfang Database)、PubMed及Cochrane library, 收集中药方剂治疗产后抑郁的随机对照试验, 按照Jadad量表中随机隐藏的质量标准来评价所纳入研究的质量。采用Rev Man 5. 3软件进行Meta分析。结果 共纳入7篇研究, 包括683例产后抑郁患者。Meta分析结果显示: ①治疗产后抑郁的HMAD量表积分上中药方剂疗效优于基础药物或心理疏导治疗［MD=-6. 61, 95%CI(-7. 54, -4. 78), Z=8. 74, P＜0. 00001］。②中药方剂治疗组在SAS评分所反映的疗效优于基础药物组［MD=-9. 56 95%CI(-10. 31, -8. 819), Z=35. 55, P＜0. 00001］。③中药方剂治疗组在MADRS评分所反映的疗效优于基础药物组［MD=-0. 74, 95%CI(-0. 86, -0. 61), Z=11. 47, P＜0. 00001］。④中药方剂治疗组在中医证候评分所反映的疗效优于基础药物组［MD=-0. 43, 95%CI(-0. 45, -0. 41), Z=39. 25, P＜0. 00001］。⑤中药方剂治疗组在血清内性激素含量所反映的疗效优于基础药物组［MD=-11. 88, 95%CI(-12. 21, -11. 56), Z=72. 44, P＜0. 00001］。⑥中药方剂治疗产后抑郁抑制5-HT及NE分泌的能力优于基础药物组［MD=52. 12, 95%CI(47. 52, 56. 72), Z=22. 22, P＜0. 00001］。结论 中药方剂治疗产后抑郁优于单纯基础药物治疗, 但中药方剂各具体组方药物的起效机制尚需有待研究。)
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