柴胡疏肝散治疗抑郁症对照研究临床疗效的Meta分析  

Meta-analysis of Clinical Efficacy of Chaihu Shugansan in Treatment of Depression

作　　者：金卫东[1] 邢葆平[1] 王鹤秋[1] 陈炯[1] 童振华[1] 王乃信[1] 

机构地区：[1]浙江省立同德医院,浙江省精神卫生中心,浙江杭州310012

出　　处：《中华中医药学刊》2009年第7期1397-1399,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中西医结合抑郁症重点专科项目(2007D001)

摘　　要：目的:评价柴胡疏肝散治疗抑郁症的效果。方法:应用循证医学方法对符合标准的17项研究进行分析,评价柴胡疏肝散联合抗抑郁药物或单一治疗抑郁症的有效率、痊愈率以及与对照组的差异。结果:(1)与空白对照相比,柴胡疏肝散有较好的有效率和痊愈率,差异有统计学意义(痊愈率:23.4%vs11.2%,Z=2.41,P<0.05,OR=2.61,OR95%CI=1.19～5.69;有效率:81.3%vs43.9%,Z=5.45,P<0.001,OR=6.34,OR95%CI=3.27～12.32),而且症状学评分也显著降低(WMD=-2.87,OR95%CI=-3.23～-2.51,Z=15.56,P<0.001)。(2)柴胡疏肝散与抗抑郁药物治疗抑郁症的痊愈率和有效率相比差异没有统计学意义(痊愈率:41.6%vs38.4%,Z=0.58,P>0.05,OR=1.15,OR95%CI=0.69～1.92;有效率:65.1%vs58.2%,Z=1.20,P>0.05,OR=1.35,OR95%CI=0.83～2.22),但是柴胡疏肝散比抗抑郁药物治疗后HAMD评分低(WMD=-1.96,OR95%CI=-2.80～-1.11,Z=4.52,P<0.001)。(3)柴胡疏肝散联合抗抑郁药物的中西药联合组与单一使用抗抑郁药物相比,痊愈率和有效率均非常显著增高,具有统计学意义(痊愈率:30%vs25.6%,Z=4.56,P<0.001,OR=2.08,OR95%CI=1.52～2.85;有效率:68.6%vs50.5%,Z=5.03,P<0.001,OR=2.30,OR95%CI=1.66～3.19),同时第4周末的HMAD非常显著降低,差异有统计学意义(WMD=-3.04,OR95%CI=-3.67～-2.40,Z=9.40,P<0.001)。结论:柴胡疏肝散对抑郁症有良好效果。Objective ：To assess the effects of Chaihu Shugansan in treatment of depression. Methods：IT studies meeting our criteria were analyzed by based-evidence medicine, comparing the difference in efficacy rate, full remission rate and effect size of therapy. Results ： （1） Comparing to empty - control, Chaihu Shugansan had higher full remission rate and effective rate （ full remission rate ：23.4% vs 11.2%, Z = 2. 41,P 〈 0. 05, OR = 2. 61,OR95% CI = 1.19 - 5.69 ; effective rate：81.3 % vs 43.9%, Z = 5.45, P 〈 0. 001, OR = 6. 34,OR95% CI = 3.27 -12. 32 ）, and lower HAMD （ WMD = - 2. 87, OR95 % CI = - 3.23 - - 2.51, Z = 15.56, P 〈 0. 001 ）. （2） No differences in full remission rate and effcacy rate were found between Chaihu Shugansan and antidepressants in treatment of depression （full remission rate： 39. 3% vs 36.7%, Z = 0. 19, P 〉 O. 05, OR = 1.05, OR95 % CI = 0. 65 -1.67 ; efficacy rate ：73.8 % vs 64. 5 %, Z = 1.79, P 〉 0. 05, OR = 1.55,0R95% CI = 0. 96 - 2.52）, but it was found that Chaihu Shugansan had lower HAMD than that of antidepressants at end of observation （ WMD = - 1.96,0R95 % CI = - 2. 80 - - 1.11, Z = 4.52, P 〈 0. 001 ）. （ 3 ） It was also found that Chaihu Shugansan combing antidepressants had higher full remission rate and higher efficacy rate than that of single antidepressants in management of depression （ full remission rate： 30% vs 25.6%, Z = 4. 56, P 〈 0. 001, OR = 2. 08, 0R95% CI = 1.52 - 2.85 ; efficacy rate ： 68.6% vs 50.5%, Z = 5.03, P 〈 0. 001, OR = 2. 30, 01195% CI = 1.66 - 3. 19）, and lower HAMD than that of antidepressants at 4th weekend（ WMD = - 3.04,0R95% CI = - 3. 67 - - 2.40, Z = 9.40,P 〈 O. 001 ）. Conclusion：Chaihu Shugansan have positive and better efficacy in treatment of depression.

关 键 词：柴胡疏肝散 抗抑郁药物 抑郁症 有效率 痊愈率 META分析 

分 类 号：R749.4[医药卫生—神经病学与精神病学]