疏肝健脾法治疗肝郁脾虚型卒中后抑郁的疗效Meta分析  

Soothing Liver and Strengthening Spleen on Post-Stroke Depression with Syndrome of Liver Depression and Spleen Deficiency:A Meta-analysis of Randomized Clinical Trials

作　　者：田丹枫 林景峰 高强[1] 常泽 王育纯 张丹丹[1] 韩振蕴 TIAN Danfeng;LIN Jingfeng;GAO Qiang;CHANG Ze;WANG Yuchun;ZHANG Dandan;HAN Zhenyun(Beijing University of Chinese Medicine,Beijing 100029,China;Technology Department of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学科技处,北京100029

出　　处：《辽宁中医杂志》2020年第4期20-25,共6页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81673910);北京市科技新星计划项目(2009A36)。

摘　　要：目的评价疏肝健脾法治疗肝郁脾虚型卒中后抑郁的临床疗效。方法电子系统及人工检索PubMed、The Cochrane Library、EMbase、CNKI、VIP、WanFang Data和CBM数据库,时限为从建库至2018年9月。收集疏肝健脾法治疗肝郁脾虚型卒中后抑郁的随机对照试验(RCTs),采用Cochrane Reviewer’s Handbook 5.1.0中的方法进行文献质量评价和资料分析,运用Rev Man 5.3软件对纳入的RCT研究进行Meta分析,分类和连续型变量分别用相对危险度(RR)和标准化均数差(SMD)或均数差(MD)作为合并效应量。结果共纳入15个RCTs,包括1099例患者。Meta分析结果示,汉密尔顿抑郁量表(HAMD)有效率[RR=1.19,95%CI(1.12,1.26),P<0.00001],HAMD评分[SMD=-0.79,95%CI(-1.12,-0.46),P<0.00001],中医证候有效率[RR=1.35,95%CI(1.15,1.59),P=0.0002],中医证候总积分[MD=-3.96,95%CI(-6.42,-1.50),P=0.002]、社会功能缺陷量表(SDSS)评分[MD=-2.57,95%CI(-4.29,-0.84),P=0.004]。结论疏肝健脾法治疗肝郁脾虚型卒中抑郁的临床疗效较对照组存在明显优势。Objective To systematically evaluate the efficacy of soothing liver and strengthening spleen on post-stroke depression with syndrome of liver depression and spleen deficiency.Methods A computer-based retrieval was conducted at PubMed,EMBASE,The Cochrane Library,CNKI,VIP,WanFang Data and CBM database.The retrieval time was from the establishment date of database to Sep 2018.Randomized controlled trials(RCTs)of soothing liver and strengthening spleen comparing with other interventions on post-stroke depression with syndrome of liver depression and spleen deficiency were included.The relative risk(RR)and standardized mean difference(SMD)or mean difference(MD)were used as combined effects for categorical variables and continuous variables respectively.Results Totally 15 RCTs were included involving 1099 patients.Compared with the control group,soothing liver and strengthening spleen for post-stroke depression with syndrome of liver depression and spleen deficiency was superior in the HAMD effective rate[RR=1.19,95%CI(1.12,1.26),P<0.00001],HAMD[SMD=-0.79,95%CI(-1.12,-0.46),P<0.00001],TCM syndrome effective rate[RR=1.35,95%CI(1.15,1.59),P=0.0002],TCM syndrome[MD=-3.96,95%CI(-6.42,-1.50),P=0.002]and SDSS[MD=-2.57,95%CI(-4.29,-0.84),P=0.004]with significant differences.Conclusion According to the results of the Meta-analysis,soothing liver and strengthening spleen on post-stroke depression with syndrome of liver depression and spleen deficiency is better than the control group.

关 键 词：疏肝健脾法 肝郁脾虚 卒中后抑郁 疗效META分析 

分 类 号：R255.2[医药卫生—中医内科学]