舒肝解郁胶囊治疗女性抑郁症有效性和安全性的Meta分析  

Meta-analysis of the efficacy and safety of Shugan Jieyu Capsules in the treatment of female depression

作　　者：代宝安 杨丽旋 敖与天 董凯强 郭蓉娟[3] Dai Bao'an;Yang Lixuan;Ao Yutian;Dong Kaiqiang;Guo Rongjuan(Beijing University of the Traditional Chinese Medicine,Beijing 100029,China;不详)

机构地区：[1]北京中医药大学,100029 [2]北京市丰台区中医医院/北京市丰台区南苑医院脑病科,100076 [3]北京中医药大学东方医院脑病科,100078

出　　处：《疑难病杂志》2025年第1期93-101,共9页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金(82374412、U21A20401)。

摘　　要：目的系统评价舒肝解郁胶囊治疗女性抑郁症的有效性和安全性。方法在PubMed、Cochrane Library、Embase、APA Psyclnfo、中国生物医学文献服务系统、中国知网、维普和万方数据等数据库中,检索建库至2024年3月31日发表的舒肝解郁胶囊治疗女性抑郁症的随机对照试验(RCT),采用RevMan 5.4软件对纳入研究进行Meta分析。结果共纳入21篇RCTs、1783例患者。Meta分析结果显示,在降低女性汉密尔顿抑郁量表(HAMD)评分方面,舒肝解郁胶囊联合抗抑郁化药优于单用抗抑郁化药[SMD=-0.87,95%CI(-1.17,-0.57),P<0.01],单用舒肝解郁胶囊优于单用抗抑郁化药[SMD=-0.44,95%CI(-0.84,-0.04),P=0.03]。对于产后抑郁症(PPD)和围绝经期抑郁症(PMD)患者,在降低HAMD评分方面,舒肝解郁胶囊联合抗抑郁化药均优于单用抗抑郁化药[SMD=-0.86,95%CI(-1.49,-0.22),P=0.008;SMD=-1.02,95%CI(-1.57,-0.47),P=0.0003],单用舒肝解郁胶囊与单用抗抑郁化药的疗效差异无统计学意义(P>0.05)。在降低汉密尔顿焦虑量表(HAMA)评分方面,舒肝解郁胶囊联合抗抑郁化药优于单用抗抑郁化药[MD=-1.19,95%CI(-2.22,-0.16),P=0.02],对于PMD患者,舒肝解郁胶囊单用优于盐酸舍曲林,与帕罗西汀相当。在不良事件(AEs)方面,舒肝解郁胶囊联合抗抑郁化药不会增加AEs的发生率(P>0.05),单用舒肝解郁胶囊的AEs发生率低于单用抗抑郁化药[RR=0.37,95%CI(0.27,0.51),P<0.01]。结论舒肝解郁胶囊治疗女性抑郁症具有较好的有效性和安全性,可用于抑郁症女性的特殊时期,如产后和围绝经期,舒肝解郁胶囊与抗抑郁化药联合使用优于单用抗抑郁化药。Objective To systematically evaluate the efficacy and safety of Shugan Jieyu Capsules in the treatment of female depression.Methods In PubMed,Cochrane Library,EMBASE,APA Psyclnfo,China Biomedical Literature Service System,China Knowledge Network,Wipro and Wanfang databases,randomized controlled trials(RCTs)of Shugan Jieyu Capsules for the treatment of female depression published by March 31,2024 were searched,and RevMan 5.4 software was used for the included Meta-analysis of the studies was performed.Results 21 clinical studies and a total volume of 1783 patients were ultimately included in this study.Analysis results showed that,in terms of reducing HAMD scores on female depression,the administration of Shugan Jieyu Capsules in combination with antidepressant chemical was superior to the administration of antidepressant chemical alone(SMD=-0.87,95%CI[-1.17,-0.57],P<0.01),the administration of Shugan Jieyu Capsules alone was superior to the administration of antidepressant chemical alone for female depression(SMD=-0.44,95%CI[-0.84,-0.04],P=0.03).For postpartum depression(PPD)and perimenopausal depression(PMD)patients,Shugan Jieyu capsule combined with antidepressants was superior to antidepressants alone in reducing HAMD scores(SMD=-0.86,95%CI[-1.49,-0.22],P=0.008;SMD=-1.02,95%CI[-1.57,-0.47],P=0.0003).In terms of reducing HAMA scores,the administration of Shugan Jieyu Capsules in combination with antidepressant chemical was superior to the administration of antidepressant chemical alone(MD=-1.19,95%CI[-2.22,-0.16],P=0.02),the administration of Shugan Jieyu Capsules alone was superior to the administration of Sertraline Hydrochloride alone,but comparable to that of Paroxetine.For patients with Postpartum Depression(PPD)or Perimenopausal Depression(PMD),in terms of reducing HAMD scores,the administration of Shugan Jieyu Capsules in combination with antidepressant chemical was superior to the administration of antidepressant chemical alone(P<0.01).There was no statistical significance in the difference of efficacy

关 键 词：女性抑郁症 产后抑郁症 围绝经期抑郁症 舒肝解郁胶囊 疗效 META分析 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R453[医药卫生—临床医学]