草药作为抗抑郁药治疗中风后抑郁症的辅助疗法:随机对照试验的系统审查和网络元分析
Jian Zhang1,2, Shuping Ming3, Xiaoming Chen1,2
1Department of Encephalopathy, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China.
Frontiers in pharmacology
|July 31, 2023
概括
草药抗抑郁药,如Shugan Jieyu囊 (SJC) 与选择性血清素再吸收抑制剂 (SSRI) 结合,显示对中风后抑郁的有效性. 这些草药选择也可能为单独的SSRI提供更安全的替代品,副作用更少.
科学领域:
- 综合医学是一个整体的医学.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 脑卒中后抑郁症 (PSD) 是一种常见的并发症,影响患者的康复.
- 草药正在被探索为PSD的辅助疗法.
- 对PSD草药抗抑郁药的疗效和安全性的证据进行了综合.
研究的目的:
- 对PSD的草药进行随机对照试验 (RCT) 的系统审查和网络元分析.
- 与标准治疗相比,评估各种草药干预措施的疗效和安全性.
- 为了确定PSD的成年人最有效和最安全的草药抗抑郁药选择.
主要方法:
- 在多个数据库 (Cochrane Library,Embase,PubMed,CNKI,Wan Fang,VIP) 进行系统的文献搜索,截至2022年12月.
- 包括51个RCT,包括4507名参与者,评估PSD的草药.
- 使用了频率主义的随机效应网络元分析和推评估,开发和评价 (GRADE) 框架的评级.
主要成果:
- 舒甘杰尤囊 (SJC) 加上SSRI,杰尤囊加上SSRI,和武林囊加上SSRI在响应率方面表现出高效率 (中等确定性证据).
- 与Hypericum或SSRI结合的Wuling囊显示,汉密尔顿抑郁症评分表 (HAMD) 评分显著降低 (中等确定性证据).
- SJC显示出与SSRI相比的潜在安全优势,胃肠道和神经系统事件的风险明显降低 (中等确定性证据).
结论:
- 组合疗法,特别是SJC,Jie-Yu药片或Wuling囊与SSRI,对于改善中风后患者的抑郁症状是有效的.
- 某些草药干预措施,如SJC,与单独的SSRI相比,可能会提供有利的安全概况.
- 进一步的研究表明,低至非常低的确定性证据表明,这些草药组合不会增加不良事件的风险.
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