1.山东中医药大学(山东 济南 250014)
2.山东省泰安市中医医院(山东 泰安 271000)
3.上海中医药大学附属龙华医院(上海 200032)
李吉旭,男,硕士研究生,主要从事中西医结合治疗心系疾病的临床与研究工作
郭延林,副主任医师;E-mail:guoyanlinguo@163.com
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李吉旭,张林,李伟,等.血府逐瘀汤治疗卒中后抑郁临床疗效的Meta分析[J].上海中医药杂志,2023,57(3):15-20.
LI Jixu,ZHANG Lin,LI Wei,et al.Meta⁃analysis of clinical efficacy of Xuefu Zhuyu Decoction for post⁃stroke depression[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(3):15-20.
李吉旭,张林,李伟,等.血府逐瘀汤治疗卒中后抑郁临床疗效的Meta分析[J].上海中医药杂志,2023,57(3):15-20. DOI: 10.16305/j.1007-1334.2023.2207059.
LI Jixu,ZHANG Lin,LI Wei,et al.Meta⁃analysis of clinical efficacy of Xuefu Zhuyu Decoction for post⁃stroke depression[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(3):15-20. DOI: 10.16305/j.1007-1334.2023.2207059.
目的,2,系统评价血府逐瘀汤治疗卒中后抑郁的临床疗效。,方法,2,计算机检索中国知网(CNKI)、维普中文期刊服务平台(VIP)、万方数据知识服务平台(WanFang Data)、中国生物医学文献数据库(SinoMed)、Embase、PubMed、Cochrane Library、Web of Science等数据库中血府逐瘀汤治疗卒中后抑郁的相关文献(随机对照试验),文献发表时间为建库至2022年7月10日。借助Cochrane 5.4.1系统手册评估工具评价文献质量,采用RevMan5.4.1软件进行Meta分析。,结果,2,本研究共纳入19篇文献,涉及1 352例患者,其中观察组679例、对照组673例。Meta分析结果显示,观察组临床有效率高于对照组[,OR,=4.41,95%,CI,(3.02,6.44),,P,<,0.000 01];治疗后,观察组汉密尔顿抑郁量表[,MD,=-4.98,95%,CI,(-6.12,-3.83)]、卒中量表[,MD,=-4.09,95%,CI,(-4.74,-3.45)]、日常生活能力量表[,MD,=-4.19,95%,CI,(-8.16,-0.22)]评分低于对照组,,P,均,<,0.000 01;观察组不良反应发生率低于对照组[,OR,=0.07,95%,CI,(0.02,0.26),,P,<,0.000 01]。,结论,2,与单纯采用常规西药相比,加用血府逐瘀汤治疗卒中后抑郁疗效满意,能更好地改善患者的临床症状、提高日常生活能力,且安全性良好;但由于文献数量和质量等因素,相关结论有待进一步验证。
Objective,2,To systematically evaluate the clinical efficacy of Xuefu Zhuyu Decoction (XFZYD) for post-stroke depression.,Methods,2,The literature related to the XFZYD treatment of post-stroke depression (randomized controlled trials) was retrieved from databases including Chinese National Knowledge Infrastructure (CNKI), VIP Chinese Science Journals Database (VIP), WanFang Data, Chinese Biomedical Literature Service System (SinoMed), Embase, Pubmed, Cochrane Library and Web of Science. The collected literature was published from the establishment date of each database up to July 10, 2022. The quality of the included literature was evaluated with the Manual Cochrane 5.4.1, and RevMan 5.4.1 was used to perform meta-analysis.,Results,2,The included 19 articles in the study involved 1,352 patients, with 679 patients in the observation group and 673 patients in the control group. Meta-analysis results showed that the clinical efficiency of the observation group was higher than that of the control group [,OR,=4.41,95%,CI,(3.02,6.44),,P,<,0.000 01]; After treatment, observation group had lower scores than control group in Hamilton depression scale (HAMD) [,MD,=-4.98,95%,CI,(-6.12,-3.83)], NIH stroke scale (NIHSS) [,MD,=-4.09,95%,CI,(-4.74,-3.45)], and activity of daily living scale (ADL) [,MD,=-4.19,95%,CI,(-8.16,-0.22)], ,P,<,0.000 01; And the incidence of adverse reactions in the observation group was lower than that in the control group [,OR,=0.07,95%,CI,(0.02,0.26),,P,<,0.000 01].,Conclusion,2,The combined use of XFZYD with conventional western medicine has more satisfactory efficacy than the single use of conventional therapy for post-stroke depression, and can better improve clinical symptoms and patients’ activity of daily living with good safety; However, the relevant findings need further validation due to the quantity and quality of included literature.
脑卒中抑郁血府逐瘀汤中医药疗法Meta分析
strokedepressionXuefu Zhuyu Decoctiontraditional Chinese medicine therapymeta-analysis
GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet, 2017, 390(10100): 1151-1210.
王拥军,李子孝,谷鸿秋,等. 中国卒中报告2020(中文版)(1)[J]. 中国卒中杂志,2022, 17(5): 433-447.
王凯,荣良群,魏秀娥,等. 老年人卒中后抑郁与脑微出血的相关性研究[J]. 中华老年医学杂志,2019, 38(7): 750-754.
岳慧丽,秦鹏涛,付徐伟,等. 轻型缺血性脑卒中患者卒中后抑郁的相关因素研究[J]. 中国实用神经疾病杂志,2019, 22(19): 2128-2134.
邹昊,邹勇. 中西医结合治疗脑卒中后抑郁研究进展[J]. 中国中医药现代远程教育,2021, 19(1): 204-206.
吴剑宏,陈幸谊.血府逐瘀汤方剂的现代药理研究进展[J].中成药,2013, 35(5): 1054-1058.
中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志,2018, 51(9): 666-682.
RUDD A G, BOWEN A, YOUNG G R, et al. The latest national clinical guideline for stroke[J]. Clin Med, 2017, 17(2): 154-155.
张茵多. 血府逐瘀汤联合黛力新治疗脑卒中后抑郁患者的临床疗效观察[J]. 中国医药指南,2018, 16(3): 5-6.
王琳. 血府逐瘀汤联合帕罗西丁治疗脑卒中后抑郁患者的临床疗效观察[J]. 中国医药指南,2018, 16(3): 7-8.
李岩峰. 血府逐瘀汤联合黛力新治疗缺血性脑卒中后伴抑郁的疗效观察[J]. 内蒙古中医药,2020, 39(4): 81-82.
鲁晓凤,张泽旺. 血府逐瘀汤对中风后抑郁或焦虑的应用价值分析[J]. 健康必读,2019(12): 181-182.
程园园,杨文明. 血府逐瘀汤联合氟伏沙明治疗脑卒中后抑郁的临床疗效及对血浆同型半胱氨酸水平的影响[J]. 中医药临床杂志,2020, 32(9): 1698-1702.
李紫媚. 王乐亭脾胃老十针+血府逐瘀汤联合西药综合治疗脑卒中后抑郁随机平行对照研究[J]. 实用中医内科杂志,2018, 32(8): 69-73.
成晓霞,陈齐鸣. 血府逐瘀汤联合氟西汀治疗脑卒中后抑郁疗效观察[J]. 实用中医药杂志,2017, 33(8): 930-931.
杨华. 血府逐瘀汤加味方对脑卒中后抑郁患者神经评分及睡眠质量的影响[J]. 现代中西医结合杂志,2020, 29(28): 3159-3162.
周亮. 血府逐瘀汤加减治疗卒中后抑郁疗效及其对神经功能康复的影响[J]. 新中医,2014, 46(12): 73-74.
余胜利. 血府逐瘀汤治疗缺血性脑卒中后抑郁症32例疗效观察[J]. 浙江中医杂志,2007, 42(3): 148-149.
韩辉,杨文明,韩明向,等. 加减血府逐瘀汤治疗脑卒中后抑郁症的随机对照临床研究[J]. 中药新药与临床药理,2010, 21(1): 86-88, 100.
吴清珍,罗东辉,史文莉. 血府逐瘀汤加减方对脑卒中后抑郁患者自主神经功能及生活质量的影响[J]. 中国医院用药评价与分析,2020, 20(9): 1056-1059.
陈衍. 血府逐瘀汤加减对脑卒中合并抑郁症患者神经功能与认知功能的影响[J]. 中国中医药科技,2017, 24(3): 368-369.
郭慧娟,张瑞. 血府逐瘀汤联合帕罗西汀治疗脑卒中后抑郁的临床效果[J]. 临床医学研究与实践,2019, 4(5): 117-118.
陈绍云,姚自强,陈梓朗,等. 血府逐瘀汤合西酞普兰治疗缺血性脑卒中后抑郁症的临床研究[J]. 北方药学,2016, 13(2): 67.
邹永玲. 血府逐瘀汤联合帕罗西汀治疗脑卒中后抑郁的临床疗效观察[J]. 中国现代药物应用,2016, 10(1): 18-20.
田明思. 血府逐瘀汤治疗中风后抑郁症的临床研究[J]. 四川中医,2006, 24(8): 53-54.
孟长君,刘景隆,胡玲芹,等. 血府逐瘀汤配合心理疏导治疗脑卒中后抑郁40例[J]. 光明中医,2016, 31(15): 2210-2211.
李显雄,胡建芳,余志辉,等. 血府逐瘀汤治疗中风后抑郁或焦虑临床研究[J]. 中医药临床杂志,2013, 25(8): 676-677.
LIU F, SONG M, HUANG X, et al. Symptomatic plaque enhancement is associated with early-onset post-stroke depression[J]. J Affect Disord, 2022, 306: 281-287.
GU S, HE Z, XU Q, et al. The relationship between 5-hydroxytryptamine and its metabolite changes with post-stroke depression[J]. Front Psychiatry, 2022, 13: 871754.
吕红,赵凌霄,闫咏梅. 卒中后抑郁中医治疗及其机制研究进展[J]. 现代中西医结合杂志,2022, 31(6): 872-876.
胡蓉,刘振华,王又闻,等. 严世芸血府逐瘀汤异病同治验案举隅[J]. 中华中医药杂志,2019, 34(11): 5196-5199.
李伟霞,泥文娟,王晓艳,等. 当归化学成分、药理作用及其质量标志物(Q-marker)的预测分析[J]. 中华中医药学刊,2022, 40(6): 40-47, 274.
吴玲芳,王子墨,赫柯芊,等. 赤芍的化学成分和药理作用研究概况[J]. 中国实验方剂学杂志,2021, 27(18): 198-206.
刘梦,张文静,吕穆杰,等. 川芎红花药对“异病同治”缺血性脑卒中和失眠中的机制分析[J]. 中医药临床杂志,2022, 34(4): 687-696.
陈金鹏,张克霞,刘毅,等. 地黄化学成分和药理作用的研究进展[J]. 中草药,2021, 52(6): 1772-1784.
张妍妍,韦建华,卢澄生,等. 桃仁化学成分、药理作用及质量标志物的预测分析[J].中华中医药学刊,2022, 40(1): 234-241.
熊婷,何堃,孙梦盛,等. 基于网络药理学的牛膝防治阿尔茨海默病的物质基础与作用机制研究[J]. 中草药,2019, 50(1): 142-149.
YANG Z Y, TANG T, LI P F, et al. Systematic analysis of tRNA-derived small RNAs reveals therapeutic targets of Xuefu Zhuyu decoction in the cortexes of experimental traumatic brain injury[J]. Phytomedicine, 2022, 102: 154168.
彭雪峰,刘毅,赵飞,等. 血府逐瘀汤治疗失眠障碍作用机制的网络药理学研究[J]. 云南中医中药杂志,2022, 43(1): 41-50.
MARCHETTI B. Wnt/β-catenin signaling pathway governs a full program for dopaminergic neuron survival, neurorescue and regeneration in the MPTP mouse model of Parkinson's disease[J]. Int J Mol Sci, 2018, 19(12): 3743-3743.
YANG Z Y, WU Y, LI X, et al. Bioinformatics analysis of miRNAs and mRNAs network-Xuefu Zhuyu Decoction exerts neuroprotection of traumatic brain injury mice in the subacute phase[J]. Front Pharmacol, 2022, 13: 772680.
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