| Objectives. Post-stroke depression(PSD) which includes a lot of modes of treatment is a common occurrence after stroke. Chinese medicine is gradually paid attention to at present for clinical application because of its small side effects and having advantage of resolving the current problems and eliminating the root causes. We intended to compare the clinical outcomes and safety of CHSGS san for PSD.Methods. To search all the reports of randomized control trials of Chaihushugan san(CHSGS) with western conventional medication(WCM) versus WCM for post-stroke depression, the search ranged included Pub Med Database, EMBASE Database, Cochrane Library, WANFANG full-text Database, VIP Chinese sci-tech periodical full text database, CNKI Database and the China Biological Medicine Database, which were from their inception to June, 2014. Two reviewers scanned the qualified literatures and completed the extraction of the date independently, and assessed the methodological quality of included studies separately according to the Cochrane Handbook for Systematic Reviews of Interventions [updated March 2011].Data-analysis, Sensitivity analysis, Publication bias and Heterogeneity test were analysised by the Software Revman5.2. As to classifying variable, relative risk(RR) and95% confidence interval(95%CI) were calculated. As to continuous variable,standardized mean differences(SMD) or mean differences(MD) and 95% confidence interval(95%CI) were calculated. The chi-square test and I2 statistic were used to test heterogeneity among studies. Data was analyzed with a fixed effect model if no statistical heterogeneity was observed(p>0.1 and I2<50%), otherwise, a random effect model and sensitivity analysis were used. Once the p value was not consistent with the I2 value, used the I2 value as the main criteria to determine the statistical significance of heterogeneity. We compared CHSGS and WCM with WCM for the treatment of PSD through a forest plot. The p value less than 0.05 was considered statistically significant.Publication bias was detected graphically using a funnel plot.Results. According to search strategy, 11 clinical randomized control trials(869 patients)were included in the meta-analysis, which were all single center studies and all published in domestic journals and magazines. Based on the data collection and analysis,we got some results: 1. Comparing with western conventional medication(WCM),CHSGS with WCM could improve the clinical effective rate of PSD patients more effectively. 2. Comparing with western conventional medication(WCM), CHSGS with WCM could significantly decrease the Hamilton Depression Rating Scale scores and the Scandinavian Stroke Scale scores, and could increase the Barthel Index scores.3. There were 7 trials reporting the information about adverse events and the other 4trials without providing safety assessments.Conclusion. According to the evidence of this meta-analysis, CHSGS with WCM appears to be more effective and safer than WCM for the treatment of PSD. CHSGS with WCM can promote the condition of depression and functional recovery of nerve injury, improve the ability of the daily lives of patients with PSD, and have better security, which can reduce the adverse effects of Western medicine effectively. However,current evidence is insufficient to warrant a clinical recommendation that CHSGS therapy is a routine use for PSD, because of the small number and low methodological quality of the included RCTs. Thus, multi-center, large sample size, high-quality of RCTs are needed in the future. |
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