Efficacy Of Danzhi Xiaoyao San For Post Sroke Depression:a Meta-analysis

Objective:To systematically review the efficacy and safety of Danzhi Xiaoyao San for patients with post stroke depression and provide evidence for future clinical research and application.Methods :Pub Med,The Cochrane Library,EMBASE,CBM,CNKI,VIP,and Wanfang Database were electronically searched for randomizedcontrolled trials(RCTs)on Danzhi Xiaoyao San for patients with depression after stroke.Meanwhile,relevant data were retrieved by hand search and data from pharmaceutical factories were collected.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,Publication bias and Heterogeneity test were analysised by the Software Revman5.2.Results :1.Search Results We initially identified 147 records of which 18 RCTs(non-placebo-controlled trials)involving 1682 patients were enrolled.There were 6 trials comparing Danzhi Xiaoyao San with he former antidepressants alone and 12 trials comparing Danzhi Xiaoyao San plus other antidepressants with the former antidepressants alone.The quality of the included studies were generally moderate.2.The results of Meta analysis :(1)The result of meta analy-sis(15studies,1462 patients)showed that the effectiveness rate of the the Danzhi Xiaoyao San group was significantly higher than that of the control group [OR=1.20,95%CI(2.53,4.61),P<0.00001];(2)The results of meta analysis(15 studies,1411 patients)showed that HAMD scores decreased significantly in Danzhi Xiaoyao San used alone [ MD=-3.93,95%CI(-4.81,-3.04),P<0.00001];(3)The results of meta analysis(3 studies,237 patients)showed that ALD scores was significantly higher than that of the control group [MD=21.55,95%CI(18,25.11),P<0.00001];(4)The results of subgroup analysis were performed according to Dan zhi xiaoyao and other therapy.The effectiveness rate of the the Danzhi Xiaoyao San group was significantly higher than Amitriptyline,but it combined other therapy is no significant differences compare with Paroxetine Hydrochloride and Deanxit.The results of Danzhi Xiaoyao San combined other therapy showed that HAMD scores was significantly higher than that Amitriptyline,Fluoxetine and Deanxit.But it can't draw a positive conclusion combined Citalopram.(5)The result of meta analysis(4 studies,24 patients)showed that untoward effect include headache and dizziness,nausea and vomiting,sleep disorders and diarrhea.Conclusion:1.Danzhi Xiaoyao San can improve the state of depression in patients with PSD;2.Danzhi Xiaoyao San can promote the condition of depression and functional recovery of nerveinjury in patients with PSD;3.Danzhi Xiaoyao San can promote the ability of the daily live s of patients with PSD;4.Danzhi Xiaoyao San in treating of VCI is safe in a certain extent.