| ObjectiveDepression is one of the most common non-motor symptom of Parkinson’ s Disease(PD).Resent years more and more clinical trials have reported Chinese herbal medicine therapy(CHMT)as a treatment of choice for depression in Parkinson’ s disease(dPD).Despite several reports on the antidepressant value of Chinese herbal medicine,no recent meta-analysis has evaluated the efficiency and safety of ChaiHu-ShuGan medicine(CHSG)for dPD in adult.Therefore,we decided to conduct such a systematic review and meta-analysis to assess the therapeutic effect and safety of ChaiHu-ShuGan method for depression in dPD.MethodsDatabases of CNKI、CBM、VIP、WF and PubMed、Cochrane Library were electronically searched for gathering randomized controlled trials(RCTs)of dPD involving Chinese Medicine of CHSG from the year of database establishment to July 31th of 2017,and journals related to the research were also manually searched from the library of Guangzhou University of Chinese Medicine.Data were extracted and evaluated by two reviewers independently.The software of RevMan5.3 was applied for Meta-analysis.ResultsThere were totally 11 randomized controlled trials(RCTs)involving 809 patients met all inclusion criteria.There was marked differences between CHSG combinating with antidepressants group and control group in terms of HAMD scores scale(WMD=-2.22,95%CI[-4.00,-0.44],P=0.01)、total effective rate(OR=3.87,95%CI[1.90,7.90],P=0.0002)、UPDRS scores scale(WMD=-5.40,95%CI[-9.08,-1.73],P=0.004)、MMSE scores scale(WMD=1.93,95%CI[1.06,2.79],P<0.0001)、ADL scores scale(WMD=-3.33,95%CI[-4.57,-2.10],P<0.00001)、the dosage of Sertraline(WMD=-20.65,95%CI[-39.07,-2.22],P=0.03)、the dosage of Levodopa(WMD=-190.42,95%CI[-307.98,-72.86],P=0.001)and other outcome measurements.Moreover,experimental group showed beneficial effects on cognitive function and activities of daily living in participants with dPD.In addition,there were positive effects on the dosage of Sertraline and Levodopa.Nevertheless,The main results of Meta-analysis showed that there was no marked differences between CHSG group and control group in terms of HAMD scores scale、total effective rate、UPDRS scores scale、CGI-S scores scale and the dosage of levodopa(P>0.05).ConclusionAs a relative safe intervention method for dPD,CHSG prescription combined with western medicine showed benefits with few adverse reactions when comparing with western medicine.However,the study is limited by the quality of included literatures,and should be further reviewed by more well-designed,high-quality and large-sample RCTs. |
