| Objective: The purpose of this study is to conduct a meta-analysis of the efficacy and safety of liver dredging and blood activating therapy in the treatment of post-stroke depression(PSD).To provide further reliable basis for the clinical decision-making of the treatment of PSD.Methods: A randomized controlled clinical trial(RCT)on the treatment of poststroke depression patients by liver dredging and blood activating therapy was published on November 30,2019 by using computer to search major databases at home and abroad.After selecting relevant literature,the results of all included literature were analyzed and synthesized(using Revman 5.3 software).Results: Finally,23 studies were included,among which 3 were treated with Soothing Liver and Activating blood circulation alone and 20 were treated with Soothing Liver and Activating blood circulation Combined with antidepressant western medicine,totaling 1982 cases.Meta analysis: a total of 17 literatures reported clinical effective rate.Subgroup analysis was conducted according to different treatment methods.The results showed that the clinical effective rate of Soothing Liver and Activating blood circulation was better than that of the control group,and the difference was statistically significant(or = 7.67,95% CI [2.70,21.78],P = 0 0001;Soothing Liver and Activating blood circulation Combined with antidepressant western medicine: or = 3.65,95% CI [2.72,4.91],P < 0.00001];a total of 18 literature reports HAMD score,according to the treatment of subgroup analysis,the results show that Soothing Liver and Activating blood circulation is better than the control group in improving the HAMD score of post-stroke depression,the difference between the two groups is statistically significant(SMD =-2.52,95% CI [-4.81,-0.24],P = 0.03;prescription of Soothing Liver and Activating blood circulation combined with Western antidepressants: SMD =-1.50,95% CI [-1.93,-1.21],P < 0.00001];three articles reported the TCM syndrome score,the results showed that the combination of prescription of Soothing Liver and Activating blood circulation combined with Western antidepressants improved PSD compared with the control group There were significant differences in the scores of TCM Syndrome Scale,suggesting that the therapeutic effect of Soothing Liver and Activating blood circulation was better than that of the control group(MD =-3.66,95% CI [-5.39,-1.92]),P < 0.0001);three studies reported the Chinese neurologic impairment scoring standard in 1995,the results showed that Soothing Liver and Activating blood circulation was better than that of the control group,with statistical significance(MD =-8.06,95 %Ci [-11.29,-4.83]),P < 0.00001);two studies reported the MESSS score,the results showed that after treatment,the treatment group of Soothing Liver and Activating blood circulation Combined with antidepressant western medicine improved the scores of the patients with PSD in the same way as the control group(MD =-3.06,95 %Ci [-8.96,-2.85]),P = 0.31);two studies reported the NISHH score,the results showed that the treatment group of Soothing Liver and Activating blood circulation Combined with antidepressant western medicine improved the NISHH score better than the control group(MD =-1.22,95% CI [-1.71,-0.74]),P < 0.00001).In terms of activities of daily living,four studies were included,and the results showed that the improvement of ADL score in the Soothing Liver and Activating blood circulation Method group was better than that in the control group(SMD = 2.32,95% CI [0.41,4.23]),P = 0.02).Nine studies specifically reported adverse events.The results showed that there was no significant difference in the incidence of adverse reactions between the treatment group and the control group(MD = 0.49,95% CI [0.17,1.39]),P = 0.18).Conclusions:(1)Compared with the control group,Soothing Liver and Activating blood circulation can improve the clinical efficiency,improve the HAMD Depression Scale score,NISHH score and the stroke clinical nerve function defect criteria score,TCM syndrome score,life ability score and other major clinical symptom scores have significant advantages,and the safety is good,but it can not be explained that Soothing Liver and Activating blood circulation can effectively improve the post-stroke depression improved MESSS score. |
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