Clinical Effect of Bupleuri Radix-Contained Prescriptions Combined with Selective Serotonin Reuptake Inhibitors on Post-Stroke Depression and Its Safety : A Metaanalysis
Abstract: Objective: To systematically evaluate the clinical effect of Bupleuri Radix- Contained Prescription combined with selective serotonin reuptake inhibitors (SSRIs) on post- stroke depression and its safety. Methods:The randomized controlled trials on Bupleuri Radix-Contained Prescriptions combined with SSRIs for post-stroke depression were retrieved by computer from such databases as China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), Wanfang Data,Chinese Biomedical Literature Service System (SinoMed),Cochrane Library,Embase and PubMed. The included clinical studies were given risk of bias analysis and Meta- analysis by software Revman5.4. Results: A total of 19 documents were included in this Meta- analysis, involving 1 645 patients. These patients were divided into the trial group and the control group,with 840 and 805 cases respectively. The Meta- analysis showed that the improvements in the scores of Hamilton Depression (HAMD) Scale [MD=- 5.26 , 95%CI (- 6.32 , - 4.20),P<0.000 01],National Institute of Health Stroke Scale (NIHSS) [MD=-3.18,95%CI (-4.49,-1.87),P<0.000 01],Barthel Index [MD=5.57,95%CI (0.90,10.23),P= 0.02] and Activity of Daily Living (ADL) Scale in the trial group were better than those in the control group, but with no obvious advantages in the increase of serum BDNF[MD=3.83,95%CI (-1.05,8.72),P=0.12]. No serious adverse reactions seen in the two groups. The funnel plot suggested that there was certain bias in HAMD scoring indexes. Conclusion:Compared with those of simple SSRIs,Bupleuri Radix-Contained Prescription combined with SSRIs for post- stroke depression has better administration safety and a more significant clinical effect. But the quality of selected documents is not good enough, more high- quality randomized controlled trials are needed for further confirmation.