目的 通过网状 Meta分析评估中药注射液对卒中后抑郁(PSD)的治疗效果.方法 检索知网、万方数据、维普、中国生物医学文献、PubMed、Web of Science和Cochrane图书馆等中英文数据库,搜集有关研究.审阅并提取符合纳入标准的文献数据,使用Cochrane 偏倚风险评估工具进行质量评估,使用 RevMan5.4.1、Stata15.1 和 R软件gemtc程序包进行数据分析.结果 共纳入 14 项研究,涉及刺五加注射液、银杏达莫注射液、醒脑静注射液、天麻素注射液、银杏二萜内酯葡胺注射液和血塞通注射液 6 种中药注射液.网状 Meta分析结果表明,总有效率方面,中药注射液的疗效排名前 3 为天麻素注射液、醒脑静注射液、银杏达莫注射液;汉密尔顿抑郁量表(HAMD)评分方面,中药注射液的疗效排名前 3 为醒脑静注射液、刺五加注射液、血塞通注射液;抑郁自评量表(SDS)评分方面,中药注射液的疗效排名前 3 为:醒脑静注射液、银杏达莫注射液、天麻素注射液.在治疗过程中,6 种中药注射液均未出现严重不良反应.结论 中药注射液联合西医常规治疗可提高治疗卒中后抑郁的疗效,改善神经功能及日常生活能力,其中以醒脑静注射液总体治疗效果最好.
Objective To investigate therapeutic effects of traditional Chinese medicine injec-tions on post-stroke depression(PSD)through network meta-analysis.Methods Chinese and English databases,including China National Knowledge Infrastructure(CNKI),Wanfang Data,Wipu,China Biomedical Literature,PubMed,Web of Science and Cochrane Library,were searched to collect relevant studies.Literature data that met the inclusion criteria were reviewed and extrac-ted,quality assessment was performed using the Cochrane Risk of Bias Assessment Tool,and data analysis was performed using RevMan 5.4.1,Stata 15.1,and the R software gemtc package.Results A total of 14 studies were included,involving six Chinese medicine injections,namely,Ciwujia In-jection,Yinxing Damo Injection,Xingnaojing Injection,Tianmasu Injection,Ginkgolides Glu-cosamine Injection,and Xuesaitong Injection.Network meta-analysis showed that in terms of the total effective rate,the top three traditional Chinese medicine injections were Tianmasu Injection,Xingnaojing Injection,and Yinxing Damo Injection;in terms of Hamilton Depression Scale(HAMD)scores,the top three traditional Chinese medicine injections were Xingnaojing Injection,Ciwujia Injection,and Xuesaitong Injection;in terms of Depression Self-assessment Scale(SDS)scores,the top three traditional Chinese medicine injections were Xingnaojing Injection,Yinxing Damo Injection,and Tianmasu Injection.During the course of treatment,no serious adverse reac-tions were observed for any of the six herbal injections.Conclusion Traditional Chinese medicine injections combined with conventional Western medicine can improve the efficacy of treating post-stroke depression and improve neurological function and daily living ability,with the best overall therapeutic effect being achieved with Xingnaojing Injection.