Effectiveness and Safety of Wuling Capsule for Post Stroke Depression: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 BAIXiao-li , DUXiao-wei , ZHANGCan-fei ,  DUGan-qin

Department of Neurology, First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China;

Corresponding?author：

DUGan-qin, Email: dgq99@163.com

Keywords：

Wuling capsule; Post-stroke depression; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20140180

Video：

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Objective To systematically review the effectiveness and safety of Wuling capsule for patients with depression after stroke. Methods The randomized controlled trials (RCTs) about Wuling capsule for treating the patients with post-stroke depression was searched in PubMed, The Cochrane Library (Issue 4, 2013), EMbase, CBM, CNKI, WanFang Data and VIP from the dates of their establishment to November 2013. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment of the included studies were completed by two reviewers independently. Meta-analysis was conducted using RevMan 5.2 software. Results A total of eighteen RCTs involving 1 683 patients were finally enrolled. The results of meta-analysis indicated that:a) the Wuling capsule group was more effective in decreasing depression scores than the control group at 4, 8, 12 weeks (4 weeks:SMD=-0.87, 95%CI-1.25 to-0.5, P < 0.000 1; 8 weeks:SMD=-1.22, 95%CI-1.86 to-0.59, P=0.000 2; 12 weeks:SMD=-0.62, 95%CI-1.09 to-0.15, P=0.01). b) The effectiveness rate (92.7%) of the Wuling capsule group was significantly higher than that of the control group (77.2%) at the end of follow-up, with a significant difference (RR=1.20, 95%CI 1.14 to 1.27, P < 0.000 01). c) The two groups were alike in the incidence of palpitation. Conclusion Current evidence suggests that, Wuling capsule improves the symptoms of stroke-stroke depression with less adverse reaction. However, due to the limited quantity and quality of the included studies, more multicenter high quality RCTs with large sample size are needed to verify the above conclusion.

Citation： BAIXiao-li, DUXiao-wei, ZHANGCan-fei, DUGan-qin. Effectiveness and Safety of Wuling Capsule for Post Stroke Depression: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(9): 1104-1111. doi: 10.7507/1672-2531.20140180 Copy

1.	Ayerbe L, Ayis S, Wolfe CD, et al. Natural history, predictors and outcomes of depression after stroke:systematic review and meta-analysis. Br J Psychiatry, 2013, 202(1):14-21.
2.	Robinson RG, Spalletta G. Post stroke depression:a review. Can J Psychiatry, 2010, 55(6):341-349.
3.	Pan A, Sun Q, Okereke OI, et al. Depression and risk of stroke morbidity and mortality:a meta-analysis and systematic review. JAMA, 2011, 306(11):1241-1249.
4.	Hellmann-Regen J, Piber D, Hinkelmann K, et al. Depressive syndromes in neurological disorders. Eur Arch Psychiatry Clin Neurosci, 2013, 263 (2):123-136.
5.	Mead GE, Hsieh CF, Hackett M. Selective serotonin reuptake inhibitors for stroke recovery. JAMA, 2013, 310(10):1066-1067.
6.	Labos C, Dasgupta K, Nedjar H, et al. Risk of bleeding associated with combined use of selective serotonin reuptake inhibitors and antiplatelet therapy following acute myocardial infarction. CMAJ, 2011, 183(16):1835-1843.
7.	金衛斜, 錢敏護, 胡紀卵, 等.文拉法辛與三環類抗抑郁藥物治療抑郁癥副作用的循證醫學研究.循證醫學, 2003, 3(4):215-218.
8.	馬志章, 左萍萍.烏靈菌粉的鎮靜作用及其機理研究.中國藥學雜志, 1999, 34(6):374-377.
9.	Hatano S. Experience from a multicentre stroke register:a preliminary report. Bull World Health Organ, 1976, 54(5):541-553.
10.	各類腦血管病診斷要點.中華神經科雜志, 1995, 29(6):379-380.
11.	中華醫學會精神科分會編.中國精神障礙分類方案與診斷標準.第3版.濟南:山東科技出版社, 2001:87.
12.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochranehandbook.org.
13.	方敏.烏靈膠囊聯合帕羅西汀治療卒中后抑郁臨床觀察.中國實用神經疾病雜志, 2012, 15(22):75-76.
14.	胡春梅, 郭思思.烏靈膠囊治療腦卒中后抑郁癥60例臨床分析.中成藥, 2008, 30(8):附12-附13.
15.	胡軍, 原琳琳.烏靈膠囊聯合舍曲林治療45例腦卒中后抑郁障礙的療效觀察.中國民康醫學, 2009, 21(15):1882-1883.
16.	馬云枝, 鄭太昌, 田亞振, 等.烏靈膠囊治療缺血性中風后抑郁癥的臨床研究.中醫學報, 2012, 27(2):205-207.
17.	冉守連, 晏昆, 林濤, 等.烏靈膠囊治療卒中后抑郁的臨床研究.中成藥, 2010, 32(7):1271-1272.
18.	冉守連, 晏昆, 林濤, 等.西酞普蘭聯合烏靈膠囊治療卒中后抑郁的臨床研究.齊齊哈爾醫學院學報, 2012, 33(14):1885-1887.
19.	汪亞群, 宋水江, 江霞.烏靈膠囊合左洛復治療腦卒中后抑郁的臨床研究.浙江中醫雜志, 2007, 42(4):202-203.
20.	徐彬, 周未瑩.烏靈膠囊、百憂解治療卒中后抑郁的療效及其對卒中康復的影響:浙江省中西醫結合學會神經內科專業委員會第五次學術研討會中西醫結合神經內科學習班資料匯編.中國浙江寧海:浙江省中西醫結合學會神經內科專業委員會, 2006.
21.	Fu JL, Zhao YW, Sun XJ. Efficacy and safety of Deanxit combined with Wuling Capsule in treating post-stroke depression:a randomized controlled trial. Zhong Xi Yi Jie He Xue Bao, 2008, 6(3):258-261.
22.	郭英, 周峻偉.黛力新聯合烏靈膠囊治療腦卒中后抑郁的臨床療效和安全性觀察.大家健康(中旬版), 2013, 7(2):8-9.
23.	李書劍, 李燕.米氮平聯合烏靈膠囊治療老年卒中后抑郁對照研究.中國實用神經疾病雜志, 2013, 16(21):9-11.
24.	劉偉華.烏靈膠囊在治療腦卒中后抑郁患者中的應用.健康必讀(下旬刊), 2011, (10):317-317.
25.	史琦, 劉學源, 陳玉娟, 等.烏靈膠囊聯合氟西汀治療腦卒中后抑郁障礙和神經功能缺損的療效觀察.中成藥, 2008, 30(6):804-806.
26.	萬愛蘭, 袁也豐.烏靈膠囊與賽洛特治療腦卒中后抑郁障礙的療效對照.中國臨床康復, 2006, 10(31):4-6.
27.	吳玉紅, 王松齡, 蔣喜巧.黛力新合烏靈膠囊治療腦卒中后抑郁.光明中醫, 2013, 28(1):104-105.
28.	張莉莉, 梅健生, 張蘇莉.烏靈膠囊聯合黛力新對腦卒中后抑郁的療效觀察.當代醫學, 2010, 16(34):115-116.
29.	陳勇, 高林, 賀維亞.烏靈膠囊治療腦卒中后抑郁療效分析.中成藥, 2009, 31(4):503-504.
30.	向莉, 李書劍, 胡亞梅.烏靈膠囊聯合帕羅西汀治療卒中后抑郁療效觀察.中國實用神經疾病雜志, 2011, 14(15):36-38.
31.	Robinson RG, Kubos KL, Starr LB, et al. Mood disorders in stroke patients:importance of location of lesion. Brain, 1984, 107(1):81-93.
32.	裘濤, 陳眉, 陶水良, 等.烏靈菌粉對腦卒中后抑郁大鼠海馬區單胺類神經遞質及行為學改變的影響.中國新藥雜志, 2007, 16(11):857-860.
33.	Gainotti G, Azzoni A, Marra C. Frequency, phenomenology and anatomical-clinical correlates of major post-stroke depression. Br J Psychiatry, 1999, 175(8):163-167.
34.	House A. Depression Associated with Stroke. J Neuropsychiatry Clin Neurosci, 1996, 8(4):453-457.

1. Ayerbe L, Ayis S, Wolfe CD, et al. Natural history, predictors and outcomes of depression after stroke:systematic review and meta-analysis. Br J Psychiatry, 2013, 202(1):14-21.
2. Robinson RG, Spalletta G. Post stroke depression:a review. Can J Psychiatry, 2010, 55(6):341-349.
3. Pan A, Sun Q, Okereke OI, et al. Depression and risk of stroke morbidity and mortality:a meta-analysis and systematic review. JAMA, 2011, 306(11):1241-1249.
4. Hellmann-Regen J, Piber D, Hinkelmann K, et al. Depressive syndromes in neurological disorders. Eur Arch Psychiatry Clin Neurosci, 2013, 263 (2):123-136.
5. Mead GE, Hsieh CF, Hackett M. Selective serotonin reuptake inhibitors for stroke recovery. JAMA, 2013, 310(10):1066-1067.
6. Labos C, Dasgupta K, Nedjar H, et al. Risk of bleeding associated with combined use of selective serotonin reuptake inhibitors and antiplatelet therapy following acute myocardial infarction. CMAJ, 2011, 183(16):1835-1843.
7. 金衛斜, 錢敏護, 胡紀卵, 等.文拉法辛與三環類抗抑郁藥物治療抑郁癥副作用的循證醫學研究.循證醫學, 2003, 3(4):215-218.
8. 馬志章, 左萍萍.烏靈菌粉的鎮靜作用及其機理研究.中國藥學雜志, 1999, 34(6):374-377.
9. Hatano S. Experience from a multicentre stroke register:a preliminary report. Bull World Health Organ, 1976, 54(5):541-553.
10. 各類腦血管病診斷要點.中華神經科雜志, 1995, 29(6):379-380.
11. 中華醫學會精神科分會編.中國精神障礙分類方案與診斷標準.第3版.濟南:山東科技出版社, 2001:87.
12. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochranehandbook.org.
13. 方敏.烏靈膠囊聯合帕羅西汀治療卒中后抑郁臨床觀察.中國實用神經疾病雜志, 2012, 15(22):75-76.
14. 胡春梅, 郭思思.烏靈膠囊治療腦卒中后抑郁癥60例臨床分析.中成藥, 2008, 30(8):附12-附13.
15. 胡軍, 原琳琳.烏靈膠囊聯合舍曲林治療45例腦卒中后抑郁障礙的療效觀察.中國民康醫學, 2009, 21(15):1882-1883.
16. 馬云枝, 鄭太昌, 田亞振, 等.烏靈膠囊治療缺血性中風后抑郁癥的臨床研究.中醫學報, 2012, 27(2):205-207.
17. 冉守連, 晏昆, 林濤, 等.烏靈膠囊治療卒中后抑郁的臨床研究.中成藥, 2010, 32(7):1271-1272.
18. 冉守連, 晏昆, 林濤, 等.西酞普蘭聯合烏靈膠囊治療卒中后抑郁的臨床研究.齊齊哈爾醫學院學報, 2012, 33(14):1885-1887.
19. 汪亞群, 宋水江, 江霞.烏靈膠囊合左洛復治療腦卒中后抑郁的臨床研究.浙江中醫雜志, 2007, 42(4):202-203.
20. 徐彬, 周未瑩.烏靈膠囊、百憂解治療卒中后抑郁的療效及其對卒中康復的影響:浙江省中西醫結合學會神經內科專業委員會第五次學術研討會中西醫結合神經內科學習班資料匯編.中國浙江寧海:浙江省中西醫結合學會神經內科專業委員會, 2006.
21. Fu JL, Zhao YW, Sun XJ. Efficacy and safety of Deanxit combined with Wuling Capsule in treating post-stroke depression:a randomized controlled trial. Zhong Xi Yi Jie He Xue Bao, 2008, 6(3):258-261.
22. 郭英, 周峻偉.黛力新聯合烏靈膠囊治療腦卒中后抑郁的臨床療效和安全性觀察.大家健康(中旬版), 2013, 7(2):8-9.
23. 李書劍, 李燕.米氮平聯合烏靈膠囊治療老年卒中后抑郁對照研究.中國實用神經疾病雜志, 2013, 16(21):9-11.
24. 劉偉華.烏靈膠囊在治療腦卒中后抑郁患者中的應用.健康必讀(下旬刊), 2011, (10):317-317.
25. 史琦, 劉學源, 陳玉娟, 等.烏靈膠囊聯合氟西汀治療腦卒中后抑郁障礙和神經功能缺損的療效觀察.中成藥, 2008, 30(6):804-806.
26. 萬愛蘭, 袁也豐.烏靈膠囊與賽洛特治療腦卒中后抑郁障礙的療效對照.中國臨床康復, 2006, 10(31):4-6.
27. 吳玉紅, 王松齡, 蔣喜巧.黛力新合烏靈膠囊治療腦卒中后抑郁.光明中醫, 2013, 28(1):104-105.
28. 張莉莉, 梅健生, 張蘇莉.烏靈膠囊聯合黛力新對腦卒中后抑郁的療效觀察.當代醫學, 2010, 16(34):115-116.
29. 陳勇, 高林, 賀維亞.烏靈膠囊治療腦卒中后抑郁療效分析.中成藥, 2009, 31(4):503-504.
30. 向莉, 李書劍, 胡亞梅.烏靈膠囊聯合帕羅西汀治療卒中后抑郁療效觀察.中國實用神經疾病雜志, 2011, 14(15):36-38.
31. Robinson RG, Kubos KL, Starr LB, et al. Mood disorders in stroke patients:importance of location of lesion. Brain, 1984, 107(1):81-93.
32. 裘濤, 陳眉, 陶水良, 等.烏靈菌粉對腦卒中后抑郁大鼠海馬區單胺類神經遞質及行為學改變的影響.中國新藥雜志, 2007, 16(11):857-860.
33. Gainotti G, Azzoni A, Marra C. Frequency, phenomenology and anatomical-clinical correlates of major post-stroke depression. Br J Psychiatry, 1999, 175(8):163-167.
34. House A. Depression Associated with Stroke. J Neuropsychiatry Clin Neurosci, 1996, 8(4):453-457.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Wuling Capsule for Post Stroke Depression: A Systematic Review

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