Meta-analysis Of Suitable TCM Techniques In The Treatment Of Postpartum Depression

Objective:Through meta-analysis,the advantages and efficiency of appropriate TCM techniques in the treatment of postpartum depression were summarized,so as to provide evidence-based medical evidence for appropriate TCM techniques in the treatment of postpartum depression,and to provide ideas and methods for clinical treatment of postpartum depression.Methods:Search CNKI、Wanfang Date、VIP、CBM、Pubmed、Embase、Cochrane Library,to collect randomized controlled trials of appropriate TCM techniques for the treatment of postpartum depression,the search terms were "postpartum depression","traditional Chinese medicine","acupuncture","massage","external treatment of traditional Chinese medicine","RCT" and other subject words and their corresponding free words,the retrieval time is set to January 1,2010 to December 31,2020.Two evaluators will independently select the research and conduct quality evaluation independently.Data will be extracted according to the predesigned form,if the two researchers have different opinions,they can discuss and solve the problem or be judged by the supervisor.The literature was screened according to the predetermined inclusion and exclusion criteria.Then,the Cochrane Risk Bias Assessment Tool was used to evaluate the quality of the Meta literatures to be included.The extracted data were analyzed using the Rev Man5.4 software available from the Cochrane Library.Result:A total of 25 randomized controlled trials with 1943 subjects were included in this meta-analysis.Meta-analysis results suggest that appropriate TCM techniques can improve clinical efficiency:(RR=1.21,95%CI= [1.12,1.30],Z=0.59,,P<0.05);lower the HAMD score:(MD=-1.44,95%CI=[-1.96,-0.93],Z=5.48,P<0.05),Results of HAMD 2 weeks: MD=-1.22,[-4.41,-2.34] P= 0.06>0.05,the difference was not statistically significant;Results of HAMD 4 weeks: MD=-1.74,[-2.79,-0.70],P=0.001 < 0.05;Reduce EPDS score(MD = 2.61,95% CI = [3.58,1.64],Z = 5.26,P < 0.05),Results of EPDS 2 weeks(MD=-1.,12 [-1.73,-0.52] P<0.05),Results of EPDS4 weeks MD=-1.88,[-2.53,-1.23],P<0.05,Results of EPDS 6 weeks MD=-3.82,[-6.06,-1.58],P<0.05;Raise estrogen levels(MD=36.85,95%CI=[27.48,46.21]Z=7.71,P<0.05);Increase progesterone levels(MD=9.96,95%CI=[5.98,13.94],Z=4.90,P<0.05);The combination of traditional Chinese medicine with basic treatment of western medicine can improve the clinical efficiency(RR=1.26,95%CI=[1.16,1.36],Z=5.60,P<0.05);lower the HAMD score:(MD=-2.88,95%CI=[-4.48,-1.28],Z=5.11,P<0.05),Results of HAMD 2 weeks: MD=-1.22,95%CI=[-4.41,-2.34] P=0.06>0.05,the difference was not statistically significant;Results of HAMD 4 weeks:MD=-3.08,95%CI=[-4.63,-1.53],P<0.05;Reduce EPDS score(MD=-2.96,95%CI=[-3.52,-2.40],Z=10.07,P<0.05),Results of EPDS 1 weeks(MD=-2.12[-2.84,-1.40],P<0.05),Results of EPDS 2 weeks(MD=-3.48,[-4.83,-2.12],P<0.05),Results of EPDS 4 weeks(MD=-1.88,[-2.53,-1.23],P<0.05),Results of EPDS 6 weeks(MD=-3.86,[-5.25,-2.48],P<0.05,Results of EPDS 8 weeks(MD=-2.83,[-3.62,-2.04],Z=7.00,P<0.05);there was no statistically significant reduction in SDS levels(MD=-2.77,95%CI=[-8.45-2.91],Z=0.96,P>0.05).Conclusions:1.The appropriate TCM techniques can significantly improve the clinical efficiency of postpartum depression.2.The appropriate TCM techniques can reduce the HAMD score and EPDS score of postpartum depression3.The combination of TCM techniques with basic treatment of western medicine can significantly improve the clinical efficiency of postpartum depression,and reduce the HAMD score and EPDS score of postpartum depression,and it is superior to the single western medicine basic treatment.4.TCM techniques can slow down the decline rate of estrogen and progesterone,but there are few studies involving this outcome index,and the evidence is not very sufficient5.The quality of the included literature in this study is not high,and some subgroups have high heterogeneity,so the results of this study should be treated with caution.6.Evidence-based medicine evidences show that the appropriate technology of traditional Chinese medicine in the treatment of postpartum depression has good clinical efficacy,less adverse reactions,simple and convenient operation,which is more acceptable to people and worthy of clinical promotion and use.