| Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of postpartum depression,and to provide a reference for the follow-up clinical researchMethods:Computer retrieval was performed on the following 11 databases,including 7 foreign language databases,namely Web of Science,Medline via Pubmed,Cochrane,Embase,PsyclNFO,ICTRP and Clinical Trails.There are 4 Chinese databases,namely CNKI,CBM,VIP and WANFANG.The retrieval date is January 1,2019.Manual retrieval was carried out on several TCM core journals,such as Clinical Journal of Traditional Chinese Medicine,China Journal of Traditional Chinese Medicine and Pharmacy,journal of zhejiang Chinese medical university,etc.The retrieval dates were all from January 1,2019.Retrieval of Grey literature or conference papers is achieved by searching Sciencepaper online and Open Grey.The selected literatures were analyzed and data were extracted.Meta-analysis and bias analysis were performed on the data obtained.HADM,EPDS,TESS were the main outcome indicators used in this study.Secondary outcome indicators included TCM syndrome score,SDS,SAS and adverse reactionsResults:A total of 30 randomized controlled trials with 2350 people were included.According to the control method,30 studies were divided into four subgroups,including 19 studies comparing traditional Chinese medicine(TCM)+western medicine group control western medicine group,3 studies comparing TCM group control western medicine group,5 studies comparing TCM group control psychological treatment group,3 studies comparing TCM group control placebo group.However,The overall methodological quality of the included studies was poor.And there is the possibility of bias1.The following results were obtained by analyzing 19 studies comparing TCM+western medicine control western medicine:(1)In terms of HAMD score,there was no statistically significant difference between the two groups at weekend 2 and weekend 3(P>0.01).However,the intervention group of integrated traditional Chinese and western medicine at 4 weeks and 6 weeks after intervention was lower than the single western medicine group,and the difference between the two groups was statistically significant(P<0.01).(2)In terms of the depression scale score reduction rate,the integrated traditional Chinese and western medicine group was more effective than the western medicine group,and the difference was statistically significant(P<0.01).(3)In terms of the improvement degree of TCM symptoms,the integrated Chinese and western medicine group was better than the single western medicine group,and the difference was statistically significant(P<0.01).(4)In terms of side effects,the side effect in the integrated Chinese and western medicine group were less than those western medicine group,and the difference was statistically significant(P<0.01),suggesting that patients should take traditional Chinese medicine together with western medicine in clinical practice.It can reduce the side effects of western medicine2.By analyzing three studies comparing TCM with western medicine,the following results were obtained:(1)in terms of HAMD score,there was no statistically significant difference between the two groups at weekends 2,4 and 6(P>0.01).(2)In the HAMD score reduction rate,there was no statistically significant difference between the two groups(P>0.01),and the evidence was insufficient to prove the effectiveness of the intervention group.3.Based on the analysis of 5 studies on TCM+psychotherapy control psychotherapy,the following results were obtained:(1)In terms of SDS and SAS scores,TCM+psychotherapy group was more effective in reducing depression and anxiety scores than pure psychotherapy group,and the difference was statistically significant(P<0.01).(2)In terms of the improvement degree of TCM symptoms,the treatment group was superior to the control group.4.Based on the analysis of 3 studies on Chinese medicine control placebo,the following results were obtained:(1)Chinese medicine was superior to the placebo group in terms of the reduction efficiency of EPDS,and the difference was statistically significant(P<0.01).(2)In terms of the improvement degree of TCM symptoms,the Chinese medicine group was superior to the placebo group.Conclusion:1.Compared with western medicine,integrated traditional Chinese and western medicine treatment can better improve the depression degree of PPD patients,and is more beneficial for patients with more than 4 weeks of intervention.2.Compared with western medicine,the combination of Chinese and western medicine can improve the TCM syndromes of PPD patients and reduce the side effects of western medicine.3.Compared with western medicine,the evidence is not enough to prove that Chinese medicine alone is more effective in treating PPD.4.Compared with psychological treatment alone,Chinese medicine combined with psychological treatment can effectively improve the degree of depression and anxiety of patients and improve the symptoms of Chinese medicine5.Compared with placebo,Chinese medicine can improve the depression degree of PPD patients. |
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