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.	金卫斜, 钱敏护, 胡纪卵, 等.文拉法辛与三环类抗抑郁药物治疗抑郁症副作用的循证医学研究.循证医学, 2003, 3(4):215-218.
8.	马志章, 左萍萍.乌灵菌粉的镇静作用及其机理研究.中国药学杂志, 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.	各类脑血管病诊断要点.中华神经科杂志, 1995, 29(6):379-380.
11.	中华医学会精神科分会编.中国精神障碍分类方案与诊断标准.第3版.济南:山东科技出版社, 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.乌灵胶囊联合帕罗西汀治疗卒中后抑郁临床观察.中国实用神经疾病杂志, 2012, 15(22):75-76.
14.	胡春梅, 郭思思.乌灵胶囊治疗脑卒中后抑郁症60例临床分析.中成药, 2008, 30(8):附12-附13.
15.	胡军, 原琳琳.乌灵胶囊联合舍曲林治疗45例脑卒中后抑郁障碍的疗效观察.中国民康医学, 2009, 21(15):1882-1883.
16.	马云枝, 郑太昌, 田亚振, 等.乌灵胶囊治疗缺血性中风后抑郁症的临床研究.中医学报, 2012, 27(2):205-207.
17.	冉守连, 晏昆, 林涛, 等.乌灵胶囊治疗卒中后抑郁的临床研究.中成药, 2010, 32(7):1271-1272.
18.	冉守连, 晏昆, 林涛, 等.西酞普兰联合乌灵胶囊治疗卒中后抑郁的临床研究.齐齐哈尔医学院学报, 2012, 33(14):1885-1887.
19.	汪亚群, 宋水江, 江霞.乌灵胶囊合左洛复治疗脑卒中后抑郁的临床研究.浙江中医杂志, 2007, 42(4):202-203.
20.	徐彬, 周未莹.乌灵胶囊、百忧解治疗卒中后抑郁的疗效及其对卒中康复的影响:浙江省中西医结合学会神经内科专业委员会第五次学术研讨会中西医结合神经内科学习班资料汇编.中国浙江宁海:浙江省中西医结合学会神经内科专业委员会, 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, 周峻伟.黛力新联合乌灵胶囊治疗脑卒中后抑郁的临床疗效和安全性观察.大家健康(中旬版), 2013, 7(2):8-9.
23.	李书剑, 李燕.米氮平联合乌灵胶囊治疗老年卒中后抑郁对照研究.中国实用神经疾病杂志, 2013, 16(21):9-11.
24.	刘伟华.乌灵胶囊在治疗脑卒中后抑郁患者中的应用.健康必读(下旬刊), 2011, (10):317-317.
25.	史琦, 刘学源, 陈玉娟, 等.乌灵胶囊联合氟西汀治疗脑卒中后抑郁障碍和神经功能缺损的疗效观察.中成药, 2008, 30(6):804-806.
26.	万爱兰, 袁也丰.乌灵胶囊与赛洛特治疗脑卒中后抑郁障碍的疗效对照.中国临床康复, 2006, 10(31):4-6.
27.	吴玉红, 王松龄, 蒋喜巧.黛力新合乌灵胶囊治疗脑卒中后抑郁.光明中医, 2013, 28(1):104-105.
28.	张莉莉, 梅健生, 张苏莉.乌灵胶囊联合黛力新对脑卒中后抑郁的疗效观察.当代医学, 2010, 16(34):115-116.
29.	陈勇, 高林, 贺维亚.乌灵胶囊治疗脑卒中后抑郁疗效分析.中成药, 2009, 31(4):503-504.
30.	向莉, 李书剑, 胡亚梅.乌灵胶囊联合帕罗西汀治疗卒中后抑郁疗效观察.中国实用神经疾病杂志, 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.	裘涛, 陈眉, 陶水良, 等.乌灵菌粉对脑卒中后抑郁大鼠海马区单胺类神经递质及行为学改变的影响.中国新药杂志, 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. 金卫斜, 钱敏护, 胡纪卵, 等.文拉法辛与三环类抗抑郁药物治疗抑郁症副作用的循证医学研究.循证医学, 2003, 3(4):215-218.
8. 马志章, 左萍萍.乌灵菌粉的镇静作用及其机理研究.中国药学杂志, 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. 各类脑血管病诊断要点.中华神经科杂志, 1995, 29(6):379-380.
11. 中华医学会精神科分会编.中国精神障碍分类方案与诊断标准.第3版.济南:山东科技出版社, 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.乌灵胶囊联合帕罗西汀治疗卒中后抑郁临床观察.中国实用神经疾病杂志, 2012, 15(22):75-76.
14. 胡春梅, 郭思思.乌灵胶囊治疗脑卒中后抑郁症60例临床分析.中成药, 2008, 30(8):附12-附13.
15. 胡军, 原琳琳.乌灵胶囊联合舍曲林治疗45例脑卒中后抑郁障碍的疗效观察.中国民康医学, 2009, 21(15):1882-1883.
16. 马云枝, 郑太昌, 田亚振, 等.乌灵胶囊治疗缺血性中风后抑郁症的临床研究.中医学报, 2012, 27(2):205-207.
17. 冉守连, 晏昆, 林涛, 等.乌灵胶囊治疗卒中后抑郁的临床研究.中成药, 2010, 32(7):1271-1272.
18. 冉守连, 晏昆, 林涛, 等.西酞普兰联合乌灵胶囊治疗卒中后抑郁的临床研究.齐齐哈尔医学院学报, 2012, 33(14):1885-1887.
19. 汪亚群, 宋水江, 江霞.乌灵胶囊合左洛复治疗脑卒中后抑郁的临床研究.浙江中医杂志, 2007, 42(4):202-203.
20. 徐彬, 周未莹.乌灵胶囊、百忧解治疗卒中后抑郁的疗效及其对卒中康复的影响:浙江省中西医结合学会神经内科专业委员会第五次学术研讨会中西医结合神经内科学习班资料汇编.中国浙江宁海:浙江省中西医结合学会神经内科专业委员会, 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, 周峻伟.黛力新联合乌灵胶囊治疗脑卒中后抑郁的临床疗效和安全性观察.大家健康(中旬版), 2013, 7(2):8-9.
23. 李书剑, 李燕.米氮平联合乌灵胶囊治疗老年卒中后抑郁对照研究.中国实用神经疾病杂志, 2013, 16(21):9-11.
24. 刘伟华.乌灵胶囊在治疗脑卒中后抑郁患者中的应用.健康必读(下旬刊), 2011, (10):317-317.
25. 史琦, 刘学源, 陈玉娟, 等.乌灵胶囊联合氟西汀治疗脑卒中后抑郁障碍和神经功能缺损的疗效观察.中成药, 2008, 30(6):804-806.
26. 万爱兰, 袁也丰.乌灵胶囊与赛洛特治疗脑卒中后抑郁障碍的疗效对照.中国临床康复, 2006, 10(31):4-6.
27. 吴玉红, 王松龄, 蒋喜巧.黛力新合乌灵胶囊治疗脑卒中后抑郁.光明中医, 2013, 28(1):104-105.
28. 张莉莉, 梅健生, 张苏莉.乌灵胶囊联合黛力新对脑卒中后抑郁的疗效观察.当代医学, 2010, 16(34):115-116.
29. 陈勇, 高林, 贺维亚.乌灵胶囊治疗脑卒中后抑郁疗效分析.中成药, 2009, 31(4):503-504.
30. 向莉, 李书剑, 胡亚梅.乌灵胶囊联合帕罗西汀治疗卒中后抑郁疗效观察.中国实用神经疾病杂志, 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. 裘涛, 陈眉, 陶水良, 等.乌灵菌粉对脑卒中后抑郁大鼠海马区单胺类神经递质及行为学改变的影响.中国新药杂志, 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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