Herbal medicine (Gan Mai Da Zao decoction) for depression: A systematic review and meta-analysis of randomized controlled trials |
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| Institution: | 1. Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea;2. Hyundai Prime Silver Hospital, Gongju, South Korea;1. The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing 100029, China;2. School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China;3. College of Acupuncture and Orthopedics, Guizhou University of Traditional Chinese Medicine, Guiyang 550025, China;4. Fangshan Hospital, Beijing University of Chinese Medicine, Beijing 102400, China;1. Department of Cardiology, Guang''anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China;2. School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing 100029, China;1. School of Pharmacy, China Medical University, 77 Puhe Road, Shenyang 110122, PR China;2. Hubei Three Gorges Polytechnic, No.31 Stadium Road, Yichang 443000, PR China;1. Tianjin State Key Laboratory of Modern Chinese Medicine, School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;2. Division of Modernized Traditional Chinese Medicine, Tianjin Tasly Group Co., Ltd., Tianjin 300410, China;3. Tasly R&D Institute, Tianjin Tasly Group Co., Ltd., Tianjin 300410, China |
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| Abstract: | The objective of this review was to analyze the trial data on the efficacy and safety of Gan Mai Da Zao (GMDZ) decoction for depression. PubMed, the Cochrane Library, and EMBASE, AMED, Korea Med, DBPIA, OASIS, RISS, KISS, CNKI, Wan Fang Database, and VIP were searched through to May 2014. Randomized controlled trials (RCTs) testing GMDZ decoction for any type of depression were considered. All RCTs of GMDZ decoction or modified GMDZ decoction were included. Data were extracted by 2 independent reviewers. Meta-analysis was used for the pooled data. A total of 298 potentially relevant studies were identified, and 13 RCTs met our inclusion criteria. All of the included RCTs had a high risk of bias across their domains. Three RCTs failed to show favorable effects of GMDZ decoction on response rate or HAMD score in major depression. One RCT showed a beneficial effect of GMDZ decoction on response rate in post-surgical depression, while another failed to do so. Two studies showed favorable effects on response rate in post-stroke depression, while another two failed to do so. A meta-analysis, however, showed that GMDZ decoction produced better response rates than anti-depressants in post-stroke depression (RR: 1.17, I2 = 15%). One trial failed to show any beneficial effects of GMDZ decoction on response rate or HAMD score in depression in an elderly sample. Two trials tested GMDZ decoction in combination with anti-depressants but failed to show effects on response rate in major depression, while another did show beneficial effects on response rate in post-stroke depression. In summary, our systematic review and meta-analysis failed to provide evidence of the superiority of GMDZ decoction over anti-depressant therapies for major depression, post-surgical depression, or depression in the elderly, although there was evidence of an effect in post-stroke depression. The quality of evidence for this finding was low, however, because of a high risk of bias. |
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| Keywords: | Depression Gan Mai Da Zao (GMDZ) decoction Chinese herbal medicine |
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