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Prescription of Chinese Herbal Medicine in Pattern-Based Traditional Chinese Medicine Treatment for Depression: A Systematic Review.

Yeung WF, Chung KF, Ng KY, Yu YM, Zhang SP, Ng BF, Ziea ET - Evid Based Complement Alternat Med (2015)

Bottom Line: Traditional Chinese medicine (TCM) treatments are often prescribed based on individuals' pattern diagnoses.Bai Shao (Paeonia lactiflora Pall.) and Chai Hu (Bupleurum chinense DC.) were commonly used across different TCM patterns regardless of the prescribed Chinese herbal formulas.The rationale underlying herb selection was seldom provided.

View Article: PubMed Central - PubMed

Affiliation: School of Chinese Medicine, University of Hong Kong, Hong Kong.

ABSTRACT
Traditional Chinese medicine (TCM) treatments are often prescribed based on individuals' pattern diagnoses. A systematic review of randomized controlled trials in Chinese and English literatures on TCM pattern-based treatment for depression has therefore been conducted. A total of 61 studies, 2504 subjects, and 27 TCM patterns were included. Due to the large variation of TCM pattern among participants, we only analyzed the top four commonly studied TCM patterns: liver qi depression, liver depression and spleen deficiency, dual deficiency of the heart, and spleen and liver depression and qi stagnation. We found that Xiaoyao decoction was the most frequently used herbal formula for the treatment of liver qi depression and liver depression with spleen deficiency, while Chaihu Shugan decoction was often used for liver depression and qi stagnation. Bai Shao (Paeonia lactiflora Pall.) and Chai Hu (Bupleurum chinense DC.) were commonly used across different TCM patterns regardless of the prescribed Chinese herbal formulas. The rationale underlying herb selection was seldom provided. Due to the limited number of studies on TCM pattern-based treatment of depression and their low methodological quality, we are unable to draw any conclusion regarding which herbal formulas have higher efficacy and which TCM patterns respond better to CHM.

No MeSH data available.


Related in: MedlinePlus

Study selection flowchart.
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Related In: Results  -  Collection


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fig1: Study selection flowchart.

Mentions: The search yielded 5097 potential titles for review, of which 929 were duplicated records and 3594 were excluded for reasons of irrelevance. The full text of 574 was retrieved for detailed assessment, of which 278 were excluded for various reasons (Figure 1). Of the 296 studies on CHM for depression, 61 of them examined pattern-based treatment. A total of 27 different TCM patterns were identified in the 61 studies. We analyzed the most commonly studied TCM patterns: liver qi depression, liver depression and spleen deficiency, dual deficiency of the heart and spleen, and liver depression and qi stagnation and liver-kidney yin deficiency. These four commonly studied TCM patterns were described in 42 of the 61 studies (68.9%) and involved 1762 subjects accounting for 70.4% of the total 2504 subjects (Table 1). Eighteen of the 42 studies examined CHM alone and the other 24 studies examined CHM plus antidepressants [24–65]. The 1762 participants had a mean age of 40.7 years, of which 59.0% were female. The participants were suffering from depression unspecified in 33 of the 42 studies, six studies on poststroke depression and three on depression comorbid with diabetes. The diagnosis of depression was based on 17-item or 24-item Hamilton Depression Rating Scale (HAMD17/24) in 36 studies, the Chinese Classification of Mental Disorder Second/Second-revised/Third Edition (CCMD-2/2-R/3) in 35 studies, Zung Self-rating Depression Scale (SDS) in seven studies, and one study each using DSM-IV, Clinical Global Impression Scale (CGI), and International Classification of Diseases Version 10 (ICD-10). The response to intervention was assessed by the HAMD17/24 in 34 studies and by effective rate in 33 studies.


Prescription of Chinese Herbal Medicine in Pattern-Based Traditional Chinese Medicine Treatment for Depression: A Systematic Review.

Yeung WF, Chung KF, Ng KY, Yu YM, Zhang SP, Ng BF, Ziea ET - Evid Based Complement Alternat Med (2015)

Study selection flowchart.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4477207&req=5

fig1: Study selection flowchart.
Mentions: The search yielded 5097 potential titles for review, of which 929 were duplicated records and 3594 were excluded for reasons of irrelevance. The full text of 574 was retrieved for detailed assessment, of which 278 were excluded for various reasons (Figure 1). Of the 296 studies on CHM for depression, 61 of them examined pattern-based treatment. A total of 27 different TCM patterns were identified in the 61 studies. We analyzed the most commonly studied TCM patterns: liver qi depression, liver depression and spleen deficiency, dual deficiency of the heart and spleen, and liver depression and qi stagnation and liver-kidney yin deficiency. These four commonly studied TCM patterns were described in 42 of the 61 studies (68.9%) and involved 1762 subjects accounting for 70.4% of the total 2504 subjects (Table 1). Eighteen of the 42 studies examined CHM alone and the other 24 studies examined CHM plus antidepressants [24–65]. The 1762 participants had a mean age of 40.7 years, of which 59.0% were female. The participants were suffering from depression unspecified in 33 of the 42 studies, six studies on poststroke depression and three on depression comorbid with diabetes. The diagnosis of depression was based on 17-item or 24-item Hamilton Depression Rating Scale (HAMD17/24) in 36 studies, the Chinese Classification of Mental Disorder Second/Second-revised/Third Edition (CCMD-2/2-R/3) in 35 studies, Zung Self-rating Depression Scale (SDS) in seven studies, and one study each using DSM-IV, Clinical Global Impression Scale (CGI), and International Classification of Diseases Version 10 (ICD-10). The response to intervention was assessed by the HAMD17/24 in 34 studies and by effective rate in 33 studies.

Bottom Line: Traditional Chinese medicine (TCM) treatments are often prescribed based on individuals' pattern diagnoses.Bai Shao (Paeonia lactiflora Pall.) and Chai Hu (Bupleurum chinense DC.) were commonly used across different TCM patterns regardless of the prescribed Chinese herbal formulas.The rationale underlying herb selection was seldom provided.

View Article: PubMed Central - PubMed

Affiliation: School of Chinese Medicine, University of Hong Kong, Hong Kong.

ABSTRACT
Traditional Chinese medicine (TCM) treatments are often prescribed based on individuals' pattern diagnoses. A systematic review of randomized controlled trials in Chinese and English literatures on TCM pattern-based treatment for depression has therefore been conducted. A total of 61 studies, 2504 subjects, and 27 TCM patterns were included. Due to the large variation of TCM pattern among participants, we only analyzed the top four commonly studied TCM patterns: liver qi depression, liver depression and spleen deficiency, dual deficiency of the heart, and spleen and liver depression and qi stagnation. We found that Xiaoyao decoction was the most frequently used herbal formula for the treatment of liver qi depression and liver depression with spleen deficiency, while Chaihu Shugan decoction was often used for liver depression and qi stagnation. Bai Shao (Paeonia lactiflora Pall.) and Chai Hu (Bupleurum chinense DC.) were commonly used across different TCM patterns regardless of the prescribed Chinese herbal formulas. The rationale underlying herb selection was seldom provided. Due to the limited number of studies on TCM pattern-based treatment of depression and their low methodological quality, we are unable to draw any conclusion regarding which herbal formulas have higher efficacy and which TCM patterns respond better to CHM.

No MeSH data available.


Related in: MedlinePlus