目的 系統(tǒng)評價口服中成藥治療卒中后抑郁的有效性和安全性。方法 檢索中國期刊全文數(shù)據(jù)庫（CNKI）、維普數(shù)據(jù)庫（VIP）、萬方數(shù)據(jù)庫、PubMed、Cochrane Library，檢索起止時間為建庫至2020年12月。由2位研究員獨立篩選文獻、提取資料并按照Jadad量表對文獻進行質(zhì)量評價，采用Stata 16.0軟件進行統(tǒng)計分析。結(jié)果 共納入59個研究，總樣本量6 074例，干預(yù)措施包括烏靈膠囊、舒肝解郁膠囊、解郁丸、養(yǎng)血清腦顆粒、益心舒膠囊、舒肝顆粒、甜夢口服液共7種中成藥。網(wǎng)狀Meta分析結(jié)果顯示，在漢密爾頓抑郁量表（HAMD）評分方面，累積概率排序為：舒肝顆粒+常規(guī)治療（90.3%）>舒肝解郁膠囊+常規(guī)治療（74.9%）>甜夢口服液+常規(guī)治療（67.4%）>益心舒膠囊+常規(guī)治療（55.0%）>烏靈膠囊+常規(guī)治療（47.7%）>解郁丸+常規(guī)治療（38.3%）>養(yǎng)血清腦顆粒+常規(guī)治療（25.7%）>常規(guī)治療（0.6%）。在抑郁臨床療效方面，累積概率排序為：解郁丸+西醫(yī)常規(guī)治療（74.5%）>烏靈膠囊+西醫(yī)常規(guī)治療（65.9%）>養(yǎng)血清腦顆粒+西醫(yī)常規(guī)治療（56.1%）>舒肝解郁膠囊+西醫(yī)常規(guī)治療（53.4%）>西醫(yī)常規(guī)治療（0.1%）。在美國國立衛(wèi)生研究院卒中量表（NIHSS）評分方面，累積概率排序為：舒肝顆粒+常規(guī)治療（95.6%）>養(yǎng)血清腦顆粒+常規(guī)治療（74.4%）>舒肝解郁膠囊+常規(guī)治療（61.8%）>解郁丸+常規(guī)治療（34.2%）>烏靈膠囊+常規(guī)治療（32.5%）>常規(guī)治療（1.5%）。在Barthel指數(shù)方面，養(yǎng)血清腦顆粒+常規(guī)治療（73.6%）>舒肝顆粒+常規(guī)治療（73.1%）>益心舒膠囊+常規(guī)治療（65.1%）>舒肝解郁膠囊+常規(guī)治療（61.7%）>烏靈膠囊+常規(guī)治療（26.1%）>常規(guī)治療（0.2%）。結(jié)論 對于卒中后抑郁患者，舒肝顆粒在HAMD量表和NIHSS評分方面療效排序靠前，解郁丸和養(yǎng)血清腦顆粒分別在抑郁臨床療效以及提高Barthel指數(shù)方面效果最好。但受納入研究質(zhì)量所限，且存在發(fā)表偏倚，該結(jié)論仍需開展高質(zhì)量研究進一步驗證，并根據(jù)中醫(yī)證型、病人情況進行選擇。

Objective To evaluate the efficacy and safety of Chinese patent medicine in the treatment of post-stroke depression. Methods China National Knowledge Infrastructure (CNKI), VIP database (VIP), Wanfang Database, PubMed and Cochrane Library were all searched until December 2020. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature according to the Jadad scale. Stata 16.0 was used for statistical analysis. Results A total of 57 studies were included, with a total sample size of 6 074 cases. The measures included 7 Chinese medicines, covering Wuling Capsule (WLC), Shugan Jieyu Capsule (SGJYC), Jieyu Pill (JYP), Yangxue Qingnao Granule (YXQNG), Yixinshu Capsule (YXSC), Shugan Granule (SGG), Tianmeng Oral Liquid (TMOL). On the part of HAMD, results of network meta analysis showed that the rank of cumulative probability was: SGG + CT (90.3%)>SGJYC + CT (74.9%)>TMOL + CT (67.4%)>YXSC + CT (55.0%)>WLC + CT (47.7%)>JYP + CT (38.3%)>YXQNG + CT (25.7%) >CT (0.6%). On the part of clinical effects in depression, results of network meta analysis showed that the rank of cumulative probability was: JYP + CT (74.5%)>WLC + CT (65.9%)>YXQNG + CT (56.1%)>SGJYC + CT (53.4%)>CT(0.1%). In terms of NIHSS, the rank of cumulative probability was: SGG + CT (95.6%)>YXQNG + CT (74.4%)>SGJYC + CT (61.8%)>JYP + CT (34.2%)>WLC + CT (32.5%)>CT (1.5%). In the aspect of Barthel index, the rank of cumulative probability was: YXQNG + CT (73.6%) >SGG + CT (73.1%)>YXSC + CT (65.1%)>SGJYC + CT (61.7%)>WLC + CT (26.1%)>CT (0.2%). Conclusion For patients with post-stroke depression, SGG had better effect in HAMD scale and NIHSS score, while JYP and YXQNG ranked first in improving clinical curative effects and Barthel index. However, limited by the quality of the included studies, this conclusion still needs to be further verified by highquality studies. Moreover, we should select Chinese patent medicines referring to TCM syndrome and patient condition.

R965.1;R971

北京市雙一流高層次人才科研經(jīng)費資助項目（1000041510053）