2023 年第 12 期 第 18 卷

逍遥散加减辅助治疗高血压病合并焦虑抑郁有效性与安全性的Meta分析

Meta-analysis of the efficacy and safety of modified Xiaoyao powder in the adjuvant treatment of hypertension combined with anxiety and depression

作者：罗山河黄凯琳王茜张雨晴许露馨吴焕林

英文作者：Luo Shanhe Huang Kailin Wang Xi Zhang Yuqing Xu Luxin Wu Huanlin

单位：北京中医药大学东直门医院心内科，北京100700

英文单位：Department of Cardiology Dongzhimen Hospital Beijing University of Chinese Medicine Beijing 100700 China

关键词：高血压病；焦虑；抑郁；逍遥散；Meta分析

英文关键词：Hypertension;Anxiety;Depression;Xiaoyaopowder;Meta-analysis

• 摘要：

• 目的  使用Meta分析方法系统评价逍遥散加减联合常规西药治疗高血压病合并焦虑抑郁的临床效果。方法  系统检索中国期刊全文数据库、中国生物医学文献数据库、维普中文科技期刊数据库、万方数据库4个中文数据库及PubMed、Web of Science数据库、Springer Link、EMBASE、Cochrane Library 5个英文数据库，筛选从建库至2023年4月逍遥散及其加减方治疗高血压病合并焦虑抑郁的临床随机对照试验，根据纳入排除标准进行文献筛选，提取筛选出文献的相关资料并进行文献质量评价。观察组为逍遥散系列加减+常规西医治疗，对照组为常规西医治疗。应用Review Manager 5.4.1软件进行统计学分析，评价所纳入研究观察组和对照组的治疗效果和安全性差异。结果  共纳入10项研究，884例高血压病合并焦虑抑郁患者。Meta分析结果显示观察组在降低收缩压（均数差=-9.54，95%置信区间：-11.33～-7.74，Z=10.42，P＜0.000 01）与舒张压（均数差=-7.89，95%置信区间：-9.34～-6.44，Z=10.70，P＜0.000 01）、C反应蛋白、白细胞介素1β、血管紧张素Ⅱ、细胞间黏附分子1，升高5-羟色胺、一氧化氮水平方面的效果均优于对照组，同时观察组在降低临床焦虑抑郁相关评分（焦虑自评量表、抑郁自评量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表和9项患者健康问卷）方面均较对照组有优势，且不良反应较少，差异均有统计学意义（均P≤0.05）。结论  在高血压病合并焦虑抑郁患者中，在常规西药治疗基础上加用逍遥散加减方可降低血压，改善患者焦虑抑郁等相关症状，改善相关实验室检查指标，且不良反应较少。

• Objective To systematically evaluate the clinical effect of modified Xiaoyao powder combined with conventional western medicine in the treatment of hypertension combined with anxiety and depression by Meta-analysis. Methods Four Chinese databases including China National Knowledge Infrastructure, China Biology Medicine disc, VIP Chinese Science and Technology Journal Database, Wanfang Database and five English databases including PubMed, Web of Science database, Springer Link, EMBASE, Cochrane Library were systematically searched. Randomized controlled trials of Xiaoyao powder and its modified prescriptions in the treatment of hypertension combined with anxiety and depression from the establishment of the database to April 2023 were screened. According to the inclusion and exclusion criteria, the literature was screened, the relevant data of the screened literature was extracted, and the quality of the literature was evaluated. The observation group was treated with Xiaoyao powder series plus conventional western medicine, and the control group was treated with conventional western medicine. Review Manager 5.4.1 software was used for statistical analysis to evaluate the differences in therapeutic effect and safety between the observation group and the control group. Results  A total of 10 studies involving 884 hypertensive patients with anxiety and depression were included. Meta-analysis results showed that the observation group showed better results at reducing systolic blood pressure(mean difference=-9.54, 95% confidence interval: -11.33--7.74, Z=10.42, P＜0.000 01), diastolic blood pressure(mean difference=-7.89， 95% confidence interval: -9.34--6.44, Z=10.70, P＜0.000 01), C-reactive protein, interlenkin-1β, angiotensin Ⅱ and intercellular cell adhesion molecule-1, and increasing 5-hydroxytryptamine and nitric oxide. At the same time, the observation group had advantages in reducing clinical anxiety and depression related scores(Self-Rating Anxiety Scale, Self-Rating Depression Scale, Hamilton Anxiety Scale, Hamilton Depression Scale, and Patient Health Questionare-9) compared with the control group, and there were fewer adverse reactions (all P≤0.05). Conclusions  In patients with hypertension combined with anxiety and depression, the addition of modified Xiaoyao powder on the basis of conventional western medicine treatment can reduce blood pressure, improve the related symptoms such as anxiety and depression, and improve the related laboratory test indicators, with fewer adverse reactions.