Data_Sheet_1_Efficacy of Chinese herbal medicine on poststroke depression in animal models: A systematic review and meta-analysis.PDF

BackgroundPoststroke depression (PSD) is a common complication that can seriously affect patients' functional recovery and quality of life after a stroke. Various side effects have been found to be associated with the pharmacological therapies used for PSD. Studies have shown that Chinese herbal medicine (CHM) can effectively improve PSD-like behavior and neurological function in clinical and animal studies. The efficacy of CHM on PSD in animal models has not been systematically analyzed.
MethodsThe following electronic databases were searched for articles published up to September 2022: PubMed, Web of Science, the Cochrane Library, and Embase. Studies that reported the efficacy of CHM in animals with PSD and were written in English were included. Depression-like behavior and the neurological deficit score were assessed as measures of efficacy. The included studies assessed depression-like behavior using sucrose preference, open-field, forced swimming, and tail suspension tests, as well as body weight. The Review Manager version 5.4 and STATA version 13.1 software packages were used for the meta-analysis. The standardized mean difference (SMD) with 95% confidence intervals was used to assess all the outcomes. Subgroup analyses were performed to explore the sources of heterogeneity. The Egger's test and funnel plots were used to assess the potential publication bias. Sensitivity analyses were used to identify the stability of the results.
ResultsA total of 14 studies, including 12 CHMs involving 442 rats, fulfilled the inclusion criteria for meta-analysis. The pooled results showed that CHM significantly alleviated neurological deficits (−1.72 SMD, −2.47– −0.97) and was efficacious in improving the depression-like behavior of rats in the sucrose preference (2.08 SMD, 1.33–2.84), open-field (2.85 SMD, 1.88–3.83), forced swimming (−1.83 SMD, −2.23−1.44), and tail suspension tests (−1.35 SMD, −1.94−0.76).
ConclusionOur results suggest that CHM could significantly improve depression-like behavior and neurological function in animals with PSD. The current results should be interpreted with caution because only animal studies were included.

背景：卒中后抑郁（Poststroke depression, PSD）是卒中后常见并发症，可严重影响患者的功能康复与生活质量。现有研究发现，用于治疗卒中后抑郁的药物疗法常伴随多种不良反应。多项研究表明，在临床与动物实验中，中草药（Chinese herbal medicine, CHM）可有效改善卒中后抑郁样行为与神经功能，但目前尚未有研究对中草药在卒中后抑郁动物模型中的治疗效果开展系统性分析。
方法：本研究检索了截至2022年9月发表的相关文献，检索数据库包括PubMed、Web of Science、Cochrane图书馆及Embase。纳入以英文发表、报道中草药对卒中后抑郁动物模型治疗效果的研究。以抑郁样行为与神经功能缺损评分作为疗效评价指标。纳入的研究均通过蔗糖偏好实验、旷场实验、强迫游泳实验、悬尾实验以及体重检测来评估动物的抑郁样行为。本研究使用Review Manager 5.4版与STATA 13.1版软件开展荟萃分析，采用标准化均数差（standardized mean difference, SMD）结合95%置信区间对所有结局指标进行评价。通过亚组分析探究异质性来源，采用Egger检验与漏斗图评估潜在的发表偏倚，并通过敏感性分析检验研究结果的稳定性。
结果：最终共有14项符合荟萃分析纳入标准的研究被纳入，涉及12种中草药，共442只大鼠。合并分析结果显示，中草药可显著改善卒中后抑郁大鼠的神经功能缺损（SMD=-1.72，95%置信区间：-2.47~-0.97），并可有效改善大鼠的抑郁样行为：蔗糖偏好实验（SMD=2.08，95%置信区间：1.33~2.84）、旷场实验（SMD=2.85，95%置信区间：1.88~3.83）、强迫游泳实验（SMD=-1.83，95%置信区间：-2.23~-1.44）及悬尾实验（SMD=-1.35，95%置信区间：-1.94~-0.76）。
结论：本研究结果表明，中草药可显著改善卒中后抑郁动物模型的抑郁样行为与神经功能。由于本研究仅纳入动物实验，因此对该结果的解读需谨慎。