Role of Medicinal Plants for Liver‐Qi Regulation Adjuvant Therapy in Post‐stroke Depression: A Systematic Review of Literature

Abstract

Current evidence demonstrated certain beneficial effects of medicinal herbs as an adjuvant therapy for poststroke depression (PSD) in China; Chai-hu (Chinese Thorowax Root, Radix Bupleuri) is an example of a medicinal plant for Liver-Qi regulation (MPLR) in the treatment of PSD. Despite several narrative reports on the antidepressant properties of MPLR, it appears that there are no systematic reviews to summarize its outcome effects. Therefore, the aim of this review was to assess the effectiveness and safety of MPLR adjuvant therapy in patients with PSD. Seven databases were extensively searched from January 2000 until July 2016. Randomized control trials (RCTs) involving patients with PSD that compared treatment with and without MPLR were taken into account. The pooled effect estimates were calculated based on Cochrane Collaboration's software RevMan 5.3. Finally, 42 eligible studies with 3612 participants were included. Overall, MPLR adjuvant therapy showed a significantly higher effective rate (RR = 1.23; 95% CI = 1.19, 1.27; p < 0.00001) compared to those without. Moreover, the administration of MPLR was superior to abstainers regarding Hamilton Depression Scale (HAMD) score changes after 3 weeks (WMD = À4.83; 95% CI = À6.82, À2.83; p < 0.00001), 4 weeks (WMD = À3.25; 95% CI = À4.10, À2.40; p < 0.00001), 6 weeks (WMD = À4.04; 95% CI = À5.24, À2.84; p < 0.00001), 8 weeks (WMD = À4.72; 95% CI = À5.57, À3.87; p < 0.00001), and 12 weeks (WMD = À3.07; 95% CI = À4.05, À2.09; p < 0.00001). In addition, there were additive benefits in terms of response changes for the National Institutes of Health Stroke Scale (NIHSS) and other self-rating scores. No frequently occurring or serious adverse events were reported. We concluded that there is supporting evidence that adjuvant therapy with MPLR is effective in reducing the depressive symptoms and enhancing quality of life for patients with PSD. More well-designed RCTs are necessary to explore the role of MPLR in the treatment of PSD.

Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho‐oncologic relevance

“…Previous reviews have documented herbal remedies for the treatment of depression and/or anxiety (Bandelow et al, ; Ernst, ; Farah et al, ; Lakhan & Vieira, ; Muszynska, Lojewski, Rojowski, Opoka, & Sulkowska‐Ziaja, ; Sarris, Panossian, Schweitzer, Stough, & Scholey, ; Zeng et al, ). One study used polyherbal formulas for both symptoms (Liu et al, ).…”

Evidence‐based practice guideline on integrative medicine for stroke 2019

“…The Hamilton Depression Scale (HAMD) is a widely used clinician‐reporting tool for assessing poststroke depression in China and has a minimal clinically important difference of 7 points in terms of the MD and 0.875 in terms of the standardized mean difference 88 . A systematic review in 2016 89 showed that Chinese herbal medicine that soothes the liver and regulates qi used in addition to antidepressant medication achieved a greater reduction in HAMD scores by relieving signs and symptoms of poststroke depression (MD = –3.25, 95% CI –4.10 to –2.40 after 4 weeks of treatment; MD = –4.04, 95% CI –5.24 to –2.84, after 6 weeks of treatment; MD = –4.72, 95% CI –5.57 to –3.87, after 8 weeks of treatment; MD = –3.07, 95% CI –4.05 to –2.09, after treatment for 12 weeks). The quality of evidence was low because of the risk of bias and heterogeneity.…”

<p>Research Progress on Classical Traditional Chinese Medicine Jieyu Pills in the Treatment of Depression</p>

“…It is used to treat liver qi stagnation, chest and rib pain, anal prolapse, uterine prolapse, and irregular menstruation. In recent years, research on the application of RB has mainly focused on its use against depression, 24 for inhibiting cancer growth and metastasis, 25 anti-hepatitis B virus (HBV) effects, 26 antioxidative, anti-inflammatory, and hepatoprotective effects, 27 antimicrobial, antiviral, hepatoprotective, neuroprotective, and immunomodulatory effects, 28,29 antiepileptic effect, 30 and its use for treating AD. 31 Although there is an extensive range of clinical applications of RB, recent research has mainly focused on its antidepressant effect.…”