Table 1.
Characteristics of included randomized controlled trials.
| Study ID | Diagnosis standard | Sample size I/C |
Age (year) I/C |
Course of disease I/C |
Syndrome differentiation of TCM | Therapeutical method of TCM | Intervention | Control | Duration | Follow-up | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cai 2015 [28] | CCMD-III | 71/40 | 32.5 ± 4.5/34.5 ± 2.5 | 41.6 ± 6.7 d/39.7 ± 5.3 d | Stagnation of liver and la tortura and deficiency of both heart and spleen | Relieving liver qi and invigorating the spleen, tonifying qi and blood. | Shugan jianpi kaixin decoction + sertraline + vitamin D drops + cognitive therapy, behaviour therapy + relaxation therapy + music therapy | Sertraline + vitamin D drops + cognitive therapy, behaviour therapy + relaxation therapy + music therapy | NR | NR | Effective rate, HAMD scores, EPDS scores, SCL-90 scores |
|
| |||||||||||
| Chen et al. 2015 [29] | CCMD-III | 30/30 | 26.1 ± 1.2/25.3 ± 0.4 | 0.87 ± 0.14 y/0.85 ± 0.16 y | NR | NR | Fuling shenzhi shuangxin pill + sertraline hydrochloride tablets, fluoxetine hydrochloride tables | Sertraline hydrochloride tablets, fluoxetine hydrochloride tables | 4 m | NR | Effective rate, adverse events |
|
| |||||||||||
| Chen et al. 2011 [30] | DSM-IV | 38/38 | 30.2 ± 1.5/30.0 ± 1.8 | 3.8 ± 1.2 m/4.1 ± 1.0 m | NR | NR | Self-made qingyu pingxin decoction + Fluoxetine | Fluoxetine | 1 m | NR | Effective rate, adverse events |
|
| |||||||||||
| Ding et al. 2010 [31] | DSM-IV | 40/30 | 27.46 ± 5.215/25.42 ± 4.441 | 27.15 ± 11.841 d/24.21 ± 9.718 d | NR | NR | Modification decoction of xiaoyao san + Mirtazapine | Mirtazapine | 8 w | NR | Obvious effective rate, effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Fan 2011 [32] | DSM-IV | 52/52 | 29.3/28.6 | 35.5 d/37.7 d | NR | NR | Modification mixture of tianwang buxin decoction + fluoxetine | Fluoxetine | 4 w | 6 m | Effective rate, adverse events |
|
| |||||||||||
| Fang 2014 [33] | CCMD-III | 57/56 | 26.8 ± 2.9/27.4 ± 3.2 | 11.2 ± 3.8 w/10.5 ± 3.5 w | NR | NR | Self-made tiaoxue jieyu decoction + venlafaxine hydrochloride sustained-release tablets | Venlafaxine hydrochloride sustained-release tablets | 8 w | NR | SAS scores, MADRS scores, adverse events |
|
| |||||||||||
| Gao 2010 [34] | DSM-IV | 36/28 | 25–35/25–35 | NR | NR | Tonifying qi and blood, psyche-nourishing and tranquilizing mind. | Modification mixture of yulin decoction | Fluoxetine | 6 w | NR | Effective rate, adverse events |
|
| |||||||||||
| Guo et al. 2011 [35] | DSM-IV | 38/34 | 26.14 ± 2.5/25.84 ± 2.7 | NR | NR | Strengthening heart and spleen, relieving liver qi stagnation. | Modification decoction of chaihu shugan san and ganmai dazao tang | Fluoxetine | 4 w | NR | HAMD scores, effective rate, adverse events |
|
| |||||||||||
| Hao 2015 [36] | DSM-IV | 28/28 | 27 ± 9/27 ± 8 | 24.5 ± 2.8 w/23.4 ± 3.2 w | NR | NR | Shugan jieyu capsule + citalopram | Citalopram | 6 w | NR | HAMD scores, effective rate, adverse events |
|
| |||||||||||
| He and Ren 2008 [37] | DSM-IV | 47/44 | 26.1 ± 2.5/25.8 ± 2.7 | NR | NR | NR | Modification decoction of xiaoyao san + fluoxetine | Fluoxetine | 4 w | NR | HAMD scores, effective rate, adverse events |
|
| |||||||||||
| Hu 2013 [38] | DSM-IV | 50/50 | 27.6 ± 2.5/26.3 ± 2.7 | 21 ± 5.4 d/22 ± 5.5 d | NR | NR | Xiaoyao pill + fluoxetine | Fluoxetine | 6 w | NR | Effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Jiang et al. 2012 [39] | CCMD-III | 35/35 | 27 ± 5.4/26 ± 5.7 | 4.5 ± 0.8 m/4.7 ± 0.9 m | NR | NR | Zhen yuan capsule + duloxetine | Duloxetine | 8 w | NR | HAMD scores, cure rate, effective rate, adverse events |
|
| |||||||||||
| Jin and Ying 2013 [40] | DSM-IV | 50/50 | 26 ± 3/27.0 ± 2.5 | 7 ± 4 m/8 ± 3 m | NR | Strengthening heart and spleen, relieving liver qi stagnation. | Shugan jieyu capsule + paroxetine | Paroxetine | 8 w | NR | Effective rate, HAMD scores |
|
| |||||||||||
| Lei and Fu 2015 [41] | CCMD-III, DSM-V | 49/49 | 27.38 ± 5.69/27.68 ± 5.53 | NR | NR | NR | Jieyu xiaoyou decoction + amitriptyline | Amitriptyline | 6 w | NR | Cure rate, effective rate, EPDS scores, adverse events |
|
| |||||||||||
| Li et al. 2013 [42] | DSM-IV | 75/75 | 25.4 ± 3.6/25.8 ± 3.2 | NR | NR | NR | Modification decoction of taohe chengqi and xiao chaihu | Fluoxetine | 6 w | NR | EPDS scores, HAMD scores, effective rate, adverse events |
|
| |||||||||||
| Li and Zhang 2014 [43] | DSM-IV | 30/30 | 26.4 ± 6.5/26.4 ± 6.5 | NR | NR | NR | Self-made jieyu xiaoyou decoction + fluoxetine | Fluoxetine | 4 w | 6 m | Effective rate, adverse events |
|
| |||||||||||
| Liang et al. 2012 [44] | DSM-IV | 60/60 | 26.12 ± 4.1/25.74 ± 5.01 | 22 ± 7.65 d/21 ± 6.73 d | NR | NR | Xiaoyao pill + fluoxetine | Fluoxetine | 6 w | NR | Effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Lin et al. 2008 [45] | DSM-IV | 37/31 | 27.14 ± 4.75/26.57 ± 4.16 | NR | NR | Relieving liver qi and invigorating the spleen. | Electuary of xiaoyao san + paroxetine | Paroxetine | 6 w | NR | Effective rate, obvious effective rate, HAMD scores |
|
| |||||||||||
| Liu 2015 [46] | CCMD-III | 43/39 | 29.23 ± 8.91/28.39 ± 8.31 | NR | Deficiency of qi and blood | NR | Huo li su oral liquid + sertraline hydrochloride | Sertraline hydrochloride | 8 w | NR | HAMD scores, aerum norepinephrine, aerum 5-hydroxytryptamine, effective rate, adverse events |
|
| |||||||||||
| Lv 2007 [47] | DSM-IV | 30/30 | 24.9 ± 2.1/25.2 ± 1.8 | NR | Deficiency of both heart and spleen | Strengthening heart and spleen. | Gui pi decoction + supportive psychotherapy | Supportive psychotherapy | 4 w | NR | Effective rate, HAMD scores, estradiol, progesterone |
|
| |||||||||||
| Mi et al. 2014 [48] | DSM-IV | 43/43 | 31.23 ± 5.33/31.48 ± 5.81 | 10.19 ± 2.98 d/11.09 ± 2.01 d | Liver depression and spleen deficiency | Invigorating the spleen and regulating the liver. | Decoction of jianpi tiaogan + fluoxetine hydrochloride dispersible tablets | Fluoxetine hydrochloride dispersible tablets | 4 w | NR | Effective rate, EPDS scores |
|
| |||||||||||
| Pan and Wu 2013 [49] | CCMD-III | 30/30 | 26.23 ± 33.45/25.68 ± 35.26 | 1.56 ± 1.25 m/1.45 ± 1.50 m | NR | NR | Pill of danzi xiaoyao san + Venlafaxine | Venlafaxine | 12 w | 24 w | Obvious effective rate, effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Qian 2014 [50] | DSM-IV | 39/38 | 25.7 ± 4.5/25.3 ± 4.4 | 4.2 ± 2.3 m/4.3 ± 2.5 m | NR | NR | Shugan jieyu capsule | Paroxetine | 8 w | NR | HAMD scores, effective rate, adverse events |
|
| |||||||||||
| Ran 2013 [21] | DSM-IV | 42/40 | 30.26 ± 3.57/31.26 ± 4.05 | NR | NR | NR | Decoction of danzhi xiaoyao san + venlafaxine hydrochloride sr capsules + health and physical education + psychological counseling | Venlafaxine hydrochloride sr capsules + health and physical education + psychological counseling | 12 w | NR | HAMD scores, clinical control rate, effective rate |
|
| |||||||||||
| Ren 2009 [51] | DSM-IV | 30/30 | 25.6/26.1 | 12.5 d/12.1 d | NR | NR | Modification decoction of xiaoyao san + Fluoxetine | Fluoxetine | 6 w | NR | Effective rate, adverse events |
|
| |||||||||||
| Shao et al. 2011 [52] | DSM-IV | 50/50 | 28.1/28.4 | 29.5 d/37.3 d | NR | Relieving liver qi stagnation, tranquilizing the mind, regulating spleen and stomach. | Xiao chaihu decoction + paroxetine | Paroxetine | 30 d | NR | Effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Shi 2013 [53] | DSM-IV | 40/36 | 29/29 | NR | NR | NR | Self-made liqi yangxue decoction + Fluoxetine hydrochloride | Fluoxetine hydrochloride | 4 w | NR | Effective rate, adverse events |
|
| |||||||||||
| Su 2014 [54] | DSM-IV | 59/29 | 21.8/25.4 | 22.5 d/24.3 d | NR | Nourishing the blood and tranquilizing mind, regulate qi removing stagnation. | Shugan jieyu decoction + paroxetine | Paroxetine | 6 w | NR | Cure rate, HAMD scores, adverse events |
|
| |||||||||||
| Sun 2012 [55] | DSM-IV | 32/33 | 23.7 ± 2.6/23.4 ± 2.7 | 127.4 ± 33.7 d/129.3 ± 34.6 d | NR | Relieving liver qi stagnation, blood activating and stasis dissolving, regulating psychiatry. | Modification decoction of xiaoyao san + fluoxetine | Fluoxetine | 3 m | NR | HAMD scores, obvious effective rate, effective rate, adverse events |
|
| |||||||||||
| Wang et al. 2011 [56] | DSM-IV | 27/29 | 29.2 ± 1.6/29.4 ± 1.9 | 4.6 ± 1.4 m/4.5 ± 1.2 m | NR | Enriching blood, stabling qi, relieving qi stagnation. | Self-made rougan decoction + fluoxetine | Fluoxetine | 4 w | NR | Effective rate, adverse events |
|
| |||||||||||
| Wang 2012 [57] | DSM-IV | 30/30 | 30.07 ± 3.3/30.43 ± 3.43 | NR | Deficiency of both heart and spleen | Strengthening heart and spleen. | Shenqi jieyu granules | Placebo | 6 w | NR | Effective rate, clinical control rate, EPDS scores, Chinese medicine symptom score, estradiol, progesterone, adverse events |
|
| |||||||||||
| Wang et al. 2015 [58] | DSM-IV | 46/46 | 27.3 ± 4.6/28.1 ± 4.1 | NR | Stagnation of liver qi | NR | Modification mixture of self-made jieyu rougan decoction + mirtazapine + vitamin D drops + psychological counseling | Mirtazapine + vitamin D drops + psychological counseling | 6 w | NR | Effective rate, HAMD scores |
|
| |||||||||||
| Wang et al. 2014 [59] | DSM-IV | 31/32 | 31.23 ± 2.22/32.01 ± 1.79 | 9.39 ± 4.28 d/9.03 ± 3.69 d | NR | NR | Wu ling capsule + sertraline hydrochloride | Sertraline hydrochloride | 4 w | NR | Effective rate, estradiol, progesterone, serum OFQ level, serum 5-hydroxytryptamine, adverse events |
|
| |||||||||||
| Wei et al. 2009 [60] | CCMD-III | 32/32 | 27.38 ± 5.135/26.72 ± 4.658 | 27.03 ± 11.956 d/26.09 ± 9.663 d | Both of liver depression and spleen deficiency and stagnant heat | NR | Xiaoyao pill + sertraline | Sertraline | 6 w | NR | Obvious effective rate, effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Wu et al. 2014 [61] | DSM-IV | 35/35 | 23.7 ± 2.6/24.5 ± 2.7 | NR | NR | Relieving liver qi stagnation, blood activating and stasis dissolving, regulating psychiatry. | Xiaoyao powder + Sertraline | Sertraline | 3 m | NR | HAMD scores, obvious effective rate, effective rate, adverse events |
|
| |||||||||||
| Xu et al. 2006 [62] | DSM-IV | 30/15 | 27.6/27.4 | 38.6 d/37.3 d | NR | NR | Bu xin pill | Paroxetine | 3–6 m | NR | Effective rate, cure rate, adverse events |
|
| |||||||||||
| Xu et al. 2013 [63] | DSM-IV | 50/50 | 30.43 ± 3.43/30.07 ± 3.34 | NR | Kidney deficiency and liver stagnation | Nourishing kidney deficiency, regulating qi and tranquilizing the mind. | Yinao jieyu fang granule | Placebo | 6 w | NR | Effective rate, estradiol, progesterone, adverse events |
|
| |||||||||||
| Zhang et al. 2014 [64] | ICD-X | 48/48 | 27.03 ± 5.12/26.72 ± 4.67 | 27.38 ± 11.95 d/26.09 ± 9.66 d | NR | NR | Shugan jieyu capsule | Fluoxetine | 6 w | NR | Effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Zhang 2015 [65] | CCMD-III | 48/48 | 26.8 ± 4.3/25.9 ± 4.8 | 4.3 ± 0.7 m/4.1 ± 0.8 m | NR | NR | Shugan jieyu capsule | Citalopram | 6 w | NR | HAMD scores, effective rate, adverse events |
|
| |||||||||||
| Zhang and Liu 2009 [66] | DSM-IV | 46/42 | 29.04 ± 3.9/29.12 ± 4.26 | 38.2 d/41.7 d | NR | NR | Wu ling capsule + fluoxetine + psychological therapy | Fluoxetine + psychological therapy | 6 w | NR | HAMD scores, effective rate, adverse events |
|
| |||||||||||
| Zhao and Lin 2006 [67] | DSM-IV | 45/42 | 29.04 ± 3.99/29.12 ± 4.26 | NR | NR | Normalizing qi dynamic | Decoction of chaihu shugan san + fluoxetine | Fluoxetine | 4 w | NR | HAMD scores, effective rate, adverse events |
|
| |||||||||||
| Zheng 2013 [68] | DSM-IV | 54/54 | 30.44 ± 5.2/30.56 ± 5.13 | 10.28 ± 3.35 d/9.48 ± 3.35 d | Deficiency of qi and blood and blood stasis | Strengthening primordial qi, activating and nourishing blood, tranquilize the mind. | Shen gui ren mixture + psychological counseling | Psychological counseling | 6 w | NR | Effective rate, EPDS scores, Chinese medicine symptom score, adverse events |
|
| |||||||||||
| Zheng 2015 [26] | DSM-IV | 39/39 | 28.6 ± 4.1/29.0 ± 4.3 | 4.2 ± 0.5 m/4.0 ± 0.4 m | NR | Relieving liver qi stagnation, blood-activating and stasis-dissolving, d regulating psychiatry. | Decoction of shenghua xiaoyao san + paroxetine | Paroxetine | 8 w | NR | Effective rate, adverse events |
|
| |||||||||||
| Zhou 2013 [69] | CCMD-III | 25/25 | 22–32/22–32 | NR | NR | NR | Self-made yangxue ningshen decoction + sertraline | Sertraline | 40 d | NR | Effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Zhou et al. 2015 [70] | DSM-IV | 30/30 | 26.15 ± 2.6/25.85 ± 2.9 | NR | NR | NR | Modification mixture of yueju wan and ganmai dazao tang + psychological therapy | Psychological therapy | 4 w | NR | HAMD scores, effective rate |
|
| |||||||||||
| Zhu 2008 [71] | DSM-IV | 50/50 | 28.1/28.4 | 25.9 d/37.3 d | NR | NR | Yangxin jieyu decoction | Paroxetine | 30 d | NR | Effective rate, HAMD scores, adverse events |
|
| |||||||||||
| Zhu 2014 [72] | DSM-IV | 32/31 | 23.32 ± 1.86/23.42 ± 2.06 | NR | NR | Relieving liver qi stagnation, enriching blood and promoting blood flow, enriching blood to anchor the mind, clearing heat and relieving fidgetiness. | Modification mixture of suan zao ren decoction | Paroxetine | 4 w | NR | Effective rate, HAMD scores, adverse events |
I: intervention group; C: control group; TCM: traditional Chinese medicine; DSM: diagnostic and statistical manual of mental disorders; CCMD: Chinese classification of mental disorders; ICD: international classification of diseases; NR: not reported; d: day; w: week; m: month.