Xiaoyao pill for treatment of functional dyspepsia in perimenopausal women with depression

AIM: To evaluate the efficacy and safety of the Xiaoyao pill for treatment of functional dyspepsia (FD) associated with perimenopausal depression.

METHODS: This was a double-blind, randomized, controlled trial including 180 patients with FD accompanied by depression that were divided into two groups of 90. Patients in the treatment group received oral administration of the Xiaoyao pill for soothing the liver and activating the spleen, and patients in the control group received a placebo. This trial included an 8-wk therapy period with a follow-up period of 6 mo. The total efficacy and degree of depression, as assessed by the Hamilton Rating Scale for Depression (HRSD), were evaluated. Plasma levels of motilin and gastrin were measured and a gastric emptying test was conducted in each participant.

RESULTS: The Xiaoyao pill had a good therapeutic effect and improved the symptoms in patients with perimenopausal FD as assessed by the HRSD score, motilin and gastrin levels, and rate of gastric emptying. The total effective rate of the Xiaoyao pill in the treatment group was significantly superior to that of the placebo in the control group. In the control group, the initial HRSD score was 12.12 ± 2.29 and decreased to 7.14 ± 1.67 after therapy (P < 0.01). In the treatment group, the initial HRSD score was 11.44 ± 2.15, which significantly decreased to 6.20 ± 2.08 after therapy (P < 0.01). Moreover, the HRSD score in the treatment group was significantly lower than in control group after 8 wk (P < 0.01). Motilin and gastrin levels in both groups were significantly increased after the 8-wk therapy (P < 0.05). The gastric emptying rate was also improved in both groups after therapy (P < 0.05), and the improvement was significantly better in the treatment group compared to the controls (P < 0.05). These results confirm the therapeutic effects of the Xiaoyao pill in perimenopausal FD patients and indicate that it is worthy of clinical promotion.

CONCLUSION: The Xiaoyao pill is effective and safe for the treatment of perimenopausal women with FD associated with depression.

Meta-analysis of Chinese herbal Xiaoyao formula as an adjuvant treatment in relieving depression in Chinese patients

BACKGROUND

Chinese herbal Xiaoyao formula (XYF) has been widely used as an adjuvant treatment for depression in China. The objective of this meta-analysis was to assess the efficacy and safety of XYF in relieving depression in Chinese patients.

METHODS

Systematic literature searches were carried out on the Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database (prior to June 2013). Only randomized controlled trials (RCTs) comparing XYF plus antidepressants with antidepressants alone for patients with depression were selected. The main outcomes were changes in weighted mean difference (WMD) and 95% confidence interval (CI) of the Hamilton depression scale (HAMD) and risk ratios (RRs) and 95% CI for adverse events.

RESULTS

Ten RCTs involving 735 patients were identified and analyzed. All of the included RCTs were associated with a moderate to high risk of bias. In the meta-analysis, XYF plus antidepressants reduced the HAMD scores compared with antidepressants alone (WMD -2.15; 95% CI -3.56 to -0.74) in a random effect model. In subgroup analysis, XYF plus antidepressants reduced WMD was not observed in the treatment duration less than 8 weeks' subgroup (WMD -1.37; 95% CI -2.92 to 0.19) and XYF powder subgroup (WMD -2.87; 95% CI -7.40 to 1.66). The adverse events included hyperhidrosis, dry mouth, nausea, and constipation. No serious adverse events were reported in any of the included trials.

CONCLUSIONS

XYF as an adjuvant treatment appeared to have benefits on depressive patients. In addition, XYP appeared to reduce insomnia and constipation related to antidepressants.