A meta-analysis of the efficacy and safety of the traditional Chinese medicine formula Kaixinsan decoction for depression.

BACKGROUND: Kaixinsan (KXS) decoction is a traditional Chinese herbal formulation commonly used to treat depression. This study aimed to evaluate the efficacy and safety of KXS, which is widely used, alone and in combination with other therapies, for the treatment of depression. The main objective was to assess the efficacy and safety of KXS in the treatment of depression as a single agent or in combination with other methods. METHODS: Randomized controlled trials of KXS in the treatment of depression were systematically searched from several Chinese and English databases with no language restriction. Patients in these studies met the relevant diagnostic criteria for depression. Data on HAMD, SDS, practical situations, and occurrence of side effects in the studies were extracted. Finally, the methodological quality and risk of bias of the included studies were assessed using the Jadad scale and Cochrane bias evaluation tool. RESULTS: Twelve studies with 1034 patients were included after screening. The Jadad scale and Cochrane bias evaluation tool indicated that the quality of the studies ranged from fair to good, with 41.7% categorized as good and 58.3% as poor. Egger test and funnel plots showed that the publication bias remain low. CONCLUSION: The results showed that the frequency of side effects in the control group was higher than that in the treatment group, and there was a statistically significant difference. KXS was comparable or superior to antidepressants in treating depression and has fewer side effects. The data analysis showed that effectiveness and other indicators differed significantly by geographic area and dosage form, which has implications for future clinical work.

The Efficacy and Safety of Acupuncture for Treating Osteoporotic Vertebral Compression Fracture- (OVCF-) Induced Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) are common health issues in the elderly that cause chronic pain in over one-third of patients. This study was sought to evaluate the efficacy and safety of acupuncture for alleviating pain caused by OVCFs. METHODS: We performed a search of 8 electronic databases for publications from the inception to 30th March 2021. Eligible studies were randomized clinical trials (RCTs) that evaluated the effect of acupuncture for the treatment of OVCFs. Two investigators evaluated literature quality and extracted data independently. RevMan V.5.4.1 was used for data analyses, with pooled risk estimates presented as mean difference (MD) or relative risk (RR) along with corresponding 95% confidence intervals (CIs), as appropriate. RESULTS: Fourteen RCTs involving 1,130 patients were included in this meta-analysis. Compared with the control group, acupuncture showed a greater benefit on pain reduction caused by OVCFs (1 week: MD = -1.26, 95% CI: (-1.82,-0.70); 1 month: MD = -1.63, 95% CI: (-1.82,-1.43); 6 months: MD = -1.13, 95% CI: (-1.55, -0.70)). Acupuncture treatment was also associated with fewer adverse events, lower ODI index, and higher bone density than the control group (safety: (RR: 0.30, 95% CI: 0.12-0.75); ODI: MD = -3.19, 95% CI: (-5.20, -1.19); bone density: MD = 0.15, 95% CI: (0.05, 0.26)). The GRADE quality of these results was assessed as low or very low. CONCLUSIONS: Compared with the control treatment, acupuncture was more effective and safer in relieving the pain caused by OVCF and made a greater improvement on patient's ODI score and bone density. Given the low level of our study evidence, future high-quality studies are needed to verify our study findings.