Meta-Analysis on the Efficacy of Traditional Chinese Medicine Decoction in the Treatment of Cardiac Neurosis Complicated with Depression and Anxiety

Abstract

Objective. To analyze and evaluate the effectiveness of traditional Chinese medicine decoction (TCMD) in the treatment of cardiac neurosis (CN) complicated with depression and anxiety. Methods. Relevant literature on TCMD in the treatment of CN complicated with depression and anxiety was retrieved from Chinese and English databases, and the retrieved literature was included and excluded. The quality of the retrieved literature was evaluated according to the Cochrane system, and the meta-analysis was undertaken with RevMan5.3 software. Results. A total of 10 papers were included, including 686 patients and 349 patients in the treatment group (131 males and 218 females), and there were 337 cases in the control group (131 males and 206 females). The results of the meta-analysis showed that compared with the control group, TCMD could significantly improve palpitation (MD = 0.78, 95% CI = 0.55–1.01, $P<0.00001$ ), chest tightness/chest pain (MD = 0.53, 95% CI = 0.10–0.97, $P<0.05$ ), shortness of breath (MD = 0.60, 95% CI = 0.26–0.93, $P=0.0005$ ), and TCM syndrome score (MD = 5.91, 95% CI = 4.32–7.49, $P<0.00001$ ), reduce resting heart rate (MD = 13.21, 95% CI = 9.01–17.40, $P<0.00001$ ), and could reduce psychological scale scores, such as Zung’s self-rating Depression Scale (MD = 7.90, 95% CI = 4.98–10.83, $P<0.00001$ ), Zung’s self-rating Anxiety Scale (MD = 6.55, 95% CI = 4.25–8.86, $P<0.00001$ ), Hamilton Depression Scale (MD = 4.46, 95% CI = 3.00–5.92, $P<0.00001$ ), and Hamilton Anxiety Scale (MD = 3.35, 95% CI = 1.85–4.85, $P<0.0001$ ). The differences were statistically significant. Tonic drugs were commonly used; Angelica sinensis, Poria cocos, Polygala tenuifolia, Wild jujube kernel, and Bupleurum were the most frequently used traditional Chinese medicines. Conclusion. TCMD mainly composed of tonic and tranquilizing herbs could significantly improve the clinical symptoms of patients with CN and reduce heart rate, anxiety, and depression scores. However, the evidence grade of the clinical research was limited by the quality of the included literature, and more high-quality clinical trials are still needed for further verification. This trial was registered with PROSPERO: CRD42022312164