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Table 1 Characteristics of the enrolled randomized controlled trials

From: Treatment of depression with Chai Hu Shu Gan San: a systematic review and meta-analysis of 42 randomized controlled trials

Study ID

Sample size (I/C)

Gender (M/F)

Age

Intervention Group

Controlled Group

Syndrome Differentiation

Course of Treatment

Following-up

Outcomes

HAMD Mean score (SD)

Effective Rate

(events/total)

Adverse Effect

Depression

 Cheng XY 2007 [7]

33/30

I:18/15;

C:16/14

I:37.1 ± 7.6;

C:36.7 ± 8.7

Chai Hu Shu Gan San + Fluoxetine

Fluoxetine

Y

6 weeks

N

6.32(2.33) vs 7.01(3.45)

NR

I: somnolence, dry mouth and sleepy;

C: insomnia, blurred vision, nausea, headache.

(Case unknown)

 Lin B 2011 [8]

30/30

I:13/17;

C:15/15

I:52.13 ± 4.31;

C:50.43 ± 4.80

Chai Hu Shu Gan San

Fluoxetine

Y

20 days

N

11.53(7.41) vs 13.23(6.99)

26/30 vs 5/30

NR

 Liu YY 2012 [9]

31/32

I:11/19;

C:12/20

I:40.5 ± 9.9;

C:36.6 ± 15.0

Chai Hu Shu Gan San + Venlafaxine

Venlafaxine

Y

4 weeks

N

5.9(4.6) vs 8(5.6)

NR

NR

 Wang RC 2013 [10]

40/40

I:18/22;

C:21/19

I:33.6 ± 10.75;

C:34.70 ± 11.23

Chai Hu Shu Gan San

Paroxetine

Y

6 weeks

N

7.21(4.23) vs 7.52(3.79)

33/40 vs 34/40

I: slight headache, tiredness,constipation, sweat, bitter taste;

C: dry mouth, constipation, excitement and agitation, insomnia, dizziness, headache, palpitation, quiver, nausea, vomit, sexuality descent, ejaculation inhibition, female sexual lack. (Case unknown)

 Shao XQ 2016 [11]

15/13

I:8/7;

C:7/6

I:37.4 ± 7.53;

C:36.7 ± 7.61

Chai Hu Shu Gan San

Fluoxetine

Y

6 weeks

6 months

9.51(4.84) vs 10.24(4.01)

14/15 vs 12/13

No adverse effect reported in intervention group;Nausea, anorexia, headache, sexual dysfunction reported in control group (Case unknown)

 Gu XX 2016 [12]

30/30

I:18/12

C:16/14

I:33.1 ± 14.4

C:32.8 ± 17.1

Chai Hu Shu Gan San + Mirtazapine

Mirtazapine

N

8 weeks

N

7.82(1.56) vs 15.88 (1.42)

27/30 vs 24/30

Appetite increased, weight gain, edema, nausea, dry mouth, sleep disorders (Case unknown)

 Hu J 2015 [13]

48/48

I:20/28

C:22/26

I:38.56 ± 12.23

C:39.89 ± 11.83

Chai Hu Shu Gan San

Paroxetine

N

6 weeks

N

9.65(3.44) vs C:8.98(4.32)

43/48 vs 42/48

NR

 Liu CY 2015 [14]

35/34

I:21/14C:19/15

I:49.12 ± 7.64

C:48.46 ± 7.25

Chai Hu Shu Gan San + Amitriptyline

Amitriptyline

Y

3 months

N

4.83(1.37) vs 4.79(1.02)

33/35 vs 28/34

constipation (I = 1 vs C = 7/34); dry mouth (I = 0 vs C = 4); dizzy(I = 1 vs C = 5);electrocardiographic abnormality (I = 1 vs C = 6)

 Deng SZ 2012 [15]

53/48

I:28/25;

C:23/25

NA

Chai Hu Shu Gan San + Citalopram

Citalopram

Y

8 weeks

N

6.07(1.86) vs 9.38(2.27)

49/53 vs 37/48

NR

 Song YM 2011 [16]

30/30

I:11/19;

C:12/18

I:46.5 ± 6.3;

C:45.3 ± 7.2

Chai Hu Shu Gan San

Fluoxetine

Y

4 weeks

N

14.8(3.3) vs 17.6(2.8)

28/30 vs 24/30

NR

 Fan QL 2008 [17]

70/35

I:28/42;

C:13/22

I:67.5;

C:67.5

Chai Hu Shu Gan San

Paroxetine

Y

3 months

N

NR

69/70 vs 29/35

NR

 Deng GQ 2013 [18]

30/30

I:13/17;

C:12/18

I:38.5 ± 10.4;

C:40.2 ± 12.1

Chai Hu Shu Gan San

Paroxetine

Y

6 weeks

N

8.9(3.5) vs 9.7(2.8)

24/30 vs 22/30

NR

 Wang L 2012 [19]

30/30

I:12/18;

C:14/16

NA

Chai Hu Shu Gan San + Fluoxetine

Fluoxetine

Y

4 weeks

N

NR

28/30 vs 25/30

Insomnia, mental tension, nausea, headache (C = 9 vs I = 3)

Post-stroke Depression

 Chang XH 2010 [20]

50/50

I:31/19;

C:28/22

I:42–74;

C:45–75

Chai Hu Shu Gan San + Fluoxetine

Fluoxetine

Y

28 days

N

10.24(3.4) vs 14.2(2.7)

48/50 vs 41/50

NR

 Chen HH 2013 [21]

47/47

I:30/17;

C:29/18

I:67 ± 4;

C:66 ± 5

Chai Hu Shu Gan San

Fluoxetine

N

4 weeks

N

5.82(1.56) vs 6.21(1.38)

43/47 vs 42/47

Nausea (I = 1 vs C = 14), nodal tachycardia (I = 0 vs C = 5), stomach discomfort (I = 2 vs C = 15), dry mouth (I = 2 vs C = 18), somnolence (I = 1 vs C = 15);

 Cui Y 2016 [22]

30/30

I:18/12;

C:16/14

I:52.23 ± 9.90;

C:50.73 ± 10.52

Chai Hu Shu Gan San + Escitalopram Oxalate Tablets

Escitalopram Oxalate Tablets

Y

6 weeks

N

8.67(4.97) vs 12.4(6.97)

NR

no apparent adverse effect in both group.

 He XM 2007 [23]

36/18

I:21/15;

C:11/7

I:53.24 ± 6.31;

C:54.36 ± 4.42

Chai Hu Shu Gan San + Fluoxetine

Fluoxetine

N

60 days

N

16.41(2.56) vs 22.06(3.35)

32/36 vs 11/18

digestive discomfort (I = 8 vs C = 10), vegetative nerve functional disturbance (I = 10 vs C = 9);

 Huang WX 2010 [24]

32/31

I:17/15;

C:16/15

I:65 ± 4.6;

C:61 ± 5.3

Chai Hu Shu Gan San + Deanxit

Deanxit

Y

8 weeks

N

15.6(4.4) vs 16.2(4.9)

NR

I; dizziness (2 cases), constipation (1 cases);

C: No adverse effect

 Huang YS 2012 [25]

39/39

I:22/17;

C:20/19

I:62.51 ± 7.47;C:61.93 ± 7.82

Chai Hu Shu Gan San + Fluoxetine

Fluoxetine

Y

3 months

N

9.57(2.11) vs 13.08(2.58)

35/39 vs 32/39

I: No adverse effect;

C: 6 cases with dry mouth, nausea, vomit, appetite reduced, insomnia, headache, tiredness.

 Lian Z 2009 [26]

30/30

I:17/13;

C:16/14

I:56.20 ± 18.6;

C:54.6 ± 17.5

Chai Hu Shu Gan San + Fluoxetine

Fluoxetine

N

60 days

N

6.21(2.53) vs 12.1(1.25)

26/30 vs 24/30

gastrointestinal discomfort (I = 6 vs C = 14), Autonomic nerve dysfunction (I = 7 vs C = 16)

 Wang GL 2009 [27]

66/66

I:24/40;

C:28/38

I:63.5 ± 2.3;

C:64.5 ± 3.4

Chai Hu Shu Gan San + Paroxetine

Paroxetine

Y

6 weeks

N

7.2(2.1) vs 10.1(1.7)

62/66 vs 52/66

NR

 Ji XL 2013 [28]

30/30

I:18/12

C:17/13

NA

Chai Hu Shu Gan San

Fluoxetine

Y

30 days

N

9.1(3.2) vs 13.3(3.5)

25/30 vs 19/30

NR

 Zhang FH 2013 [29]

40/40

I:18/22

C:16/24

I:66.3;

C:65.8

Chai Hu Shu Gan San + Deanxit

Deanxit

Y

6 weeks

N

14.2(2.1) vs 17.3(2.6)

36/40 vs 31/40

NR

 Ren MJ 2015 [30]

36/36

41/31

58.6 ± 2.1

Chai Hu Shu Gan San

Fluoxetine

Y

30 days

N

8.2(2.6) vs 14.1(2.8)

35/36 vs 30/36

Dry mouth, nausea, anorexia, fatigue (I = 0 vs C = 4)

Postnatal Depression

 Zhao XP 2006 [31]

45/42

I:0/45;

C:0/42

I:29.04 ± 3.99;

C:29.12 ± 4.26

Chai Hu Shu Gan San + Fluoxetine

Fluoxetine

Y

4 weeks

N

9.18(5.72) vs 11.36(5.73)

43/45 vs 39/42

Nausea, appetite descent, anxiety, somnipathy, quiver (Case unknown).

 Zhao Y 2016 [32]

41/42

I:0/41;

C:0/42

I:28.94 ± 5.03;

C:30.12 ± 4.3

Chai Hu Shu Gan San + Fluoxetine

Fluoxetine

N

8 weeks

N

8.31(2.05) vs 13.96(2.16)

NR

Dry mouth, dizziness, nausea, tiredness, somnolence, quiver (I = 3 vs C = 10)

Cancer and Depression

 Fang XH 2013 [33]

45/45

I:17/28;

C:24/21

I:42.3 ± 18.1;

C:47.6 ± 16.9

Chai Hu Shu Gan San

Fluoxetine

N

6 weeks

N

11.78(3.21) vs 13.98(2.12)

38/45 vs 34/45

Dry mouth (I = 2 vs C = 3), constipation (I = 2 vs C = 0), dizziness and headache (I = 3 vs C = 2),insomnia (I = 4 vs C = 1), gastrointestinal dysfunction (I = 7 vs C = 2), blurred vision (I = 2 vs C = 0)

Epilepsy and Depression

 Huang XB 2015 [34]

62/60

64/58

37.28 ± 7.29

Chai Hu Shu Gan San

Paroxetine

N

12 weeks

N

17.68(1.95) vs 22.12(1.9)

41/57 vs 25/54

NR

Chronic Pelvic Inflammation and Depression

 Li L 2006 [35]

38/36/38

I:0/38;

C1:0/36;

C2:0/38

N/A

Chai Hu Shu Gan San

C1: Paroxetine; C2: No Intervention

N

6 weeks

N

17.71(3.91) vs C1:18.55(4.51); C2: 22.00(3.91)

34/38 vs C1:28/36; C2:18/38

NR

Post-PCI and Depression

 Wang YT 2016 [36]

30/30

NA

NA

Chai Hu Shu Gan San

Deanxit

N

4 weeks

N

15.73(6.05) vs 14.77(6.84)

25/30 vs 23/30

NR

COPD and Depression

 Yang G 2011 [37]

40/40

I:24/16;

C:22/18

I:62.37 ± 6.78;

C:63.6 ± 7.25

Chai Hu Shu Gan San

No Intervention

N

4 weeks

N

14.59(1.12) vs 20.15(1.08)

34/40 vs 20/40

NR

Parkinson and Depression

 Ma YZ 2011 [38]

36/32

NA

NA

Chai Hu Shu Gan San + Sertraline Hydrochloride

Sertraline Hydrochloride

Y

4 weeks

N

9.2(3.6) vs 12.3(5.4)

NR

NR

 Zhou R 2016 [39]

36/36

I:18/18;

C:16/20

NA

Chai Hu Shu Gan San + Duloxetine

Duloxetine

Y

4 weeks

N

15.96(3.96) vs 20.28(3.56)

NR

Nausea (I = 2 vs C = 2), headache (I = 0 vs C = 1)

 Yang MJ 2010 [40]

30/30

I:18/12; C:17/13

I:62 ± 6.53;

C:62.13 ± 5.92

Chai Hu Shu Gan San + Paroxetine

Paroxetine

Y

8 weeks

N

9.02(1.24) vs 13.12(2.72)

27/30 vs 21/30

Dry mouth (I = 2 vs C = 5); fatigue (I = 1 vs C = 3); Nausea (I = 2 vs C = 3); poor appetite (I = 4 vs C = 5); insomnia (I = 2 vs C = 5); constipation (I = 2 vs C = 5)

Piman syndrome and Depression

 Qiu ZJ 2012 [41]

36/36/36

I:17/19;

C1:16/20;

C2:17/19

I:36.17 ± 13.29;

C1:36.17 ± 11.29;

C2:38.83 ± 11.94

Chai Hu Shu Gan San

C1:Deanxit;

C2: No Intervention

N

6 weeks

N

6.42(3.68) vs C1:5.42(4.14); C2:16.03(4.34)

NR

Mouth odor, nausea, vomit, inappetence, gastrointestinal dysfunction, diarrhea, constipation in three groups, (Case unknown)

Cerebrovascular disease and Depression

 Yao K 2013 [42]

38/38

I:20/18;

C:19/19

I:65.27 ± 8.35;

C:66.31 ± 7.94

Chai Hu Shu Gan San + Mirtazapine

Mirtazapine

Y

4 weeks

N

12.53(3.17) vs 15.87(3.62)

34/38 vs 30/38

Dry mouth, nausea, constipation (Case unknow)

 Shang GM 2014 [43]

29/29

I:17/12;

C:16/13

I:63.38 ± 10.21; C:62.91 ± 9.83

Chai Hu Shu Gan San

Fluoxetine

N

4 weeks

N

NR

27/29 vs 23/29

NR

Gastroesophageal Reflux Disease and Depression

 Zheng YJ 2016 [44]

43/42

I:18/25;

C:17/25

I:32.3 ± 12.6;

C:44.2 ± 7.4

Chai Hu Shu Gan San

No Intervention

N

8 weeks

N

9.2(1.3) vs 14.3(1.8)

40/43 vs 32/42

Nausea (I = 1 vs C = 5), dry mouth (I = 0 vs C = 2), dizziness (I = 0 vs C = 4)

Coronary heart disease and Depression

 Liu YH 2014 [45]

25/24

I:14/11;

C:13/11

I:60.7 ± 13.6;

C:56.8 ± 10.2

Chai Hu Shu Gan San

No Intervention

N

4 weeks

N

NR

19/25 vs 9/24

No adverse effect reported in both groups

Rheumatoid arthritis and Depression

 Chen PY 2015 [46]

34/34

NA

NA

Chai Hu Shu Gan San

Paroxetine

N

6 weeks

N

10.68(6.83) vs 19.31(7.69)

NR

NR

Diabetes and Depression

 Yang YL 2013 [47]

40/38

I:18/22; C:15/23

I:38.70 ± 11.10; C:37.5 ± 11.2

Chai Hu Shu Gan San

Paroxetine

Y

3 months

N

14.12(7.84) vs 22.69(11.66)

38/40 vs 28/38

NR

Cardiac neurosis and Depression

 Pei GX 2013 [48]

60/60

I:18/42; C:24/36

I:42.58 ± 6.12; C:44.32 ± 4.58

Chai Hu Shu Gan San + Deanxit

Deanxit

Y

8 weeks

N

11.42(3.45) vs 13.68(2.74)

57/60 vs 53/60

NR

  1. Note: Y---Yes; N---No; I---Interventional Group; C---Controlled Group; F---Female; M---Male; HAMD---Hamilton Depression Scale; SD---standard deviation; NR--- not reported
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