본문 바로가기
KERD
논문KCI 등재

범불안장애의 한약 치료에 관한 체계적 문헌고찰 및 메타분석: 최근 5년 임상연구를 중심으로

Systematic Review and Meta-Analysis on Herbal Medicine for Generalized Anxiety Disorder: Focusing on Clinical Studies over the Past 5 Years

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류한의학

초록

Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was ‘Phlegm fire disturbing upward’ (痰熱上擾), and the most used herb for therapeutic purposes was ‘Rhizome of Poria cocos’ (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.

Abstract

Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was ‘Phlegm fire disturbing upward’ (痰熱上擾), and the most used herb for therapeutic purposes was ‘Rhizome of Poria cocos’ (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.

참고문헌 (37)

  1. National Institute for Korean Medicine Development, "Clinical Practice Guideline of Korean Medicine for Anxiety Disorders", 68~70 (2021)
  2. Stein DJ, "Perceived helpfulness of treatment for generalized anxiety disorder : a World Mental Health Surveys report", BMC Psychiatry, 21(1), pp.392~ (2021)
  3. "Bigdata Open portal"[URL]
  4. Hoffman DL, "Human and economic burden of generalized anxiety disorder", Depress Anxiety, 25(1), pp.72~90 (2008)
  5. Bandelow B, "The German Guidelines for the treatment of anxiety disorders: first revision", Eur Arch Psychiatry Clin. Neurosci, 272(4), pp.571~582 (2022)
  6. Hansen AH, "The use of CAM providers and psychiatric outpatient services in people with anxiety", depression : a cross-sectional survey, 2016, pp.16(1), 461~
  7. National Evidence-based Healthcare Collaborating Agency, "NECA’s guidance for undertaking systematic reviews and meta-analyses for intervention", 78~85 (2020)
  8. Li LY, "Clinical observation on TCM syndrome differentiation in the treatment of generalized anxiety disorder", Journal of Clinical Medical Literature, 6(07), pp.14~ (2019)
  9. Wang WX, "Clinical Observation of Wendan Tablets in Treatment of Generalized Anxiety Disorder with Phlegm-heat Disturbance Syndrome", Journal of Guangzhou University of Traditional Chinese Medicine, 36(11), pp.1679~1683 (2019)
  10. Wang QL, "Analysis of the clinical efficacy of modified Xiaoyao Powder in the treatment of patients with generalized anxiety disorder due to liver stagnation and spleen deficiency", Everyone Health, 17, pp.32~ (2019)
  11. Xiong H, "Clinical effect observation of Ningxin Anshen Formula in the treatment of mild to moderate generalized anxiety disorder", China Journal of Traditional Chinese Medicine and Pharmacy, 34(06), pp.2803~2806 (2019)
  12. Liu WJ, "Application of TCM syndrome differentiation nursing in elderly patients with generalized anxiety disorder", Clinical Journal of Chinese Medicine, 11(24), pp.26~27 (2019)
  13. Sun MY, "Clinical Observation of Bupleurum Plus Dragon Bone Oyster Soup in the Treatment of Generalized Anxiety Disorder", Journal of Zhejiang Chinese Medical University, 43(06), pp.595~598 (2019)
  14. Jiang XY, "Observation on the efficacy of Suanzaoren Decoction in the treatment of 30cases of generalized anxiety disorder due to yin deficiency and fire exuberance", Journal of North Pharmacy, 17(01), pp.83~84 (2020)
  15. Diao HQ, "Effect of modified Huanglian Ejiao Decoction on treatment of 42 cases of generalized anxiety disorder in com -munity", Beijing Journal of Traditional Chinese Medicine, 39(12), pp.1225~1228 (2020)
  16. Huang HY, "Clinical Effect of Jingxin Anshen Decoction on Generalized Anxiety Anxiety Disorder", Guide of China Medicine, 18(14), pp.182~183 (2020)
  17. Zhao Q, "Efficacy and safety of Jiuwei Zhenxin granule on the treatment of generalized anxiety disorder", China Medicine, 17(07), pp.1070~1073 (2022)
  18. Bao S, "Study on the clinical efficacy of Jingxin Anshen Decoction in the treatment of generalized anxiety disorder of Qi stagnation and fire type", Electronic Journal of Clinical Medical Literature, 7(18), pp.34~ (2020)
  19. Liu Y, "Analysis of the effect of modified Guipi Decoction in the treatment of generalized anxiety disorder of heart and spleen deficiency type", Health for Everyone, (05), pp.276~ (2020)
  20. Jiang ZY, "New explanation of Bupleurum Guizhi Ganjiang Decoction in the treatment of generalized anxiety disorder", Shandong Journal of Traditional Chinese Medicine, 39(11), pp.1248~1251 (2020)
  21. Ru C, "A case report on treatment of generalized anxiety disorder by differentiation of symptoms and signs", Journal of Tianjin University of Traditional Chinese Medicine, 39(03), pp.312~315 (2020)
  22. Wang YJ, "2 cases of Professor Zhao Jianjun’s treatment of generalized anxiety disorder", Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine, 8(01), pp.187~ (2020)
  23. Yang SS, "LIU Xinchun’s Understanding and Treatment of Pathogenesis of General Anxiety Disorder in Young and Middle-aged", Journal of Practical Traditional Chinese Internal Medicine, 34(12), pp.57~60 (2020)
  24. Yue TT, "Du Shaohui treats generalized anxiety disorder based on the theory of"Too little intercourse produces Jueyin"of Qiantang Medical School", Guiding Journal of Traditional Chinese Medicine and Pharmacy, 27(12), pp.170~172 (2021)
  25. Liu HX, "Brief Talk on Treating Generalized Anxiety Disorder with the Method of Supporting Yang by Classic Prescriptions", Clinical Journal of Traditional Chinese Medicine, 33(10), pp.1900~1903 (2021)
  26. Liu HX, "Zhang Yunling’s experience in treating generalized anxiety disorder with six methods", Shanghai Journal of Traditional Chinese Medicine, 56(10), pp.29~32 (2022)
  27. Zheng X, "Guiding Principles for Clinical Research of New Traditional Chinese Medicines" (2002), China Medical Science and Technology Press
  28. The Epidemiological Survey of Mental Disorders in Korea, "Seoul national college of medicine", wMinistry of health and welfare, 56~57 (2021)
  29. Wittchen HU, "Generalized anxiety and depression in primary care: prevalence, recognition, and management", J Clin. Psychiatry, 63(8), pp.24~34 (2002)
  30. Bandelow B, "Biological markers for anxiety disorders, OCD and PTSD: A consensus statement. Part II: Neurochemistry, neurophysiology and neurocognition", World J Biol Psychiatry, 18(3), pp.162~214 (2017)
  31. Chinese Association of Integrative Medicine, "Guidelines for the diagnosis and treatment of generalized anxiety disorder with integrated traditional Chinese and Western medicine", Modern Chinese Clinical Medicine, 30(06), pp.21~27 (2023)
  32. Park DM, "The comparative clinical study of efficacy of Gamisoyo-San(Jiaweixiaoyaosan)on generalized anxiety disorder according to differently manufactured preparations : Multicenter, randomized, double blind, placebo controlled trial", Journal of Ethnopharmacology, 158, pp.11~17 (2014)
  33. Yang XY, "Effectiveness of acupuncture on anxiety disorder : a systematic review and meta-analysis of randomised controlled trials", Ann Gen Psychiatry, 20(1), pp.9~ (2021)
  34. Park DM, "Preliminary Study to Develop the Instrument of Pattern Identication for Jing Ji and Zheng Chong", Journal of oriental neuropsychiatry, 21(2), pp.1~15 (2010)
  35. Choi WC, "A Study to Assess the Reliability and Improvement of the Instrument of Pattern Identication for Jing Ji and Zheng Chong", Journal of Oriental Neuropsychiatry, 25(4), pp.371~382 (2014)
  36. Zhu KY, "A standardized chinese herbal decoction, kai-xin-san, restores decreased levels of neurotransmitters and neurotrophic factors in the brain of chronic stress-induced depressive rats", Evid Based Complement Alternat Med, 2012, pp.149256~ (2012)
  37. Yang L, "Managing Depression with Bupleurum chinense Herbal Formula : A Systematic Review and Meta-Analysis of Randomized Controlled Trials", J Altern Complement Med, 26(1), pp.8~24 (2020)

관련 논문AI추천

이 간행물의 다른 논문 (12건)