Evidence-Based Complementary and Alternative Medicine

Review Article

Chinese Herbal Medicine for Postpartum Depression: A Systematic Review of Randomized Controlled Trials

Table 3

Effect estimates of CHM for PPD.
Outcome or subgroup TrialsEffect estimates [95% CI] value
(1) HAMD scores   
(1.1) CHM versus routine treatments   
 MRLQS + MSHS versus routine treatments4MD −1.91 [−3.37, −0.44]0.01
 MRLQS + MTQB versus routine treatments1MD −7.30 [−8.23, −6.37]<0.00001
 MRLQS + MSHS + MBASD versus routine treatments1MD −2.93 [−4.36, −1.50]<0.0001
 MRLQS + MTQB + MBASD versus routine treatments1MD −0.22 [−2.40, 1.96]0.84
 Meta-analysis [REM] (heterogeneity: I2 = 95%, < 0.00001)7MD −2.60 [−4.55, −0.64]0.009
(1.2) CHM + routine treatments versus routine treatments   
 MRLQS + routine treatments versus routine treatments13MD −3.19 [−4.41, −1.97]<0.00001
 MSHS + routine treatments versus routine treatments1MD −4.10 [−6.23, −1.97]0.0002
 MTQB + routine treatments versus routine treatments3MD −2.67 [−4.48, −0.87]0.004
 MRLQS + MSHS + routine treatments versus routine treatments4MD −2.67 [−3.20, −2.14]<0.00001
 MRLQS + MBASD + routine treatments versus routine treatments1MD −4.10 [−6.65, −1.55]0.002
 MRLQS + MTQB + routine treatments versus routine treatments1MD −1.74 [−3.96, 0.48]0.12
 Meta-analysis [REM] (heterogeneity: I2 = 85%, < 0.00001)23MD −3.00 [−3.73, −2.26]<0.00001
(2) EPDS scores   
(2.1) CHM versus placebo   
 MSHS versus placebo1MD −2.67 [−3.88, −1.46]<0.0001
(2.2) CHM versus routine treatments   
 MTQB + MBASD versus routine treatments1MD −4.70 [−5.76, −3.64]<0.00001
 MRLQS + MSHS + MBASD versus routine treatments1MD −1.95 [−3.30, −0.60]0.005
 Meta-analysis [REM] (heterogeneity: I2 = 90%, = 0.002)2MD −3.36 [−6.05, −0.66]0.01
(2.3) CHM + routine treatments versus routine treatments   
 MRLQS + MSHS + routine treatments versus routine treatments3MD −3.80 [−5.27, −2.34]<0.00001
 Meta-analysis [REM] (heterogeneity: I2 = 75%, = 0.02)3MD −3.80 [−5.27, −2.34]<0.00001
(3) Serum estradiol   
(3.1) CHM versus placebo   
 MSHS versus placebo1MD 11.55 [−8.58, 31.68]0.26
 MRLQS + MTQB versus placebo1MD 43.85 [34.90, 52.80]<0.00001
 Meta-analysis [REM] (heterogeneity: I2 = 88%, = 0.004)2MD 29.01 [−2.54, 60.56]0.07
(3.2) CHM + routine treatments versus routine treatments   
 MSHS + routine treatments versus routine treatments1MD 26.73 [5.06, 48.40]0.02
 MTQB + routine treatments versus routine treatments1MD 38.58 [35.58, 41.58]<0.00001
 Meta-analysis [FEM] (heterogeneity: I2 = 11%, = 0.29)2MD 38.36 [35.38, 41.33]<0.00001
(4) Progesterone   
(4.1) CHM versus placebo   
 MSHS versus placebo1MD −1.99 [−7.28, 3.30]0.46
 MRLQS + MTQB versus placebo1MD −2.11 [−3.10, −1.12]<0.0001
 Meta-analysis [FEM] (heterogeneity: I2 = 0%, = 0.97)2MD −2.11 [−3.08, −1.14]<0.0001
(4.2) CHM + routine treatments versus routine treatments   
 MSHS + routine treatments versus routine treatments1MD −3.89 [−8.92, 1.14]0.13
 MTQB + routine treatments versus routine treatments1MD −11.64 [−13.41, −9.87]<0.00001
 Meta-analysis [REM] (heterogeneity: I2 = 88%, = 0.004)2MD −8.14 [−15.70, −0.58]0.03
(5) Incidence of adverse events   
(5.1) CHM versus placebo   
 MSHS versus placebo1RR 0.20 [0.01, 4.00]0.29
 MRLQS + MTQB versus placebo1RR 3.00 [0.13, 71.92]0.50
 Meta-analysis [FEM] (heterogeneity: I2 = 33%, = 0.22)2RR 0.67 [0.11, 3.91]0.65
(5.2) CHM versus routine treatments   
 MTQB versus routine treatments2RR 0.12 [0.04, 0.36]0.0001
 MRLQS + MSHS versus routine treatments4RR 0.21 [0.10, 0.47]0.0001
 MRLQS + MTQB versus routine treatments1RR 0.06 [0.00, 0.99]0.05
 MRLQS + MSHS + MBASD versus routine treatments1RR 0.73 [0.31, 1.71]0.46
 MRLQS + MTQB + MBASD versus routine treatments1RR 0.03 [0.00, 0.42]0.010
 Meta-analysis [REM] (heterogeneity: I2 = 57%, = 0.02) 9RR 0.18 [0.09, 0.38]<0.00001
(5.3) CHM + routine treatments versus routine treatments   
 MRLQS + routine treatments versus routine treatments9RR 0.45 [0.32, 0.64]<0.00001
 MTQB + routine treatments versus routine treatments3RR 0.76 [0.31, 1.84]0.54
 MRLQS + MSHS + routine treatments versus routine treatments3RR 0.45 [0.22, 0.93]0.03
 MRLQS + MTQB + routine treatments versus routine treatments2RR 0.32 [0.09, 1.14]0.08
 MRLQS + MBASD + routine treatments versus routine treatments2RR 0.73 [0.18, 2.93]0.66
 Meta-analysis [REM] (heterogeneity: I2 = 56%, = 0.002)19RR 0.49 [0.37, 0.65]<0.00001
(6) TESS   
(6.1) CHM versus routine treatments   
 MRLQS + MSHS versus routine treatments1MD −2.05 [−3.00, −1.10]<0.0001
(6.2) CHM + routine treatments versus routine treatments   
 MRLQS + routine treatments versus routine treatments2MD −2.31 [−3.12, −1.50]<0.00001
 MTQB + routine treatments versus routine treatments1MD −3.02 [−4.25, −1.79]<0.00001
 MRLQS + MTQB + routine treatments versus routine treatments1MD −0.83 [−1.50, −0.16]0.01
 MRLQS + MBASD + routine treatments versus routine treatments1MD −1.40 [−1.72, −1.08]<0.00001
 Meta-analysis [REM] (heterogeneity: I2 = 71%, = 0.008)5MD −1.80 [−2.46, −1.14]<0.00001
(7) SERS   
(7.1) CHM + routine treatments versus routine treatments   
 MRLQS + routine treatments versus routine treatments2MD −5.19 [−9.73, −0.64]0.03
 Meta-analysis [REM] (heterogeneity: I2 = 98%, < 0.00001)2MD 5.19 [−9.73, −0.64]0.03
FEM: fixed effects model, REM: random effects model.