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Outcomes | | No. of Participants (RCTs) | Anticipated absolute effects (95% CI) | Relative effect (95% CI) | I2 value | Quality of evidence (Grade) | Comments |
Risk with control group | Risk with SYM group |
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SYM versus placebo |
Daytime SBP (mmHg) | Total | 113 (1) | — | MD 8.84 lower (15.36–2.32 lower) | — | Not applicable | ⊕⊕⊕⃝ Moderate | Risk of bias (−1) |
Daytime DBP (mmHg) | Total | 113 (1) | — | MD 9.11 lower (12.03–6.19 lower) | — | Not applicable | ⊕⊕⊕⃝ Moderate | Risk of bias (−1) |
PHQ-9 | Total | 113 (1) | — | MD 3.52 lower (4.40–2.64 lower) | — | Not applicable | ⊕⊕⊕⃝ Moderate | Risk of bias (−1) |
TER (TCM syndrome score) | Total | 113 (1) | 737 per 1,000 | 892 per 1,000 (744–1,000) | RR 1.21 (1.01–1.45) | Not applicable | ⊕⃝⃝⃝ Very low | Risk of bias (−1) Indirectness (−1) Imprecision (−1) |
Adverse event | Total | 113 (1) | 88 per 1,000 | 71 per 1,000 (20–253) | RR 0.81 (0.23–2.88) | Not applicable | ⊕⃝⃝⃝ Very low | Risk of bias (−1) Imprecision (−2) |
|
SYM versus active controls |
Daytime SBP (mmHg) | Total | 305 (3) | — | MD 2.54 lower (4.18–0.89 lower) | — | 83% | ⊕⃝⃝⃝ Very low | Risk of bias (−1) Inconsistency (−2) |
Versus antihypertensives | 54 (1) | — | MD 5.00 higher (0.16–9.84 higher) | — | Not applicable | ⊕⊕⃝⃝ Low | Risk of bias (−1) Imprecision (−1) |
Versus antidepressants | 251 (2) | — | MD 3.52 lower (5.26–1.77 lower) | — | 15% | ⊕⊕⊕⃝ Moderate | Risk of bias (−1) |
Daytime DBP (mmHg) | Total | 305 (3) | — | MD 2.67 lower (3.73–1.60 lower) | — | 56% | ⊕⊕⃝⃝ Low | Risk of bias (−1) Inconsistency (−1) |
Versus antihypertensives | 54 (1) | — | MD 2.20 higher (2.73 lower–7.13 higher) | — | Not applicable | ⊕⃝⃝⃝ Very low | Risk of bias (−1) Imprecision (−2) |
Versus antidepressants | 251 (2) | — | MD 2.90 lower (4.00–1.81 lower) | — | 0% | ⊕⊕⊕⃝ Moderate | Risk of bias (−1) |
SAS | Total (antidepressants) | 176 (1) | — | MD 10.58 lower (11.57–9.59 lower) | — | Not applicable | ⊕⊕⊕⃝ Moderate | Risk of bias (−1) |
SDS | Total (antidepressants) | 176 (1) | — | MD 10.94 lower (12.17–9.71 lower) | — | Not applicable | ⊕⊕⊕⃝ Moderate | Risk of bias (−1) |
HAMA | Total (antidepressants) | 75 (1) | — | MD 0.28 lower (0.95 lower–0.39 higher) | — | Not applicable | ⊕⃝⃝⃝ Very low | Risk of bias (−1) Imprecision (−2) |
Adverse event | Total (antidepressants) | 75 (1) | 0 per 1,000 | 0 per 1,000 (0–0) | Not estimable | Not applicable | ⊕⊕⃝⃝ Low | Risk of bias (−1) Imprecision (−1) |
|
SYM plus active controls versus active controls |
Daytime SBP (mmHg) | Total (antihypertensives) | 113 (2) | — | MD 3.22 lower (6.15–0.29 lower) | — | 0% | ⊕⊕⊕⃝ Moderate | Risk of bias (−1) |
Daytime DBP (mmHg) | Total (antihypertensives) | 113 (2) | — | MD 2.46 lower (5.09 lower–0.18 higher) | — | 72% | ⊕⃝⃝⃝ Very low | Risk of bias (−1) Inconsistency (−1) Imprecision (−1) |
Nighttime SBP (mmHg) | Total (antihypertensives) | 154 (2) | — | MD 1.79 lower (3.81 lower–0.23 higher) | — | 0% | ⊕⊕⃝⃝ Low | Risk of bias (−1) Imprecision (−1) |
Nighttime DBP (mmHg) | Total (antihypertensives) | 154 (2) | — | MD 0.35 higher (1.78 lower–2.48 higher) | — | 0% | ⊕⊕⃝⃝ Low | Risk of bias (−1) Imprecision (−1) |
TER (BP) | Total (antihypertensives) | 254 (3) | 740 per 1,000 | 903 per 1,000 (807–1,000) | RR 1.22 (1.09 to 1.37) | 61% | ⊕⃝⃝⃝ Very low | Risk of bias (−1) Indirectness (−1) Imprecision (−1) |
TER (TCM syndrome) | Total (antihypertensives) | 154 (2) | 688 per 1,000 | 881 per 1,000 (743–1,000) | RR 1.28 (1.08 to 1.52) | 0% | ⊕⊕⃝⃝ Low | Risk of bias (−1) Indirectness (−1) |
Du's hypertension quality of life scale | Total (antihypertensives) | 60 (1) | — | MD 9.85 lower (15.87–3.83 lower) | — | Not applicable | ⊕⊕⃝⃝ Low | Risk of bias (−1) Imprecision (−1) |
Adverse event | Total (antihypertensives) | 60 (1) | 33 per 1,000 | 11 per 1,000 (0–262) | RR 0.33 (0.01 to 7.87) | Not applicable | ⊕⃝⃝⃝ Very low | Risk of bias (−1) Imprecision (−2) |
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