Prescription of Chinese Herbal Medicine in Pattern-Based Traditional Chinese Medicine Treatment for Depression: A Systematic Review

Abstract

Traditional Chinese medicine (TCM) treatments are often prescribed based on individuals' pattern diagnoses. A systematic review of randomized controlled trials in Chinese and English literatures on TCM pattern-based treatment for depression has therefore been conducted. A total of 61 studies, 2504 subjects, and 27 TCM patterns were included. Due to the large variation of TCM pattern among participants, we only analyzed the top four commonly studied TCM patterns: liver qi depression, liver depression and spleen deficiency, dual deficiency of the heart, and spleen and liver depression and qi stagnation. We found that Xiaoyao decoction was the most frequently used herbal formula for the treatment of liver qi depression and liver depression with spleen deficiency, while Chaihu Shugan decoction was often used for liver depression and qi stagnation. Bai Shao (Paeonia lactiflora Pall.) and Chai Hu (Bupleurum chinense DC.) were commonly used across different TCM patterns regardless of the prescribed Chinese herbal formulas. The rationale underlying herb selection was seldom provided. Due to the limited number of studies on TCM pattern-based treatment of depression and their low methodological quality, we are unable to draw any conclusion regarding which herbal formulas have higher efficacy and which TCM patterns respond better to CHM.

The Effectiveness of Aromatherapy for Depressive Symptoms: A Systematic Review

“…Nowadays, the first-line treatment for major depressive disorder is antidepressants including monoamine oxidase inhibitors, tricyclic antidepressants, and serotonin-norepinephrine and selective serotonin reuptake inhibitors (SN/SSRIs) [13, 30, 31]. Despite the wide variety of antidepressants available in the market, a significant proportion of patients cannot reach full remission or experience side effects [13, 32, 33].…”

“…For instance, it has been reported that nearly 30% of the patients do not respond [8]. Side effects including nauseas, insomnia, agitation, weight gain, somnolence, sexual dysfunction, and cardiovascular adverse events have been reported [9, 31, 34]. Another downside of the use of antidepressants is the long treatment period needed to experience the beneficial antidepressant effect.…”

“…Another downside of the use of antidepressants is the long treatment period needed to experience the beneficial antidepressant effect. Due to the ineffectiveness of the treatment in some patients or intolerability to the side effects, a large number of patients do not comply with the treatment and search for other therapeutic options [13, 31, 35]. Hence, increasing number of people with depressive symptoms explored other nonpharmacological interventions including psychotherapy and counseling, psychoeducation, exercise, problem solving therapy, guided self-help and behavioral activation treatments [36], or even complementary and alternative medicine (CAM) [3, 31].…”

“…In USA, about 53.6% of the patients suffering from depression have reported to use CAM as an adjuvant therapy for the treatment of depression [31, 38]. One of the CAM options that patients with depressive symptoms choose is aromatherapy.…”

The Current Situation on Major Depressive Disorder in China: Research on Mechanisms and Clinical Practice

“…In line with this theory, researchers in China have proposed that acupuncture and moxibustion can improve the symptoms of depression by soothing the liver and regulating the mind [84]. Many herbal formulae have been used to treat depression, such as the Xiaoyao decoction and the Chaihu Shugan decoction [85]. The Chinese herb Radix Angelicae Sinensis is also considered to have antidepressant-like effects.…”