Xingpi Open Yu Fang Clinical And Mechanism Study Of The Treatment Of Depression

Depression refers to a kind of emotional disorder which consists of a group of symptoms characterized by emotional depression .It has been paid more attention by the medical circles these years for its higher sick rate,recurernce rate and possibility of disablement.In the recent 20 years,great advancement has been achieved in drug therapy.However,the study in treating depression with Chinese herb medicine is relatively backward.So it is necessary to strengthen the research in this area. In this study , the origion and course of the concept of "yu"was made explicit in tradional Chinese medicine (TCM)by classifying literature and summing up clinic experiences. It's believed that pathogenic factor of depression is originated from stagnation of Qi and dampness. Emotional depression influences the Qi of ZhongJiao which results in insufficient digestion.And the function of elevating refined substances and lowering turbid essence are also reduced. Formation of dampness and phlegm will lead to mental confusion.And insufficient digestion will make spirit Qi reduced. So the clinic features is depressive.The therapeutic principle is removing dampness by means of aromatics,activating spleen Qi and relieving stagnation. The formula XingPiKaiYuFang(XF) is formed based on BuHuanJinZhengQiSan. Based on the classical depression animal model the reliability of XF was tested and the possible mechanism of antidepression was explored. The model was established by separation and chronic unpredictable mild stress. The antidepression effect of the formula was investigated from the point of behavor by Openfield test and forced swimming.And the content of monoamine neurotransmitters and its metabolites in rat hippocampus and cortex was observed by HPK-ECD. It has been proved that model rat's and mice's duration of immobility in forced swimming test was shortened by having XF(p <0.05),and By HPLC-ECD it was determined that content of 5-HT and DA in depressive rat's hippocampus or cortex were lowered (p <0.05)and DOPAC HVA rised.DOPAC/DA 5-HIAA/5-HT of hippocampus and 5-HIAA/5-HT of cortex rised obviously (p<0.05)while 5-HT /NE of cortex lowered than that of the normal group.XF obviously increased 5-HT in cortex and hippocampus and decreased DOPAC and HVA in hippocampus .XF also decreased DOPAC/DA, 5-HIAA/5-HT of hippocampus and 5-HIAA/5-HT of cortex.So the possible antidepression mechanism of XF maybe involved in inhibiting the metabolism of 5-HT and DA in cortex and hippocampus ,and relatively increasing the level of 5-HT and DA in hippocampus and 5-HT in cortex . Depression belongs to "YuBing" in TCM.It is observed that most cases have the syndrome of stagnation of Qi and dampness.In the study, the effectiveness of XF was determined compared with fluoxetine by observing 40 cases of depression. Results showed that 7(35%)out of 20 patients were cured in the therapeutic group and 8(40%)out of 20 in the control group were cured according to HAMD effect criterion.The effective rate of the therapeutic group was 75% and it was 65% in the control group.There were not obvious difference in effect between the two groups.According to TCM syndrome effect criterion the cure rate and effective rate of the therapeutic group was 15% and 80%, while that of the control group was 5% and 55%,there was not obvious difference between the groups (p>0.05). According to symptom estimation,HAMD score of both the therapeutic group and the control group was significantly reduced compared with those before treating (p<0.001).There was not obvious difference between the two groups. HAMD score difference compared with those before treating of the two groups were similar(p>0.05). Compared with those before treating ,anxiety/somatization factor and retardation factor were all improved significantly in the two groups(p<0.05).Sleep disorder factor and weight factor were also improved in the therapeutic group(p<0.001).The control group had little effect in improving weight factor and sleep disorder factor (p>0.05). TCM syndrome score were also reduced significantly...