| Background:The global incidence of depression was about 3.1%, while nearly 6% in developed countries, with social development and the accelerated pace of life, the incidence of depression, severe depression is increasing, there are more than 8900 million people worldwidely in 2002, and the amount of depression reached 340 million. At the age of 20-year-old adults, the annual incidence of depression increases by 11.3%. the incidence of depression in developed countries will rise to 8 to 10% by 2005; to 2020, depression will rise to the big category of disease, second to ischemic heart disease. The incidence of depression in our country is about 3%-5%, there are already more than 2600 million people suffering from depression. Antidepressants in 1980 was mainly TCA (including tetracyclines) and MAOI, it had positive effect on depression, but also with anticholinergic side effects. Appeared in the 20th century a new generation'of effective antidepressants, mainly SSRI, SNRI, NDRI, NaSSA, SARI, but dose was not easy to control, and with slow withdrawal, adverse effects and more expensively.Purpose:In accordance with the standared design of clinical trials, the decoction established by the principle of nutritioning Heart activating blood and soothing liver treated 30 patients with depression,30 patients in control group of drug using sertraline, observing the efficacy and safety of this decoction, Evaluating the effects of the decotion established by the principle of nutritioning Heart activating blood and soothing liver in treating with depression and exploring the new ways for effective treatment depression.Methods:In March 2009-2009 in December in Jiangsu Provincial Hospital of Neurology,30 patients with depression diagnosed were set in the treatment group. Control group selected in March 2009-2009 in Taiwan in December of Neurology, diagnosed 30 patients with depression, and gender, age, educational attainment were paralled between two group. Treatment group:taking Traditional Chinese medicine decoction blood nourishing the heart, one day, fried thick as 200ml,2 times orally. (Composed of:Bupleurum 10g, immature bitter orange 10g, peony 15g, peach kernel 10g, Salvia miltiorrhiza 15g, floating wheat 15g, jujube 5, Iris 10g, licorice 6g). The control group was given sertraline (Pfizer's SSRI medicines, trade name Zoloft), the initial dose of 50mg, QD, may increase the condition of patients after the drug to the 100-150mg/day, morning and evening 2 pm taking. Were treated for 3 months, followed up for 3 months. Different time during the treatment given other antipsychotics and antidepressants. Outcomes included safety (blood, urine, stool, liver and kidney function, TESS adverse scale score), efficacy index (TCM integration, HAMD score, etc.), using SPSS 11.5 for windows software, and efficacy the level of information compared with X2 test, HAMD depression scale integrated points, side effects rating scale score±SD of measurement data to that used t test, P <0.05 as statistically significant.Results:The study included 60 patients with depression, the treatment group and control group 30 patients.36 males and 24 females; average heart rate (76.95±10.5) beats/min, the fastest heart rate 94 beats/min, the slowest heart rate 59 beats/min; average age (47.47±17.8) years, and maximum age 90 years Minimum age of 22 years; the treatment group, the average body weight (70.3±9.5) Kg, the average weight of the control group (66.2±14.0) Kg, maximum weight 90Kg, minimum 45Kg. Treatment group,19 cases were male,11 female patients in the control group were 17 men and 13 were female. Depression syndromes frequency appears different, such as the emotional spirit of the (frequency 60), the first body trapped weight (frequency 60), headache (frequency 60), irritability (frequency 60), insomnia (frequency 60), palpitation (frequency 60), dark urine (frequency 60), fatigue (frequency 60), tongue (frequency 60), mouth pain (frequency 59), constipation (frequency 59), etc., and symptom severity to symptom scores that showed that depression the more obvious symptoms of insomnia (258 points), palpitation (248 points), fatigue (190 points), mood disorders (190 points), other sites, including irritability, tongue, mouth pain, backache, the first body trapped heavy looking dull, dry mouth, throat and so on. Treatment group to support the Heart Traditional Traditional Chinese medicine decoction cubic oral control group were treated with sertraline, compared two groups of patients was found after the integrated effect of the treatment group were cured in 8 cases,13 cases were markedly effective,8 cases ineffective 1 case, the total effective rate 96.7%; control group were cured,5 cases markedly effective in 8 cases, effective in 15 cases and ineffective in 2 cases, the total efficiency of 93.3%. The ridit, and the treatment group= 0.433, control group= 0.567, P= 0.059. After treatment, the integrated effect of the difference was not statistically significant. However, the efficiency of the treatment group were significantly higher than the control group, P value close to 0.05, worthy of further study at larger samples. Individual evaluation of the two drugs on patients with depression syndromes improvements, the Sichuan Traditional Chinese medicine to support the Heart Decoction treatment group cubic symptoms disappeared in 10 cases,14 cases significantly reduce, reduce in 5 cases,1 case no improvement; the control group symptoms disappeared in 6 cases,9 cases were reduced significantly reduce the nine cases, no improvement in 6 cases. The ridit, and the treatment group= 0.418, control group= 0.583; P= 0.020, effect of the two groups after treatment significantly integrated. Help Sichuan Traditional Chinese Herbs to support heart can significantly improve depression symptoms, compared to control group better efficacy of sertraline. Two groups of patients before and after the treatment group HAMD basic control points in 7 cases,8 cases were markedly effective in 14 cases,1 patient; basic control group,9 cases were 10,10 cases improved and 1 failed. The ridit, and the treatment group= 0.533, control group= 0.467, P= 0.360. After treatment, no significant difference between integrated effect can be considered to support the Heart Traditional Traditional Chinese medicine decoction cubic HAMD integral aspect in improving the efficacy of similar patients. In particular, the two groups after treatment, palpitation, insomnia, mental mood, fatigue, irritability and other symptoms were significantly'improved compared with before treatment, the difference was statistically significant (P<0.05), but the two groups after treatment, the difference No statistically significant. Syndrome compared two groups of total score, total score before treatment group (47.73±6.9) hours after the end of treatment (14.47±1.8) points, total score of the control group before treatment (47.87±10.6) points after treatment was (14.27±1.8) minutes. Meanwhile, the two groups were raised by the Sichuan Traditional Chinese medicine decoction and the Heart cubic sertraline treatment, compared each factor and total scores in the anxiety/somatization, sleep disturbance, hopelessness three dimensions of difference statistical significance. The remaining two factors and total score compared with no significant differences. But before and after treatment, both groups significantly decreased total score, suggesting that blood to support the Heart Traditional Chinese medicine decoction and cubic sertraline for depression are effective, but traditional Chinese medicine decoction group to improve the anxiety/somatization, sleep obstacles to clear advantages compared with sertraline, and sertraline in improving the patient's desperate sense of factors have better results. The treatment of depression are more common adverse drug reactions, this study side effects scale (TESS) assessment of two therapies intensity of side-effects, results showed that the average points for the treatment group (4.28±0.54) and the control group (13.15±2.73) points. Difference between two groups was statistically significant (P<0.05), traditional Chinese medicine decoction in the treatment group significantly less than the western side effects of sertraline group, and other safety indicators no significant differences between the two groups.Conclusion:Nutritioning Heart activating blood and soothing liver is the major principle in treatment with depression; the decotion can improve depression symptoms and signs, and HAMD points; the establishment of nutritioning heart activating blood and soothing liver can support the treatment of depression, and the decotion had less adverse reaction and a good effect. |
PDF Full Text Request