| Background:As people life rhythm speeding up, work, family and social pressure also will increase, and people’s psychological health problem has become increasingly apparent, represented by subthreshold depression of the increase of psychological barriers of the crowd. Clinical epidemiological showed more about 1/5 people have different levels of depressive symptoms. These groups of depressive symptoms did not reach the DSM-Ⅳ diagnostic criteria for depression disorders, attributable to the subthreshold depression. Subthreshold depression can result in serious damage similar to depression, the depression has a role in predicting and has a high risk of future clinical depression. Now for the diagnosis and treatment of depression is not the simple treatment to the prevention and treatment of combining development, so understanding of subthreshold depression and intervention, has become the key to the prevention and treatment of depression. Since the subthreshold depression can achieve no diagnostic criteria, clinical depression reason exists whether drug intervention, choice of drug, side effects of curative effect evaluation and choice debate.Research shows that depression is the best period for interventional therapy of traditional Chinese medicine, in the early stages of this period to active intervention of Chinese medicine, often can be a very good development, to prevent diseases and has its particular advantages in comparison with western medicine. Previous studies confirm liver spleen deficiency and glove two deficiency is most common in the depression. Review past Chinese medicine understanding of depression, this study with five hidden god as the main theoretical basis, think of subthreshold depression is mainly involving the zang-fu organs, liver and spleen, lungs and pathogenesis in liver pathogenesis, lienal lose health, heart is displaced as the main contradiction, viscera disorder of qi and blood, Yin and Yang are closely connected with the whole;The disease with qi activity stasis is given priority to, day long turn virtual or factors. In the prevention and treatment of depression, when based on heart, liver and spleen differentiation as priority treatment to mediate, liver and spleen, spleen yangxin (nourishing heart) for solution. Therefore, this study Xiaoyao bolus and Guipi bolus of Traditional Chinese Medicine as the main intervention, the quality of life of patients with subthreshold depression was observed, providing scientific evidence for reasonable intervention in subthreshold depression of Chinese medicine.Objective:1. Through the literature review comprehensive analysis understanding of subthreshold depression, modern medicine and traditional Chinese medicine understanding of subthreshold depression, provide theoretical and literature basis for follow-up study.2. Prospective cohort study methods, Xiaoyao bolus and Guipi bolus of Traditional Chinese Medicine as the main intervention, the life quality of patients with subthreshold depression was observed.Methods:1. Literature researchFrom the basic concept of subthreshold depression, epidemiology, classification and manifestations, etiology and pathogenesis, measuring tools, prognosis and modern treatment to clarify the understanding of the modern medicine;From subthreshold depression disease, past dynasties doctor of Traditional Chinese Medicine knowledge, and five zang-organs theory, Yin and Yang, and the heart, liver, spleen, modulation solution to clarify the understanding of the Traditional Chinese Medicine.2. Clinical researchIn 150 cases of eligible subjects, Use prospective cohort study design. Xiaoyao bolus group (N=50):think proprietary Chinese medicine at large for the intervention measures. Belong to Guipi bolus group (N=50):think proprietary Traditional Chinese Medicine belongs to Guipi bolus for intervention measures. The control group (the blank group) (N=50):do not take any treatment. Observe 12 weeks. Outcome indicators for Depression self rating Scale (CES-D),17 items of Hamilton Depression rating Scale (Hamilton’Scale, HAMD-17), the world health organization quality of life questionnaire (WHOQOL-100) and xiaoyao bolus subthreshold Depression syndrome diagnosis table with subthreshold Depression Guipi bolus the quantitative diagnosis table.Results:1. The baseline dataThree groups of subjects in terms of age, sex, duration and the scores were not statistically significant (P> 0.05).2. CES-D scoreFor Xiaoyao bolus groups before intervention CES-D score was 20.50 ± 3.31,4 weekend intervention CES-D rating fell to 17.09±2.78, compared with before intervention was statistically significant (P< 0.05); Intervention at the 8 weekend CES-D rating fell to 16.36 ± 2.50, compared with before intervention was statistically significant (P< 0.05); Intervention at the 12 weekend CES-D rating fell to 16.14±2.70, compared with before intervention was statistically significant (P< 0.05). Belong to Guipi bolus group intervention before CES-D score was 19.85 ± 3.16,4 weekend intervention CES-D ratings drop 17.21 ± 2.60, compared with before intervention was statistically significant (P< 0.05);Intervention at the 8 weekend CES-D rating fell to 16.40±2.47, compared with before intervention was statistically significant (P< 0.05);Intervention at the 12 weekend CES-D rating fell to 16.20 ± 2.61, compared with before intervention was statistically significant (P< 0.05). Blank group intervention at the 4 weekend CES-D score was 18.80 ± 2.91, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05); In 8 weekend intervention CES-D score was 18.78 ± 2.65, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05); Intervention in 12 CES-D score was 18.82 ± 2.75 over the weekend, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05). Xiaoyao bolus groups in each measuring point and Guipi bolus group were no statistical significance (P> 0.05).This shows that the Xiaoyao bolus or Guipi bolus can effectively improve participants’depressive state, with the extension of treatment, the effect is also increasing.3. The HAMD-17 scoresXiaoyao bolus group HAMD-17 score was 13.36±2.50 before intervention, intervention 4 weekend HAMD-17 scores dropped to 11.21 ± 2.33, compared with before intervention was statistically significant (P< 0.05); Intervention 8 weekend HAMD-17 scores dropped to 10.02 ± 2.26, compared with before intervention was statistically significant (P< 0.05);Intervention 12 weekends HAMD-17 scores dropped to 8.13 ± 2.40, compared with before intervention was statistically significant (P< 0.05). Belong to lienal bolus group HAMD-17 score was 13.58 ± 2.38 before intervention, intervention 4 weekend HAMD-17 scores drop 12.15±2.40, compared with before intervention was statistically significant (P< 0.05);Intervention 8 weekend HAMD-17 scores dropped to 10.60 ± 2.30, compared with before intervention was statistically significant (P< 0.05);Intervention 12 weekends HAMD-17 scores dropped to 8.35±2.19, compared with before intervention was statistically significant (P< 0.05). In blank group intervention HAMD-17 score was 14.15 ± 2.45 4 weekend, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention HAMD-17 score was 14.13 ± 2.40 8 weekend, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention 12 weekends HAMD-17 score was 14.18±2.37, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05). Xiaoyao bolus groups in each measuring point and Guipi bolus group were no statistical significance (P> 0.05). This shows that the Xiaoyao bolus or Guipi bolus can effectively improve participants’depressive state, with the extension of treatment, the effect is also increasing.4. The WHOQOL-100 score(1) The physical dimensions (PHYS)Xiaoyao bolus group PHYS score was 45.39 ± 9.26 before intervention, intervention PHYS score 4 weekend rose to 55.48 ± 9.17, compared with before intervention was statistically significant (P< 0.05);8 weekend intervention PHYS score rose to 59.26 ± 9.20, compared with before intervention was statistically significant (P< 0.05);Intervention PHYS score 12 weekend rose to 63.78 ± 9.37, compared with before intervention was statistically significant (P< 0.05). Belong to Guipi bolus group PHYS score was 44.20±9.38 before intervention, intervention 4 weekend PHYS score rose 58.37 ± 9.26, compared with before intervention was statistically significant (P< 0.05);8 weekend intervention PHYS score rose to 64.18±9.11, compared with before intervention was statistically significant (P< 0.05);Intervention PHYS score 12 weekend rose to 68.27 ± 9.25, compared with before intervention was statistically significant (P< 0.05). In blank group intervention PHYS score was 44.60±9.35 at 4 weekend, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05); In intervention PHYS score was 44.63 ± 9.28 at 8 weekend, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention 12 weekends PHYS score was 45.16 ± 9.27, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05). Xiaoyao bolus and Guipi bolus group in each measuring point had statistical significance (P< 0.05). This shows that the free and unfettered scattered or Guipi bolus can effectively improve participants’depressive state, with the extension of treatment, the effect is also increasing. And Guipi bolus is better than that of xiaoyao bolus on the improvement of the physical dimension.(2) The psychological dimension (PSYCH)Xiaoyao bolus group PSYCH score was 41.20 ± 8.70 before intervention, intervention PSYCH score 4 weekend rose to 52.31±8.50, compared with before intervention was statistically significant (P< 0.05);8 weekend intervention PSYCH score rose to 58.42 ± 8.36, compared with before intervention was statistically significant (P< 0.05);Intervention PSYCH score 12 weekend rose to 60.59 ± 8.60, compared with before intervention was statistically significant (P< 0.05).Belong to lienal bolus group PSYCH score was 42.09±8.18 before intervention, intervention 4 weekend PSYCH score rose 49.18±8.47, compared with before intervention was statistically significant (P< 0.05);8 weekend intervention PSYCH score rose to 54.37 ± 8.24, compared with before intervention was statistically significant (P< 0.05);Intervention PSYCH score 12 weekend rose to 57.37 ± 8.48, compared with before intervention was statistically significant (P< 0.05).In blank group intervention PSYCH score was 42.11 ± 8.20 at 4 weekend, were significantly lower than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention PSYCH score was 42.18±8.26 at 8 weekend, were significantly lower than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention 12 weekends PSYCH score was 42.29±6.19, were significantly lower than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05). Xiaoyao bolus and Guipi bolus group in each measuring point had statistical significance (P< 0.05). This shows that the free and unfettered scattered or Guipi bolus can effectively improve participants’depressive state, with the extension of treatment, the effect is also increasing. And xiaoyao bolus is better than that of Guipi bolus on the improvement of the psychological dimension.(3) The independence dimension (IND)Xiaoyao bolus group IND score was 47.50 ± 6.68 before intervention, intervention 4 weekend IND rating fell to 52.15±6.36, compared with before intervention was statistically significant (P< 0.05);8 weekend intervention IND rating fell to 58.33 ± 6.19, compared with before intervention was statistically significant (P< 0.05);Intervention 12 weekends IND rating fell to 62.39 ± 6.40, compared with before intervention was statistically significant (P< 0.05). Belong to lienal bolus group IND score was 46.29±6.36 before intervention, intervention 4 weekend IND score 51.27 ± 6.28, compared with before intervention was statistically significant (P< 0.05); 8 weekend intervention IND rating fell to 58.19 ± 6.24, compared with before intervention was statistically significant (P< 0.05);Intervention 12 weekends IND rating fell to 61.70 ± 6.33, compared with before intervention was statistically significant (P < 0.05). In blank group intervention IND score was 46.90 ± 6.22 at 4 weekend, were significantly higher than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention IND score was 46.92 ± 6.30 8 weekend, were significantly lower than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention 12 weekends IND score was 46.97 ± 6.21, were significantly lower than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05). Free and unfettered three groups in each measuring point and Guipi bolus group were no statistical significance (P> 0.05). This shows that the use of free and unfettered scattered or Guipi bolus can effectively improve the subjects’independent state, with the extension of treatment, the effect is also increasing.(4) The relationship of social dimension (SOCIL)Xiaoyao bolus group SOCTL score was 54.29 ± 7.70 before intervention, intervention SOCIL score 4 weekend rose to 56.35 ± 7.24, compared with before intervention has no statistical significance (P> 0.05);8 weekend intervention SOCIL score rose to 58.21 ± 7.37, compared with before intervention was statistically significant (P< 0.05);Intervention SOCIL score 12 weekend rose to 59.14 ± 7.22, compared with before intervention was statistically significant (P< 0.05). Belong to Guipi bolus group SOCIL score was 53.70 ± 7.29 before intervention, intervention 4 weekend SOCIL score rose 55.50 ± 7.33, compared with before intervention has no statistical significance (P> 0.05);8 weekend intervention SOCIL score rose to 57.46±7.28, compared with before intervention was statistically significant (P< 0.05);Intervention SOCIL score 12 weekend rose to 58.58± 7.36, compared with before intervention was statistically significant (P< 0.05). In blank group intervention SOCIL score was 53.50 ± 7.39 at 4 weekend, with the same period of Xiaoyao bolus group and compare Guipi bolus group were no statistical significance (P> 0.05);In intervention SOCIL score was 54.10±7.40 at 8 weekend, were significantly lower than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention 12 weekends SOCIL score was 54.09±7.38, were significantly lower than the same period of Xiaoyao bolus and Guipi bolus group (P< 0.05). Free and unfettered three groups in each measuring point and Guipi bolus group was no statistical significance (P> 0.05). This shows that the use of free and unfettered scattered or Guipi bolus can effectively improve the subjects’social relationship, but need a longer period of treatment, after 8 weeks.(5) The environmental dimensions (ENVIR)Xiaoyao bolus group ENVIR score was 56.48 ± 7.38 before intervention, intervention ENVIR score 4 weekend rose to 57.19±7.26, compared with before intervention has no statistical significance (P> 0.05); 8 weekend intervention ENVIR score rose to 58.38 ± 7.38, compared with before intervention has no statistical significance (P> 0.05);Intervention ENVIR score 12 weekend rose to 59.20 ± 7.16, compared with before intervention was statistically significant (P< 0.05).Belong to Guipi bolus group ENVIR score was 54.39 ± 7.19 before intervention, intervention 4 weekend ENVIR score rose 56.39 ± 7.30, compared with before intervention has no statistical significance (P> 0.05);8 weekend intervention ENVIR score rose to 57.69 ± 7.28, compared with before intervention has no statistical significance (P> 0.05);Intervention ENVIR score 12 weekend rose to 58.77 ± 7.21, compared with before intervention was statistically significant (P < 0.05).In blank group intervention ENVIR score was 55.52 ± 7.18 at 4 weekend, with the same period of Xiaoyao bolus and Guipi bolus group is no statistical significance (P> 0.05);In 8 weekend intervention ENVIR score was 55.60 ± 7.21, compared with the Xiaoyao bolus and Guipi bolus group is no statistical significance (P> 0.05);In intervention 12 weekends ENVIR score was 55.65 ± 7.30, were significantly lower than the same period of xiaoyao bolus and Guipi bolus group (P< 0.05). Xiaoyao bolus group in each measuring point and Guipi bolus group were no statistical significance (P> 0.05). This shows that the use of Xiaoyao bolus or Guipi bolus can effectively improve the subjects’environment dimension, but need a longer period of treatment, after 12 weeks.(6) The spiritual beliefs (D0M6)Xiaoyao bolus group DOM6 score was 46.77 ± 6.69 before intervention, intervention D0M6 score 4 weekend rose to 48.38 ± 6.37, compared with before intervention has no statistical significance (P> 0.05);8 weekend intervention D0M6 score rose to 50.18 ± 6.28, compared with before intervention has no statistical significance (P> 0.05);Intervention D0M6 score 12 weekend rose to 51.19 ± 6.19, compared with before intervention was statistically significant (P< 0.05). Belong to Guipi bolus group D0M6 score was 45.80 ± 6.38 before intervention, intervention D0M6 score 4 weekend rose to 47.49±6.29, compared with before intervention no statistical significance (P< 0.05);8 weekend intervention DOM6 score rose to 49.20±6.34, compared with before intervention was statistically significant (P< 0.05);Intervention D0M6 score 12 weekend rose to 50.27± 6.26, compared with before intervention was statistically significant (P< 0.05). In blank group intervention D0M6 score was 45.60 ± 6.30 at 4 weekend with the same period of xiaoyao bolus and Guipi bolus group was no statistical significance (P< 0.05);In intervention D0M6 score was 45.70 ± 6.22 at 8 weekend, were significantly lower than the same period in Xiaoyao bolus and Guipi bolus group (P< 0.05);In intervention 12 weekends D0M6 score was 45.72 ± 6.39, were significantly lower than the same period of xiaoyao bolus and Guipi bolus group (P<0.05). Xiaoyao bolus group in each measuring point and Guipi bolus group were no statistical significance (P> 0.05).This shows that the Xiaoyao bolus or Guipi bolus can effectively improve the subjects’spiritual beliefs, but need a longer period of treatment, after 12 weeks.5. The Xiaoyao bolus of the quantitative scoreXiaoyao bolus group was 58.80±9.20 before intervention, intervention 4 weekend fell to 49.32±9.17, compared with before intervention was statistically significant (P< 0.05); 8 weekend intervention fell to 34.21 ± 8.70, compared with before intervention was statistically significant (P < 0.05);Intervention 12 weekends fell to 28.16 ± 6.22, compared with before intervention was statistically significant (P<0.05).This shows that the xiaoyao bolus corresponding is good, can effective intervention.6. The Guipi bolus of the quantitative scoreBelong to Guipi bolus group was 60.33 ± 8.17 before intervention, intervention 4 weekend fell to 48.30 ± 8.22, compared with before intervention was statistically significant (P< 0.05); 8 weekend intervention fell to 36.20 ± 8.35, compared with before intervention was statistically significant (P< 0.05); Intervention 12 weekends fell to 26.10 ± 7.30, compared with before intervention was statistically significant (P< 0.05).This shows Guipi bolus corresponding is good, can effective intervention.7. Clinical curative effectAfter 4 weeks treatment, Xiaoyao bolus group cure 18 cases,20 cases were markedly effective, effective 9 cases,3 had no effect, the total effective rate was 94.00%;Guipi bolus group 15 cases were cured,20 cases had marked effect,10 cases were effective, invalid in 5 cases, total effective rate was 90.00%. The Ridit analysis showed no statistical significance (P> 0.05).After 8 weeks treatment, Xiaoyao bolus group cure 22 cases,17 cases had marked effect,9 cases of effective and ineffective in 2 cases, total effective rate was 96.00%; The Guipi bolus group treated 20 cases,22 cases were markedly effective, effective in 5 cases,3 had no effect, the total effective rate was 94.00%. The Ridit analysis showed no statistical significance (P> 0.05).After 12 weeks of treatment, Xiaoyao bolus group cure 25 patients,20 cases were markedly effective, effective 4 cases,1 case had no effect, total effective rate was 98.00%; Guipi bolus group 22 cases cured,24 cases were markedly effective, effective in 2 cases,2 had no effect, the total effective rate was 96.00%.The Ridit analysis showed no statistical significance (P> 0.05).Conclusion:1. The Xiaoyao bolus and Guipi bolus are effective intervention subthreshold depression group, improved the symptoms of depression, improved patient quality of life.4 weeks and began to work, need long-term medication to enhance clinical efficacy.2. Xiaoyao bolus compared to Guipi bolus, to improve the patient’s mental state Xiaoyao bolus is better than Guipi bolus. Belong to Guipi bolus somatic symptoms improved better than that of the Xiaoyao bolus on the patients. In the relationship of social dimension, the independence dimension, the spiritual beliefs dimension, etc, were not different between both. |
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