The Clinical Characteristics Of Depression With Wilson’s Disease And The Intervention Research Of Jieyu Shugan Decoction

Objectives:1、By neuropsychological scale detection to comprehend the main clinical features of hepatolenticular degeneration depression.2、By TCM syndrome integral assessment to reveal the hepatolenticular degeneration depression characteristics of TCM Syndrome.3、Evaluate Jieyu Shugan decoction which have Shugan Jieyu and Liqi Changzhong effect on hepatolenticular degeneration depression,and observed its clinical efficacy and safety.,discuss the change characteristics of the relevant physicochemical index and reveal the decoction mechanism of action,show the traditional Chinese medicine in the treatment of hepatolenticular degeneration depression advantage.Methods:1、Application of preliminary design of hepatolenticular degeneration depression of TCM syndrome integral scale to collect the four diagnostic methods by which patient were diagnosed the hepatolenticular degeneration depression,meanwhile determine the HAMDS,SDS, UWDRS scale to understand and reveal the main clinical features and characteristics of TCM Syndrome of hepatolenticular degeneration depression;2、60 patients with hepatolenticular degeneration depression(syndrome of stagnation of liver Qi) randomly divided into 2 groups,by which 30 cases of treatment group and 30 cases in the control group.All based on conventional anti copper therapy,with the treatment group were added with Jieyu Shugan decoction oral therapy and the control group to paroxetinen oral therapy,by a total of 4 weeks treatment.2 groups were compared by clinical efficacy,TCM syndrome integral,neuropsychological scale,physicochemical index and adverse reactions,etc.Results:1、The main clinical features of hepatolenticular degeneration depression performance for:anxiety/somatization(60%)、sleep disorders(53.3%)、hysteresis(43.3%).2、The clinical research revealed:(1)The comparison of the total clinical efficacy:The total efficiency comparison has no significant difference between the treatment group and the control group at the end of the second course of the treatment(P>0.05);however the total efficiency comparison has extremely significant difference between the two groups at the end of four course of the treatment(P<0.01).(2)The total score of UWDRS、UWDR I score and UWDRS II score comparison results show:compared with before treatment,scores have no significant difference between the two groups at the end of the second course of the treatment(P>0.05);both groups’ scores were decreased and have significant differences by comparison at the end of four course of the treatment(P <0.05),with the treatment group reduced more significantly(P<0.01).UWDRS III score comparison results show:compared with before treatment,score has significant difference between the two groups at the end of the second course of the treatment(P<0.05);both groups’ score were decreased and have extremely significant difference by comparison at the end of four course of the treatment(P<0.01),with the treatment group reduced more significantly(P<0.01).(3)The total crude points of HAMDS comparison results show:compared with before treatment,point has no significant difference between the two groups at the end of the second course of the treatment(P>0.05);point within the treatment group comparison has extremely significant difference at the end of four course of the treatment(P<0.01),and point has significant difference compared with the control group after the treatment(P<0.05).The relevant factor score of HAMDS comparison results show:score within the treatment group comparison has extremely significant difference after the treatment(P<0.01),and score has significant difference compared with the control group after the treatment(P<0.05).(4)The SDS score comparison results show:compared with before treatment,score has no significant difference between the two groups at the end of the second course of the treatment(P>0.05);score within the treatment group or with the control group comparison has extremely significant difference at the end of four course of the treatment(P<0.01).(5)The integral value of TCM Syndromes comparison results show:compared with before treatment,integral value has significant difference within the treatment group at the end of the second course of the treatment(P<0.05);and integral value within the treatment group or with the control group comparison has extremely significant difference at the end of four course of the treatment(P<0.01).(6)The serum ceruloplasmin、copper oxidase and copper value comparison results show:value within the treatment group or with the control group comparison has no significant difference before and after treatment(P>0.05).(7)24h urine copper value comparison results show:compared with before treatment,value has extremely significant difference within the two groups at the end of the second course of the treatment(P<0.01);and value within the treatment group or with the control group comparison has extremely significant difference at the end of four course of the treatment(P<0.01).(8)The level of serum 5-HT comparison results show:compared with before treatment,the 5-HT level has extremely significant difference within the treatment group(P<0.01),and the level has significant difference within the control group(P<0.05),with the control group comparison has extremely significant difference after the treatment(P<0.01).(9)The level of serum NE comparison results show:compared with before treatment,the NE level within the treatment group or with the control group comparison has extremely significant difference after the treatment(P<0.01).(10)Adverse reaction after treatment comparison results show:both groups’ adverse reaction have statistically significant difference at the end of two and four course of the treatment(P<0.05),and half a month after drug withdrawal,adverse reaction has extremely significant difference between the two groups(P<0.01),adverse reaction in the treatment group was significantly lower than the control group.Conclusion:1、The main clinical symptoms of hepatolenticular degeneration depression are anxiety /somatization(60%)、sleep disorders(53.3%)and hysteresis(43.3%).2、Jieyu Shugan decoction can better improve the clinical symptoms of the hepatolenticular degeneration depression,and can better promote excretion of 24-hour urine copper,while the treatment time is longer,the better curative effect.3、The pathogenesis of hepatolenticular degeneration depression involves many aspects, inside maybe closely related to the decrease in serum 5-HT,NE levels, Jieyu Shugan decoction possibly increased the 5-HT,NE levels.4、The clinical utility of Jieyu Shugan decoction which have Shugan Jieyu and Liqi Changzhong effect is better than paroxetine,thus for clinical intervene the hepatolenticular degeneration depression provides a new treatment method and drug.