| Objectives:The study aimed to explore the treatment effect and role of Chaihu Shugan San on senile depression patients,discussed the related mechanism of Chaihu Shugan San,and lays the foundation for clinical application of Chaihu Shugan San.Methods:Clinical 60 senile depression patients were selected,each group studied 30 patients including a control group with drug treatment of escitalopram oxalate tablets and an observation group added with Chaihu Shugan San,a traditional Chinese medicine(TCM)After taking the medicine for 6 weeks,some indexes were analysis including HAMD-24,TCM score,SF-36,SCL-90,BDNF,NGF,TNF-α IL-9,and lipid profile,and the evaluation and analysis were summarized and compared with those before treatment to explore the therapeutic effect and mechanism of Chaihu Shugan San.Results:(1)HAMD-24:HAMD value was23.60 ± 5.12 before treatment and 11 ± 1.82 after treatment in the control group,25.56 ± 5.21 before treatment and8.10 ± 2.20 after treatment in the observation group.Significantly the HAMD value decreased in two groups intra-group comparison,with a significant difference(P<0.05)-There were no significant differences in comparison between groups before treatment,and the observation group was significantly lower than the control group after treatment with a statistical difference between the two groups(P<0.05).In addition to the efficacy of HAMD score,the curative rate of the control group was 66.7%,and that of the observation group was 93.3%,showing obvious effects and healing effects(P<0.05).(2)TCM score:TCM score was 24.70±2.93 before treatment and 10.37±1.85 after treatment in the control group,24.90±2.84 before treatment and 7.37±2.24 after treatment in the observation group.Significantly the TCM score decreased in two groups intra-group comparison,with a significant difference(P<0.05).There were no significant differences in comparison between groups before treatment,and the observation group was significantly lower than the control group after treatment with a statistical difference between the two groups(P<0.05).In addition to the efficacy of TCM score,the curative rate of the control group was 76.7%,and that of the observation group was 96.7%,showing obvious effects and healing effects(P<0.05).(3)SF-36:After treatment,the physiological function,emotional function,social function,energy and mental health indexes of the patients in the control group and the observation group were significantly increased(P<0.05)that indicating a significant therapeutic effect.At the same time,comparison between groups the observation group in the affective function(control group:65.61±4.29;Observation group:71.30±5.67)and mental health(control group:58.32±5.35;observation group:61.77±3.68)were significantly better than the control group(P<0.0-5).(4)SCL-90:After treatment,the score of SCL-90 were 2.28 ± 0.58 and 1.43 ± 0.28 in the control group and the observation group,showing significant differences with a statistical difference between the two groups(P<0.05).(5)BDNF and NGF:BDNF was 61.51 ± 5.99 and NGF9.73 ± 1.12 before treat:ment,while BDNF was 87.12 ± 10.30 and NGF was 7.91±1.05 after treatment in the control group.In the observation group,BDNF was 61.23±7.05 and NGF 10.00±0.95 before treatment,while BDNF was 103.20±11.22 and NGF 7.35±1.15 after treatment.In comparison,BDNF in the two groups were significantly increased after treatment with statistical difference compared with that before treatment(P<0.05),NGF in the two groups were reduced after treatment with statistical difference compared with that before treatment(P<0.05).After treatment,significantly the expression levels of BDNF in the observation group were higher than those in the control group with a statistical difference between the two groups(P<0.05),and NGF in the observation group were lower than those in the control group but without statistical significance(P>0.05).(6)Immune factors:In the control group,TNF-α was 5.44±0.3 before treatment.,while TNF-α was 3.53±0.30 after treatment.In the observation group,TNF-α was 5.48 ± 0.30 before treatment,while TNF-α was 2.43 ± 0.30 after treatment.Both groups showed significant reduction in TNF-α(P<0.05).There was no significant difference in TNF-α between the two groups before treatment,and significantly lower TNF-α expression levels in the observation group after treatment than the control group.There was a statistical difference between the two groups(P=0.05).(7)Blood lipid levels:In the control group TC,TG,HDL-c and LDL-c were 3.49±0.26,1.79 ± 0.85,1.1 1 ± 0.30,and 2.49±0.29 before treatment,In the observation group,those were 3.53 ±0.27,1.97 ±0.69 1.11±0.37,and 2.56±0.30.After treatment,the control group was 3.59 ± 0.33,2.49± 0.85,1.16± 0.26,2.56±0.32,and the observation group was 3.51±0.32,2.42 ± 0.76、1.27 ± 0.35,2.51 ±0.31.TG was significantly increased in each group but within the normal range,and there was no significant difference in other indicators for comparison before and after.In the comparison between the two groups,there was no significant difference in each index before and after treatment.(8)ADR In the control group,ADR basic trend is consistently a test frequency from high to low order for nausea,dizziness,insomnia.Then comparison,A DR rate in the control group was 36.7%but that was 6.7%in the observation group,significantly lower than the control group(P<0.05),indicating Chaihu Shugan San can effectively reduce the adverse reaction.Conclusion:(1)Chaihu Shugan San can significantly improve the HAMD and TCM score of elderly patients with depression,and significantly improve the therapeutic effect.The apparent cure rate is increased from 66.7%to 93.3%in the western medicine group alone,which has obvious clinical advantages.At the same time,Chaihu Shugan San can reduce the adverse reactions of patients from 36.7%to 6.7%,which improves the medication safety of patients.(2)Significantly Chaihu Shugan San improve the quality of life of elderly patients with depression combined with esitalopram oxalate tablets,significantly improve the emotional function and mental health status of patients on the basis of western medicine with the effect and mechanism of action of Chaihu Shugan San.(3)Through multiple components,multiple targets,Chaihu Shugan San can improve physical symptoms in patients with senile depression,that mechanism based on its composition effect of anti-inflammatory,analgesic,antioxidant function,inproving the neurotrophic factors express release,protecting hippocampus neurons,and inhibiting apoptosis of hippocampus,and improving the level of 5 HT,NE,direct effecting on neurons,regulate the related neurotransmitters,antidepressant and neurons repair function and other functions,that fully embodies the Chinese medicine composition,targets,and the advantages of synergy.(4)BDNF and NGF have important neuronal protection and neuronal regeneration functions.Chaihu Shugan San can enhance the expression levels of BDNF and NGF,promote neuronal repair after injury in elderly patients with depression,to promote the treatment and rehabilitation of patients.(5)Chaihu Shugan San can regulate immune function in patients through reduced the immune and cytokine expression level of IL-9 and TNF-α,and Chaihu Shugan San can adjust level of neurotransmitter and serum immune factors such as DA,5-HT and NE and so on,and integrated network system effect from "nerve-endocrine-immune",to improve cognitive function and symptoms of depression in the elderly,and to treat depression in the elderly(6)In terms of blood lipid,the effect of Chaihu Shugan San on TG,TC,LDL-C,HDL-C and other biochemical indicators in elderly patients with depression is not clear,and no significant changes have been found. |
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