| This thesis is composed of two articles on the progress of Chinese and Western medicine research,literature and clinical research.There are two literature reviews.The first is the development of Western medicine research on subliminal anxiety and depression.It summarizes the definition,epidemiology,etiology and pathogenesis,clinical manifestations and diagnostic criteria,screening,and treatment of subliminal anxiety and depression.The second article is about the origin of TCM syndrome treatment of subliminal anxiety and depression.The author summarizes the thinking and experience of ancient medical experts in the diagnosis and treatment of depression.Part One Literature Research[Objective]Based on the statistical analysis of prescriptions and medications in clinical cases of depression treatment by ancient doctors,while studying the progress of depression research in ancient literature,it systematically summarizes the rules of the treatment of depression by ancient doctors for modern clinical treatment Depression provides diagnosis and treatment ideas to improve the clinical level of syndrome differentiation and treatment of depression.[Methods]Based on data mining technology,using IBM SPSS 25.0 and IBM SPSS Modeler software,frequency analysis of prescriptions and medications in medical cases that meet the diagnostic criteria for depression,cluster analysis of high-frequency drugs that occur more than 20 times 3.Analysis of association rules.[Results]According to the search of "Chinese Medical Code",based on the diagnosis and acceptance criteria of depression,241 cases of ancient depression medical records were finally screened out,including a total of 64 ancient books and 51 doctors.This study involved a total of 227 drugs,with a cumulative frequency of 2199 times.Manually screened drugs with a frequency of more than 15 times in ancient medical cases of depression and depression.Among them,the cumulative frequency was as high as 67.9%,with a total of 38 Chinese herbs.Weiguijing and efficacy classification.The results show that the ancient medical doctors used to treat depression with cold drugs,and the five flavors were mainly bitter.The main was to return to the liver meridian,which involved both the heart and spleen and stomach..A total of 26 traditional Chinese medicines were selected for drugs with a frequency of occurrence greater than 20 times,and cluster analysis was performed.The results showed that:Group 1:Polygala,Sour Date,Woody,and Acorus;Group 2:Ginger,Angelica,White Peony,Chai Hu,Mint,Licorice,Atractylodes,Ginseng,Poria,Peony Bark;Group 3:Tangerine,Pinellia,Magnolia,Chuanxiong,Divine Comedy,Xiangfu,Fructus Aurantii,Gardenia,Melon,Turmeric,Coptis chinensis.Judging from the confidence ranking of association analysis,Xiangfu,Chenpi,Pinellia,Poria,Atractylodes,Licorice,Angelica,White Peony,Gardenia,and Turmeric have strong association rules,suggesting that these drugs may be used by ancient medical doctors to treat depression.The core drug group of the disease.Commonly used medicines for depression in ancient medical cases:Qiqi Kaiyu:Xiangfu-Shenqu,Xiangfu-Chuanxiong;Yangshen Anshen:Shichangpu-Poria,Polygala-Sour jujube;clearing away heat:Gardenia-Gualou,Zhizhi Seeds-peony skin;Yiqi Jianpi:Poria-Atractylodes-Ginseng.The evolution of the pathogenesis of ancient medical doctors to treat depression:the initial evidence of liver qi stagnation was the main pathogenesis,and the condition was long and frail.[Conclusions]1.The core prescriptions of ancient doctors for treating depression:Xiangfu,orange peel,Pinellia,Poria,Atractylodes,licorice,angelica,white peony root,gardenia,turmeric.2.The common medicine pairs used by ancient medical doctors to treat depression:Xiangfu-Divine Comedy,Xiangfu-Ligusticum chuanxiong,Shichangpu-Poria,Polygala-Sour Date,Gardenia-Gourd,Gardenia-Peony Skin,Poria-Atractylodes-Ginseng.3.It can be seen that in the process of treating depression,ancient medical doctors mostly focused on relieving the liver and relieving depression.On the basis of relieving the liver and relieving depression,taking into account the heat-relieving and fire-fighting,nourishing the mind and calming the mind,nourishing the qi and strengthening the spleen,giving consideration to both reality and deficiency,syndrome differentiation rule.Part 2 Clinical Research[Objective]To explore the clinical efficacy of Jieyou Kaiyu Recipe in the treatment of subliminal anxiety and depression and the conversion rate of subthreshold anxiety and depression to depression and anxiety.[Methods]From February 2019 to December 2019,120 patients with sub-threshold anxiety and depression of liver-qi stagnation type in the outpatient clinic of the Third Affiliated Hospital of Beijing University of Chinese Medicine and Xiaoguan Community and Taiyanggong Community were selected and divided into solutions for depression and depression Fang treatment group and placebo control group.The treatment group took Jieyou Kaiyu Recipe,granules produced by Kangrentang Pharmaceutical Factory,one dose per day,100-150ml of warm boiled water in the morning and evening;the control group used placebo granules,the taste and texture of the placebo were consistent with Jieyou Kaiyu Granules.The course oftreatment in both groups was 8 weeks.All the patients included in the observation before the enrollment,4 weeks after enrollment,and 8 weeks after treatment were checked for safety,including blood routine,liver and kidney function,urine routine,stool routine,and electrocardiogram.The main outcome indicators are depression,anxiety conversion rate and Hamilton 17 depression score scale reduction rate,Hamilton anxiety scale reduction rate;the secondary outcome indicators are the TCM efficacy index and the occurrence of adverse reactions.Data is processed using IBM SPSS 25.0 statistical software.For measurement data,the comparison between groups was analyzed by repeated measures analysis of variance,and the comparison within groups was performed by paired sample t test,with meaną standard deviation).Counting data was measured by the chi-square test ?2 using the four grid table,expressed by individual and percentage(%),with P<0.05 having statistical significance.[Results]1.Depression and anxiety conversion rate:During the entire treatment period,none of the two groups of patients had a HAMD scale score greater than 17 points,and a HAMA score greater than 14 points.At the 3-month follow-up,1 patient in the control group had a HAMD>17 points and 2 patients had a HAMA>14 points.The conversion rates of depression and anxiety were 2.17%and 3.57%,respectively,and no conversion into depression and anxiety occurred in the treatment group;At 9 months follow-up,the conversion rates of depression and anxiety in the control group were 12.5%and 14.28%,respectively,and the conversion rates of depression and anxiety in the treatment group were 7.01%and 5.26%,respectively.2.HAMD score reduction rate and total clinical effective rate:HAMD score reduction rate can be seen by repeated analysis of variance,the interaction of group*time is not statistically significant(F=2.292,P=0.106),that is,the group,Time factor and other main effects further simple effect analysis.The influence of group factors on the subtraction rate of HAMD in patients with subthreshold anxiety and depression was statistically significant(F=23.760,P=0.00),namely Shugan Jieyu Recipe had a significant effect on the subtraction rate of HAMD in patients with subthreshold anxiety and depression.The influence of time factors on the subtraction rate of HAMD scores in patients with subthreshold anxiety and depression was statistically significant(F=47.400,P=0.00),and had a significant effect on the subtraction rate of HAMD scores in subthreshold anxiety and depression patients.At 2 weeks of treatment,the total clinical effective rate of the treatment group was 49.15%,and the total clinical effective rate of the control group was 15.52%;at 4 weeks of treatment,the total effective rate of the treatment group was 75.86%,and the total effective rate of the control group was 40.35%;treatment 8 The total clinical effective rate of the weekly treatment group was 96.49%(of which the clinical control rate was 28.07%),and the total clinical effective rate of the control group was 55.35%(of which the clinical control rate was 12.5%).At 2 weeks,4 weeks,and 8 weeks of treatment,the total clinical effective rates of the two groups were significantly different,that is,P<0.05.HAMA score reduction rate and total clinical effectiveness:The HAMA score reduction rate can be seen by repeated analysis of variance.The interaction of group*time is not statistically significant(F=1.164,P=0.316),that is,the group and time Factors and other main effects are further analyzed by simple effects.The influence of group factors on the subtraction rate of HAMA in patients with subthreshold anxiety and depression was statistically significant(F=13.306,P=0.00),namely Shugan Jieyu Recipe had a significant effect on the subtraction rate of HAMA in subthreshold anxiety and depression patients.The influence of time on the sub-threshold anxiety and depression patients HAMA score reduction rate is statistically significant(F=45.372,P=0.00),has a significant effect on the sub-threshold anxiety and depression patients HAMA score reduction rate.At 2 weeks of treatment,the total clinical effective rate of the treatment group was 42.37%,the total clinical effective rate of the control group was 18.96%;at 4 weeks of treatment,the total effective rate of the treatment group was 68.96%,and the total effective rate of the control group was 35.09%;treatment 8 The total clinical effective rate of the treatment group at week time was 94.73%(including 28.07%of the clinical control rate),and the total clinical effective rate of the control group was 64.28%(including the clinical control rate of 12.5%).The difference in clinical efficacy between the two groups at 2 weeks,4 weeks,and 8 weeks of treatment was statistically significant,that is,P<0.05.3.TCM efficacy index and total clinical effectiveness:The total effective rate of TCM in the treatment group reached 84.21%,including clinical control of 35.08%,and the total effective rate of TCM in the control group was 64.28%,including clinical control of 19.64 at 8 weeks of treatment%.4.Safety index:During the entire clinical study period,the heart rate,blood pressure,blood routine,liver function,kidney function and electrocardiogram of all MAD patients were basically normal,and no adverse reactions were seen after taking the drug,suggesting the safety of Jieyou Kaiyu Recipe in the treatment of MAD Better,with fewer side effects.[Conclusion]1.Jieyou Kaiyu Recipe can block the progress of subthreshold anxiety and depression into depression and anxiety.2.Jieyou Kaiyu Recipe can significantly improve the depression and anxiety symptoms of patients with subliminal anxiety and depression.It has a definite effect in the treatment of subliminal anxiety and depression,with fewer adverse reactions and high safety.A... |
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