| Depression is the most common mental illness in the older people, which have seriously influenced on the older people's health and quality of life. With the coming of the aging society, it is important and necessary to improve older persons'quality of life through effective prevention and treatment of minor depression in older adults.The research object is xiaoyao powder. Based on the research in the literature, a Practical randomized controlled trial was done to find symptoms improved by xiaoyao pill for minor depression in older adults. The research aimed to promote rational use of xiaoyao pill in community.The paper text is divided two parts:theoretical and clinical research.1 Theoretical research:We begin to work from the literature reorganization, study the relationship between liver and spleen from their different physiological and the five elements theory angle, think that there are close relationship between liver-spleen disorder and depression.Studies shown that the syndrome of stagnation of liver qi and it's movement was the most commonly seen cases. The basic pathogenesis of elderly minor depression is deficiency of liver qi and blood, and then causes the stagnation of liver qi. To invigorate the spleen and nourish the liver, to soothe liver qi and alleviate mental depression are the actions of xiaoyao powder, so we selected xiaoyao powder for treating elderly minor depression.2 Practical randomized controlled trials:based on the research in the literature, combined with pre-survey results and expert opinion, a summery was made and a quantitative form was designed. A randomized controlled trial with practical was done. cases were collected with Center for Epidemiological Survey,Depression Scale (CES-D) and face to face interview.Observations made on of 126 cases in total,71 cases of the treatment group and 55 cases of the control group with treatment time for six weeks.The treatment group were given XiaoYao pill, control group were given psychological intervention.Before and afer trial, Patients were evaluated with Hamilton Depression Rating Scale (HAMD), and the syndrome of Chinese Medicine Evaluation Form were conducted after two weeks, four weeks and six weeks..Results:1 Clinical curative effect of xiaoyao pill on minor depression in older adultsClinical treatment effect outcomes were assessed using HAMD scale.ITT (intention to treat) analysis showed the total rate of effect in the treatment group was 77.46%, whereas it was 18.18% in the control group.PP (explanatory analysis) analysis showed that they were 83.33% and 11.32%, respectively.Significant difference between two groups was detected (p=0.000).Treatment group is better than control group in total effect rate. 2 Curative effects were assessed using Chinese medicine criteria ITT (intention to treat) analysis showed the total rate of effect in the treatment group was 87.32%,whereas it was 10.91% in the control group.PP (explanatory analysis) analysis showed that they were 92.42% and 11.32%,respectively.Significant difference between two groups was detected(p=0.000).Treatment group is better than control group in total effect rate. 3 Clinical effect of XiaoYao pill on different sex older adults with minor depressionITT (intention to treat) analysis showed the total rate of effect in the male treatment group was 63.16%,whereas it was 82.69% in the female treatment group.PP (explanatory analysis) analysis showed that they were 66.67% and 87.5%,respectively.No significant difference between two groups was detected(p>0.05).No adverse effect was found. 4 Effect of xiaoyao pill were assessed using Chinese medicine criteria in different sex older adults with minor depression.ITT (intention to treat) analysis showed the total rate of effect in the male treatment group was 78.95%,whereas it was 88.46% in the female treatment group.PP (explanatory analysis) analysis showed that they were 88.9% and 91.8%,respectively.No significant difference between two groups was detected(p>0.05).No adverse effect was found. 5 Clinical effect of xiaoyao pill on the clinical symptomsOn the basis of published literature studying and the suggestion of the expert, symptoms that xiaoyao pill can cure were primarily establish, they were depression,irritability and susceptibility to rage,easy crying due to sadness, spiritual lassitude and fatigue, dry mouth and throat,poor appetite, chest oppression,sensation of foreign body in the throat,insomnia,dizziness,tidal fever, alternate cold and fever. The signs should be whitish tongue, thin and white tongue, taut pulse.This study shows that the most common symptoms of the syndromes treated by Xiaoyao pill for minor depression in older adults are depression,irritability and susceptibility to rage,easy crying due to sadness, insomnia, spiritual lassitude and fatigue;Obvious symptoms are sensation of foreign body in the throat, dry mouth and throat, spiritual lassitude and fatigue, insomnia, poor appetite, alternate cold and fever. Insomnia, spiritual lassitude and fatigue are common and obvious symptoms.Repeated measures analysis of variance showed that the main effects of intervention on 11 clinical symptoms (depression,irritability and susceptibility to rage,easy crying due to sadness, spiritual lassitude and fatigue, poor appetite, chest oppression,sensation of foreign body in the throat,insomnia,dizziness, tidal fever, alternate cold and fever) were significant(p<0.05),in other word,the 11 clinical symptoms (depression,irritability and susceptibility to rage,easy crying due to sadness, spiritual lassitude and fatigue, poor appetite, chest oppression,sensation of foreign body in the throat,insomnia,dizziness, tidal fever, alternate cold and fever) were significantly different with the chang of the intervention level without taking account the change of time.The main effects of time on 12 clinical symptoms (depression,irritability and susceptibility to rage,easy crying due to sadness, spiritual lassitude and fatigue, dry mouth and throat,poor appetite, chest oppression,sensation of foreign body in the throat,insomnia,dizziness,tidal fever, alternate cold and fever) were significant(p<0.01).There were significant interactions between time and intervention on 11 clinical symptoms expect for dry mouth and throat. Interaction diagram indicated that the improvement degree of Depression,irritability and susceptibility to rage,easy crying due to sadness, spiritual lassitude and fatigue, poor appetite, chest oppression,sensation of foreign body in the throat,insomnia,dizziness, tidal fever, alternate cold and fever were lower in treatment group than that of control group. PP analysis and ITT analysis results are consistent.After intervention,more significantly improving symptoms are poor appetite, spiritual lassitude and fatigue, dizziness, sensation of foreign body in the throat,less significantly improving symptoms are insomnia and alternate cold and fever in treatment group. 6 Clinical effect of XiaoYao pill on the clinical symptoms in different sexThis study shows that the most common symptoms of the syndromes treated by Xiaoyao pill for minor depression in female older adults are depression,irritability and susceptibility to rage,easy crying due to sadness, insomnia, spiritual lassitude and fatigue;Obvious symptoms are dry mouth and throat,sensation of foreign body in the throat, spiritual lassitude and fatigue, insomnia, dizziness, alternate cold and fever. Insomnia, spiritual lassitude and fatigue are common and obvious symptoms.The most frequently symptoms of the syndromes treated by Xiaoyao pill for minor depression in male older adults are depression,irritability and susceptibility to rage, insomnia, spiritual lassitude and fatigue;Obvious symptoms are sensation of foreign body in the throat, poor appetite,dry mouth and throat, spiritual lassitude and fatigue, insomnia, dizziness. Insomnia, spiritual lassitude and fatigue are common and obvious symptoms.After intervention, the symptoms which were improved more significantly among the female than male in treatment group are dizziness, spiritual lassitude and fatigue, irritability and susceptibility to rage, insomnia, alternate cold and fever.The symptoms which were improved more significantly among the male than femmale in treatment group are chest oppression, tidal fever. The Male and female patients had similar effection on poor appetite, sensation of foreign body in the throat, depression, easy crying due to sadness. Conclusio:1 To rely the theory of liver-spleen correlation in treating elderly minor depression got satisfaction curative effects2 symptoms of the syndromes treated by Xiaoyao pill for minor depression in older adults are depression,irritability and susceptibility to rage,easy crying due to sadness, spiritual lassitude and fatigue, poor appetite, chest oppression,sensation of foreign body in the throat,insomnia,dizziness,tidal fever, alternate cold and fever. The signs should be whitish tongue, thin and white tongue, and taut pulse. 3 symptoms of minor depression in older adults belong to syndrome treated by xiaoyao pill were improved after intervention by xiaoyao pill.More significantly improving symptoms are poor appetite, spiritual lassitude and fatigue, dizziness, sensation of foreign body in the throat,less significantly improving symptoms are insomnia and alternate cold and fever. The significantly improving symptoms are different in different sex patient. the symptoms which were improved more significantly among the female than male in treatment group are dizziness, spiritual lassitude and fatigue, irritability and susceptibility to rage, insomnia, alternate cold and fever.The symptoms which were improved more significantly among the male than femmale in treatment group are chest oppression, tidal fever.4 Compared with the geriatric depression scale, center for epidemiological survey depression scale with clinical symptoms is more suitable as screening survey tool for elderly depression in the community.
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