Tcm Depression Syndrome Elements And Their Distribution Characteristics Research

BackgroundDepression is common and frequently occurring disease, and Chinese Medicine (CM) had a very long history in the treatment of depression. However there are many shortcomings on the study of CM syndrome, the core character of different symptoms having different syndromes. So the research from of ancient and modern literatures to clinical investigation are necessary, which can discover the syndrome elements of depression and their distribution patterns, and can provide a scientific basis for the the syndrome standardized research.Objective(1) Based on ancient literatures:In order to investigate the viewpoints of ancient physicians about depression, the common symptoms of depression, syndrome elements and the relations between syndromes and symptoms were studied.(2) Based on modern literatures:In order to investigate the viewpoints of morden physicians about depression, the common symptoms of depression, syndrome elements and the relations between syndromes and symptoms were studied.(3) Based on clinic investgation:In order to the viewpoints of ancient physicians about depression, to study the common symptoms, syndrome elements and their distributions by investigating the clinical patients.Method(1) Ancient literature study:Literature analysis method was applyed, first, the search words of the ancient literature about depression were established, and then they were retrieved in Chinese Medical Classics software, the four diagnostic informations about depression were screened, at last,851qual if ied literatures were gotten,2873Symptoms entries of CM four diagnostic informations involved. All entries were reduced to185entries by standardized processing. Descr ipt ive analysis was applied to analyze the symptoms and syndrome elements, using the Chi-square test to analyze the relationships between syndrome elements, the relationships between syndrome elements and symptoms were analyzed by two logistic regression.(2) Modern literature study:The search words of the modern literature about depression were established, and then they were retrieved in CNKI, at last,125literatures were gotten. Descriptive analysis was applied to analyze the symptoms and syndrome elements, using the Chi-square test to analyze the relationships between syndrome elements, the relationships between syndrome elements and symptoms were analyzed by two logistic regression.(3)Clinical study:Descriptive analysis was applied to analyze the general information, symptoms and syndrome elements, the relationships between syndrome elements, symptoms and the degree of disease were analyzed by two logistic regress ion.ResultsAncient literature study:18syndrome elements were gotten from the ancient literatures, includingll nature of syndrome elements, that’s, stagnation Qi, Qi deficiency, the inner fire, sputum, Yin deficiency, blood deficiency, Kidney essence loss, inverse Qi, blood stasis, wet and Yang difficiency;7locations of syndrome elements were involved, that’s, heart, stomach, kidney, lung, bile. The relationships between syndrome elements were discovered, that’s, spleen and Qi deficiency (P=0.000), heart and blood deficiency (P=0.000),liver and Qi stagnation stagnation (P=0.000), Yin and inner fire (P=0.000), kidney and Yin deficiency (P=0.000), heart and sputum (P=0.000), Qi stagnation and phlegm (P=0.003).10relationships of syndrome element-symptom were established. Symptoms with Qi stagnation syndrom:depression, flank pain, foreign body sensation in the pharynx, abdominal fullness, cardiothoracic pain, restless, limbs pain, pantothenic acid, irritability, restlessness; Symptoms with Qi deficiency:fatigue, weakness, facial expressions and unresponsive, poor appetite, emaciation, timid and easily frightened, looking minimalist; Symptoms associated with the inner fire:sadness, fatigue, laughing and crying impermanence, irritability, dark yellow urine, rapid pulse, bitter taste in mouth; symptoms associated with sputum:foreign body sensation in the pharynx, slippery pulse, sadness, apathy; symptoms related with blood deficiency:insomnia, forgetfulness, dizziness, headache, palpitations; symptoms related with Yin deficiency:dry mouth, sadness, laughing and crying impermanence, bitter in mouth, dizziness, dysuria, dark yel low urine; symptoms associated with liver:flank pain, depression, restless, limb pain, irritability, restlessness, dizziness, limbs tiredness, dry mouth; symptoms related the spleen:lack of facial expression, the reaction retardation, anorexia, fatigue, irregular menstruation, limbs tiredness, dry mouth; symptoms related the kidney:dysuria, imbs tiredness, dry mouth, rapid pulse, restless ness, fatigue; symptoms related with heart: palpitations, insomnia, forgetfulness, easily frightened and timid, laughing and crying impermanence.Modern literature study:total number of syndrome elements was16, the number of nature of syndrome elements was11, respectively, Qi stasis Qi stagnation, phlegm syndrome, blood deficiency, blood stasis, inner fire, Yin difficiency, essence loss, inner wind, wet; the locations of syndromes elements were liver, spleen, kidney, heart, bile; The relationships between syndrome elements were discovered, that’s, liver and Qi stasis (P=0.000), liver and Qi stagnation (P=0.000), Qi deficiency and spleen (P=0.000), Qi deficiency and Yin (P=0.000), Qi deficiency and heart (P=0.000), Qi deficiency and phlegm syndrome (P=0.006), Qi deficiency and blood deficiency (P=0.000), Qi deficiency and blood stasis (P=0.001), spleen and kidney (P=0.021), spleen and heart (P=0.000), heart and liver (P=0.000).10relationships of syndrome element-symptom were established. Symptoms with liver:depression, loss of appetite, diarrhea, stringy pulse; symptoms with spleen:inattention, fatigue, irregular menstruation, loss of appetite, toungue pale, thread pulse; symptoms with the kidney:limb and kness tiredness, decreased libido, taciturn, dry in eyes, addicted to lying, anorexia, thready pulse; symptoms wi th the heart:heart palpitations, irritability, decreased libido, unresponsive, weak pulse; symptoms with the bile:cold in limbs, bitter in mouth; symptoms associated with Qi stagsis:depression, decreased libido, sigh, dark tongue, string pulse, astringent pulse; symptoms with Qi deficiency:fatigue, addicted to lying, loss of appetite, decreased libido, stool disorders, teethmarks, pale tongue; symptoms with blood deficiency:depression, less movement, palpitations, pale yellowish, pale tongue; symptoms with blood stasis:lack of facial expression, irregular menstruation, dry mouth and throat, tongue ecchymosis, pulse string, string and thready pulse; symptoms with inner fire:irritability, bitter mouth, rapid pulse; symptoms with Yang deficiency:cold in limbs, declining interest.Clinical study:The study involved150CM four diagnostic entriers,12syndrom elements were gotten, and there were8nature entries of syndrom elements, that’s, Qi deficiency, Qi stasis, Yin difficiency, phlegm, inner fire, blood stasis, Qi stagnation, blood deficiency; the locations of syndromes elements were liver, spleen, kidney and heart.12relationships were established, that’s, liver-related entries were irritability, dizziness, blurred vision, tinnitus as cicadas, bitter mouth, sigh, threatening pain in both flanks, pulse string; symptoms related with spleen:fatigue, shortness of breath, pale complexion, loose stools, big fat tongue, teethmark, pale tongue, slow pulse; kidney-related entries were tinnitus as cicadas, lumbago, backache, five upset hot in limbs and chest, tired limbs, nocturnal enuresis night sweats; heart-related entries were the timid, palpitations; the symptoms associated with Qi deficiency were timid, weak, pale lips, loose stools, tongue with scalloped edges, tongue pale; Qi stagnation Related entries were epigastric fullness, string and astringent pulse, loss of libido; Qi stasis entries were lack of facial expression, heart palpitations, threatening pain in both flank, astringent pulse; Yin-related entries were tinnitus as cicadas, waist acid, dysphoria hot, five upset hot in limbs and chest, tired in limbs and knees, night sweats, exfoliative tongue, thready pulse; entries associated with inner fire were red complexion, bitter in mouth, dark yellow urine, yellow tongue coating, rapid pulse; entries associated with blood stasis were the blue and dark eyelid, dark purple lips, sublingual varicose veins, dark tongue, irregular menstruation; entries associated with phlegm were sticky mouth, halitosis, cough less white sputum, thick, greasy and yellow tongue coating, slippery pulse; heart-related entries were fear and easily frightened, pale lips, heart palpitations, tongue body fat, and more sleep soundly, thready pulse. There are2related syndrome elements with Qi stagnation(P=0.01) and blood stasis (P=0.002).ConclusionThere are18syndrome elements in ancient literatures’ research, the most common syndrome elements are Qi stagnation, qi deficiency, liver and spleen.16syndrome elements involve in modern literatures the most common syndrome elements are Qi stasis, Qi deficiency, liver and spleen. There are12syndrome elements, the most common syndrome elements are Qi deficiency, Qi stasis,1iver and spleen. There is a high degree of consistency among the three studies, so Qi stasis, qi deficiency, liver and spleen are common in depression.The difference among3studies:ancient literature had other syndrome element, that’s, essence loss, inverse Qi, lung and stomach, without Qi stasis, but inner wind and qi stasis were observed in modern literatures and clinical studies. The differences may come from the theory of Yu about emotional disorders of the doctors, which also showed that ancient doctors had different poinlviews especially, emphasis on personal experience, so the need for harmonization and standardization research for CM depression is nessary.