| In recent years ,with the more fast living and working rhythm,the more pressure people feel,and gradually increased incidence of anxiety,among which generalized anxiety disorder(GAD) is the most common.This has been a serious threat to human health and quality of life. Modern medicine for the treatment of generalized anxiety disorder work quickly, but there adverse reactions, such as poor tolerance and dependence, and this can lead to poor clinical effect. Chinese medicine treatment for generalized anxiety disorder has its own unique advantages. This study, based on the previous work, statistical sorting through literature,was to explore the features of traditional Chinese clinical syndromes of generalized anxiety disorder.Depression of the fire type is proved to be the more common clinical type of traditional Chinese medicine,and Shugan Xiehuo is used to treat it. And from clinical syndromes,inflammatory factors,Rs-fcMRI,etc. comprehensively evaluate its clinical efficacy observed.1 Research of Xiegan Anshen Formula for the treatment of generalized anxiety disorder randomized double-blind placebo-controlled studyObjective To observe the therapeutic effect of Xiegan Anshen Formula on generalized anxiety disorder and to explore its mechanism by observing the changes of inflammatory factors.Method Outpatients selected 72 patients with generalized anxiety disorder,who were assessed with the Hamilton Anxiety Scale ( HAMA) and the Hamilton Depression Rating Scale (HAMD) .Outpatients selected with generalized anxiety disorder were treated with Xiegan Anshen Formula and placebo by randomized double-blind-double-imitate method.,a 4-course of treatment. The selection of the Hamilton Anxiety Scale (HAMA),the TCM Syndromes of self-made scale and inflammatory factors were carried out comprehensive evaluation of its efficacy and mechanism.Result 1 .The total effective rate of the HAMA of the Xiegan Anshen Formula group and placebo group was 83.33% and 40% respectively.There were significant differences between them(P <0.01 ). There were differences between before and after 2 week and 4 week treatment in the scores of HAMA and the TCM Syndromes of self-made scale in both groups(P<0.05).There wasn’t difference in improving TCM syndromes between 2 groups after 2 weeks treatment,but significant differences improved between 2 groups after 4 weeks treatment(P <0.01).2.Inflammatory factors:In interleukin 1β(IL-1β),tumor necrosis factor(TNF-a),interferonγ(IFN-y)and cortisol(CS) aspects,there were differences in Xiegan Anshen Formula group between before and after treatment(P<0.05)while there wasn’t in placebo group(P>0.05).There wasn’t differences in interleukin 6(IL-6)between 2groups(P>0.05).There were differences in prostaglandinE2 (PGE2)in2 groups (P<0.05).After 4 weeks treatment,there were differences in 2 groups in IL-1β,IL-6,TNF-a,CS and PGE2(P<0.05)except IFN-y(P>0.05).Conclusions l.The changes of the HAMA scale and the TCM Syndromes of self-made scale scores show that placebo could improve the syndromes of GAD,but its effect is far less than Xiegan Anshen Formula.And with the extension of treatment time, Xiegan Anshen Formula improve TCM symptoms better than placebo .2.Levels of IL-1β,TNF-α,IFN-γ and CS were lower in Xiegan Anshen Formula group than that in placebo group after 4weeks treatment.Though Xiegan Anshen Formula could lower the level of IL-6,its effect was so light that there was no difference between before and after treatment-Two groups could lower the level of IFN-y.Though the effect of Xiegan Anshen Formula was better than placebo,there wasn’t difference within group comparisons.Level of PGE2 could be reduced by two groups,but the effect of Xiegan Anshen Formula was better than the placebo.2 Investigation of the brain function mechanism of Xiegan Anshen Formula to treat generalized anxiety disorder with resting-state functional connectivity magnetic resonance imaging(Rs-fMRI)2.1 To investigate the mechanism of brain function in patients with GAD in different syndromes with Rs-fMRIObjective To observe the differences and mechanisms of brain function in GAD patients in different syndromes with Rs-MRI.Method Outpatients selected 20 patients with GAD in liver depression of the fire,20 with GAD in liver depression and 20 normal healthy controllers, who were assessed with the Hamilton Anxiety Scale ( HAMA) and the Hamilton Depression Rating Scale(HAMD) .Volunteers were tested in a resting-state fMRI scan only once and required to maintain the resting state: lying quietly, eyes-closed and not thinking.Result 1 .Functional connectivity analysis was used to reconstruct the default network in patients and healthy volunteers.There were significantly differences in both medial prefrontal,anterior cingulate,precuneus,back to the top of the right side among the 3 groups.2.Four increased connections were bilateral medial prefrontal,the anterior cingulate,the superior parietal gyrus and ascending parietal convolution between liver depression groups and heathy control groups,while four decreased connections were left anterior centra,lenticular nucleus,caudate and hippocampus between two groups.The brain functions in the areas of bilateral medial prefrontal cortex and the anterior cingulate in liver depression of the fire group were bigger than that of heathy control group and the brain functions of the left superior temporal gyrus,insula and post central gyrus and inferior parietal lobule in liver depression of fire group were smaller than that of heathy control group. More increased connections were bilateral precuneus and posterior cingulate in liver depression of the fire group than that of liver depression group.3.There wasn’t any effective relation between DMN and HAMA .Conclusions The differences of liver depression of fire group and liver depression group in brain function compared to the normal control may suggest it is necessary to differente in TCM.2.2 To investigate the brain function mechanism of Xiegan Anshen Formula for the treatment of generalized anxiety disorder with resting-state functional connectivity magnetic resonance imaging.Objective To observe the differences and mechanisms of brain function with Rs-MRI in GAD patients treated .Method Outpatients selected 60 patients with GAD in liver depression of the fire who were assessed with the Hamilton Anxiety Scale ( HAMA) and the Hamilton Depression Rating Scale (HAMD) and were treated with Xiegan Anshen Formula and placebo by randomized double-blind-double-imitate method.,a 4-course of treatment. Volunteers were tested in a resting-state fMRI scan before and after 4-week treatment ,who were required to maintain lying quietly,eyes-closed and not thinking during the scans.Result 1.Results of 2×2 repeated measures analysis of variance interaction in human brain default mode network were bilateral precuneus,middle cingulum,gyri occipitales superiores,middle occipital gyrus and the superior parietal gyrus.2.The brain functions in DMN of frontal lobe, lobi temporalis and parietal lobe in Xiegan Anshen Fomula group were bigger than the placebo group while the bilateral precuneusleft and cingulum were smaller.There were differences between 2 groups before treatment and this differences disappear after 4 weeks treatment.3.The brain functions of the left hippocampu,amygdaloid and gyri fusiformis were bigger in Xiegan Anshen Fomula before treatment in DMN.The brain functions of bilateral precuneus and posterior cingulate were bigger in placebo group in DMN before treatment while bilateral occipital gyrus and middle occipital gyrus were bigger after treatment.4.There wasn’t any effective relation between DMN and HAMA .Conclusions There were differences between 2 groups before treatment and this may be result from randomness.But the differences disappear after 4 weeks treatment,which meant Xiegan Anshen Fomula did effectively in treating generalized anxiety disorder. |
