| The first part IntroductionDepression is an affective disorder, is a sad,sad or depressed, negative emotional experience,may be caused by genetic factors,psychological and social environmental factors, physical factors, and other reasons. The main symptoms:depression, anhedonia, sleep disturbance, weight change, psychomotor agitation or retardation, fatigue or energy deficiency, decreased libido, and even repeated the idea of death or suicide.World Health Organization (WHO) estimates that worldwide 300 million to 40 million patients with depression, patients with depression have more than 2600 million. According to data provided by the World Health Organization, depression and suicidal behavior in patients with incidence of 28.5% - 63.7%, 25% of suicide attempts, 15 percent ultimately committed suicide, the mortality rate of patients with depression at least two times that of ordinary people. It is estimated that by 2020 depression caused by functional defects the number of patients will rise to second place, about 13% -20% of a person's life there had been a depression experience.Therefore, depression is more and more attention has been paid.The depression of the onset and development is closely related to the neurotransmitter numerous aspects of the transfer process, in addition to the endocrine and immune function of change in terms, for a variety of factors interacting results. The main etiology and pathogenesis of doctrine, including single by type of neurotransmitter doctrine the doctrine of the neurotrophic factor, nerve and endocrine theory. With the development of modem scientific and technological means,especially in recent years, functional imaging tools depression has become a hot played an important role in pathological positioning of the depression, now that the brain stem, frontal lobe, hippocampus, amygdala, cingulate return of the parts and depression occur close relationship.Depressed patients with a high incidence of depression, serious harm, high recurrence rate and other characteristics, to great suffering. Western medicine commonly used antidepressants, including tricyclic antidepressants, monoamine oxidase inhibitors, selective 5-HT reuptake inhibitors,5-HT and NE reuptake inhibitors, the specific 5-HT and NE inhibitor ,5-HT antagonist / reuptake inhibitors and so on.More Western medicine commonly used types of antidepressants, but its efficacy is similar,about 70%. And various types of antidepressant drugs have side effects. The process of treatment, the physician must be based on the condition of patients with depression, comorbidities, medication history, may have adverse reactions to make a prudent choice. A heavy financial burden due to the longer of antidepressant treatment long-term medication to patients. Therefore, the Western medicine commonly used antidepressant drugs due to the limitations and impact of the various aspects has brought many difficulties to antidepressant treatment. Then,gradually reduce the dose of Western medicine antidepressants on the basis of the treatment should be combined with Chinese medicine treatment,can reduce not only western medicine side effects, but also reduce treatment costs and reduce the economic burden of patients. Or select a curative, safe, no recurrence of the pure drug of traditional Chinese medicine is a new direction of development of antidepressant treatment.The ancient Chinese literature, there is no depression of disease, and depression-related performance, and the causes, symptoms, treatment and other aspects of records is quite rich. Grouped of depression (depressive), the other scattered lily disease, the dirty impatient, Epilepsia, Bentun gas and globus gas and other diseases,more than the basic pathogenesis of air stagnation, and folders sputum fatigue, virtual, and pathological factors such as depression, mood restless, chest stuffiness, flank pain, or irritable Yuku, or pharynx in case of foreign body obstruction embolism as the main symptoms.Tutor Professor Chen Baotian After 40 years of clinical experience and study the"Nei Jing" and other classics on the basis of integrated traditional Chinese medicine various awareness of depression, based on traditional Chinese medicine from a functional point of view, from a holistic perspective, from the change point of view to grasp the basic law of lifecharacteristics, the "yin and yang, to the tune of five gods,and business health of the overall treatment Dafa, founded the AnShenfang by side the Chaihuguizhi soup on the basis of the clinical treatment of depression and achieved good effect. The AnShenfang side Bupleurum, Scutellaria, Pinellia Codonopsis, ginger, jujube, licorice root, white peony root, cassia twig, Semen,Polygala night Kodo and other drugs. Our group pre-clinical observation and experimental study has confirmed that AnShenfang of primary insomnia, reliable efficacy and a clear pharmacodynamic mechanism. The significance of this topic is to AnShenfang of the Treatment of Depression by observing the effect; and experimental study to understand the pharmacodynamic mechanism of AnShenfangof the Treatment of Depression. Provide a reliable theoretical and clinical basis for sleep side development.The second part the experimental partObjectiveTo evaluate the pharmacodynamics of AnShenfang of the Treatment of Depression Mechanism.Methods48 Wistar rats were randomly divided into normal group, model group,AnShenfang side high dose group, AnShenfang prescription dose group, AnShenfang side low dose group and sertraline group (n = 8). In addition to the normal group, the remaining five groups of chronic moderate-intensity stress stimulus model,modeling,time for administration of 7 days for 3 consecutive weeks. The rats were observed swimming in the water does not move the time and field test. Detection of 5-HT, NE,NGF, and of BDNF.ResultsImmobility time in forced swimming rats in the water: AnShenfang side high-dose group,AnShenfang prescription dose group,AnShenfang side low dose group, the western medicine group and model group and normal group before modeling,rats swimming in the water time have no significant differences (P =0.063),indicating that the model was successful. AnShenfang side high-dose group,AnShenfang prescription dose group, AnShenfang side low-dose group, the western medicine group and model group after treatment, rats swimming in the water does not move significantly reduced, a significant difference (P <0.05), indicating that AnShenfang can improve the rat swimming in the water is fixed.Open-field test scores: medication AnShenfang side high dose group,AnShenfang of the prescription dose group, the WM group, the normal group and model group rats after the field test to take the number of cells increased significantly,a significant difference (P <0.01); medication after AnShenfang on side of the high dose group, the AnShenfang prescription dose group, the WM group, the normal group and model group field test in rats standing significantly increased frequency of significant difference (P <0.01); instructions AnShenfang can improve the model of depression mouse activity.Changes of monoamine neurotransmitters in the brainstem: to AnShenfang side high dose group, AnShenfang of the prescription dose group, the WM group after treatment, the normal group and model group, 5-HT content was significantly increased statistically significant (P<0.01),indicating that AnShenfang can improve the model of depression in the rat brainstem 5-HT content. Medication AnShenfang side of the high dose group, AnShenfang prescription dose group and normal group and model group, the NE concentration increased significantly (* P <0.001, ** P<0.05),indicating that AnShenfang can improve a model of depression NE concentration in the rat brainstem.Hippocampus after administration of nerve growth factor and brain-derived neurotrophic factor, AnShenfang side high dose group, AnShenfang of the prescription dose group, the WM group, the normal group and model group compared with the model of depression in rat hippocampal nerve growth factor significantly increased, with statistical learning differences (P <0.01), indicating that AnShenfang can improve the model of depression in rat hippocampal nerve growth factor in Medication AnShenfang side high dose group, AnShenfang of the prescription dose group, the WM group, the normal group and model group was significantly higher model of depression in rat hippocampal brain-derived neurotrophic factor, a significant difference (P <0.01), indicating the AnShenfang can improve the content model of depression in rat hippocampal brain-derived neurotrophic factor.DiscussionAnShenfang can improve the 5-HT content model of depression in the ratbrainstem; AnShenfang can come down to the content of NE in depression model rat brainstem. The AnShenfang can improve the content model of depression in rat hippocampal nerve growth factor and brain-derived neurotrophic factor.The Third Part Clinical observationPurposeObservation AnShenfang side treatment of depression in patients with efficacy and adverse effects.MethodsAll patients meet the diagnostic criteria of Chinese classification of mental disorders diagnostic criteria (CCMD-3) of depression. Patients from the Southern Hospital of Traditional Chinese Medicine, neurology clinics and wards, male or female, age 18-70 years old, a total of 60 cases were randomly divided into AnShenfang side group, Zoloft (round the forest) group. N = 30 cases. AnShenfang decoction group given to AnShenfang recipe decoction (a pair of morning and evening hours service); Zoloft (50mg, 1 / B); each group before and after treatment for three conventional, liver and kidney function tests. Evaluation of patients with Zung scale score?Chinese medicine symptom scale score and TESS adverse events scale before and after treatment.ResultsObservation group and control group Zung scale score before treatment was no significant difference (F = 0.197,P = .659). Zung scale differences in patients before and after treatment using analysis of covariance, the two groups before and after treatment, changes in depressive symptoms (F = 8.887, P = 0.004), there are significant differences. Explain the observation group than the control group to improve patients' symptoms of depression.Observation group and control group before treatment, Chinese medicine symptom scale score was no significant difference (F = 1.372, P = 0.246). Patients with Chinese medicine symptom scale differences in the two groups before and after treatment using analysis of covariance of changes in depressive symptoms before and after treatment (F = 3.878, P = 0.054), no significant difference. The observation group and control group efficacy to improve patients' symptoms of depressionAdverse reactions of taking the of AnShenfang side of patients with Tess Scale score: before and after administration between different time points in each group the differences were statistically significant (F = 97.256, P = 0.000), the experimental group F = 3.969, P = 0.056, control group F = 90.285, P = 0.000, indicating that the monthly adverse symptoms of the experimental group no significant changes in monthly adverse symptoms in the control group gradually reduced. Differences between the groups symptoms of side effects was statistically significant (F = 69.847,P = 0.000) from each time point, taking a month, taking two months, taking the 3 adverse symptoms difference statistics significance (F = 86.042,53.685,41.716, P ?0.000) Throughout the above that the symptoms of side effects of the observation group was significantly less than the control group. Each group and the interaction effect (F = 7.428, P = 0.000) between the time the medication, the analysis is consistent with the multiple comparisons between the front at different time points in each group.DiscussionAnShenfang side with sertraline compare the treatment of depression results have been very. The AnShenfang side treatment of depression symptoms of adverse reactions was significantly less than the sertraline group. |
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