| BackgroundSubthreshold depression(SD)refers to the existence of partial depressive symptoms which do not meet the diagnostic criteria of depression.It can be considered as somewhere in between the healthy and depression.With the increased social competition and the accelerated pace of our daily lives,it is generally seen a higher incidence of SD.Similar to the effects caused by depression,SD can also cause severe decline in occupational function,social impairment,increased medical burden,and a high proportion of morbidity,suicide and disability rate.Thus this caused wide attention by the researchers from all over the world.The traditional Chinese medicine(TCM)contains a wealth of preventive and therapeutic medicine.Using Chinese medicine on SD for therapy with syndrome differentiation is conducive to preventing subliminal depression to depression,and promoting depression to subliminal depression and ultimately towards being healthy,thereby improving the quality of life,and reducing national and social economic burden.ObjectiveCombining Professor Qisheng Tang's clinical experience,in this research SD of asthenia of heart and spleen type,and asthenia of heart and gallbladder qi type are selected for random,controlled,and blind method of observation.Hamilton Depression Scale(HAMD)and TCM Syndrome Evaluation Scale are being used for purpose of evaluating therapeutic efficacy.The purpose of this research is to validate the effectiveness of invigorating qi and blood to nourish heart and spleen method and tranquilizing spirit to stabilize mind method,deepening the understanding of SD,thereby verifying the accuracy of SD's TCM syndrome-classification and the effect of syndrome differentiation and treatment.According to the TCM early treatment theory,by using Chinese medicine to intervene SD,we can observe the percent conversion from SD to depression and SD's self-healing rate,to explore whether therapy with TCM syndrome differentiation interfering the progression from SD to depression.Methods and ResultsMethodsThe subjects selected from the three affiliated hospitals of Beijing University of Chinese Medicine and its six community outpatients who were undergoing subliminal depression,pursuant to the randomized,controlled,double-blind principle.The total number of cases observed is 120 cases,concluding 30 cases of asthenia of heart and spleen treatment group(that is Gui Pi Tang treatment group)and its control group of 30 cases,30 cases of asthenia of heart and gallbladder qi treatment group(that is An Shen Ding Zhi Wan treatment group)and its control group of 30 cases.The heart and spleen treatment group was interfered by Gui Pi Tang boil-free granule,the heart and gallbladder qi treatment group by An Shen Ding Zhi Wan boil-free granule,and placebo control group by starch dextrin granule.The three groups of treatment course are 6 weeks.We had observed the 1st week,2nd week,4th week and 6th week's effect of treatment.The changes of the indexes were analyzed before and after treatment,by using statistical description methods.ResultsUsing HAMD deduction rate and TCM efficacy index to evaluate the clinical curative effect:both the HAMD deducted efficacy of treatment groups are better than the controlled group.There are significant differences between groups.Analyzing the conversion rate to depression and SD's self-healing rate:there was significant difference between the two treatment groups and the control group at the 6th week.Using ?2 test to analyze,the result shows that P is less than 0.05,namely the statistically significant difference between the two groups.Through treatment,at the 6th week,25%of patients from the Gui Pi Tang test group who previously had SD recovered his health and only 1 case was converted to depression during to stress and strain changes in his daily life.In addition,there are 71.43%of the patients still remain in the SD state.But in its control group,79.31%of the patients remained in the SD state,and 13.79%were converted to depression.Self-healing phenomenon was observed in 6.90%of patients.For An Shen Ding Zhi Wan group's patients,43.33%of the cases returned to healthy,none progressed to depression,and 56.67%remained in SD state.In its control group,71.43%of the patients remained in the SD state,and 14.29%were converted to depression.Also,observed self-healing phenomenon for 14.29%of patients.Conclusion1.Application of the method of invigorating qi and blood to nourish heart and spleen and tranquilizing spirit to stabilize mind to treat SD can achieve good curative effect and have no obvious side effects.2.The rate of depression in the two groups was significantly lower than that in the control group,and the cure rate was significantly higher than that of the control group,indicating that the Gui Pi Tang and An Shen Ding Zhi Wan in the process of decline in subthreshold depression to depression played an effective role in blocking.3.At the 6th week,6.9%and 14.29%of the patients in the two control groups recovered to healthy,illustrating that SD had a tendency to self-healing. |
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