Explore The TCM Syndrome Differentiation And Classification Of Depression And Its Correlation With Objective Indicators Based On Literature And Clinical Evidence

Objective:We explores the distribution of TCM syndrome differentiation and classification,its related symptoms and the tongue pulse of depression through literature research.And we collecte and analyse the medical records of patients with clinical depression to explore the correlation between TCM syndromes of depression and objective indicators.It provides reference basis for quantification and objectification of TCM syndrome differentiation and classification and prevention of depression in the future.Methods:We retrieve relevant literatures on TCM syndrome differentiation and classification of depression from CNKI database,Wanfang database and VIP database in recent 10 years from January 2010 to December 2019,then we performed a statistical analysis of relevant data of the collected literature.At the same time we collect depression patients who were meets the inclusion and exclusion criteria and admitted to the First Teaching Hospital of Tianjin University of TCM from September 1,2016 to August 31,2020.And collecting their general information,HAMD-24 score,HAMA scores,course and laboratory related indicators and TCM syndrome type.Excel 2017 form was used to establish the database,and SPSS 21.0software was used for statistical analysis of the data.Results:1.59 literatures and 4 books were included in the literature study.And we get 23 specific syndromes and a few other syndromes by analyzing 384 syndromes related datas we collected.The common TCM syndromes of depression are deficiency of both heart and spleen,stagnation of liver-qi,stagnation of phlegm-qi,liver-qi and deficiency of spleen and qi stagnation transforming into fire.There are 17 common symptoms and 10 other rare symptoms of deficiency of both heart and spleen.The tongue pulse is mainly light,the tongue coating is thin and white,and the pulse is mainly fine,fine and deep.There are 17 common symptoms and 13 other rare symptoms of stagnation of liver-qi.The tongue veins are mainly light or red,the tongue coating is thin and white,and the pulse is mainly string or string slippery.The common symptoms of stagnation of phlegm-qi are 8 kinds and other rare symptoms are 16 kinds.The tongue veins are mainly light,the tongue coating is mainly white greasy,and the pulse is mainly string slippery.There are 14 common symptoms and 17 other rare symptoms of liver-qi and deficiency of spleen.The tongue veins are mainly light or light and red,the tongue coating is mainly thin and white or greasy,and the pulse pattern is mainly string thin.There are 11 kinds of common symptoms and 8 kinds of other rare symptoms of qi stagnation transforming into fire.Tongue veins are mainly red,tongue coating is mainly yellow,and pulse pattern is mainly string number.2.In the clinical study,301 patients with depression were included.The female patients with depression were more than male patients.The average age of the patients was52.10±11.63 years old,and the patients aged 41 to 65 years old accounted for the highest proportion.The largest proportion of occupations was retired;The highest proportion of marriage status was married.In the seasonal distribution of admission,the most patients were admitted in autumn.The main distribution of depression degree was mild and moderate depression.98.67% of the patients were accompanied by anxiety symptoms,and were mainly moderate anxiety.In the distribution of TCM syndrome types of depression patients,the syndrome of stagnation of liver and qi was the most,followed by the syndrome of qi stagnation transforming into fire,the syndrome of stagnation of liver-qi and deficiency of spleen,deficiency of heart and spleen,syndrome of qi stagnation and blood stasis,and syndrome of stagnation of phlegm-qi from high to low.In laboratory related indicators,the abnormal rate of FBG value was 4.98%;The abnormal rate of Hcy value was 26.25%;The abnormal rate of D-D value was 23.59%;The abnormal rate of WBC value was 4.98%;The anomalous rate of TC value was 29.24%;The abnormal rate of TG value was 33.22%;The abnormal rate of HDL value was 69.44%;The abnormal rate of LDL value was 16.61%;The abnormal rate of PT value was 1.33%;The abnormal rate of APTT value was 5.32%;The abnormal rate of TT value was 1.66%;The abnormal rate of FIB value was 19.27%.The course of disease of the patients with liver-qi and deficiency of spleen was generally longer than that of the patients with tagnation of liver-qi and qi stagnation transforming into fire(P<0.05).The regression coefficient of age of qi stagnation transforming into fire and tagnation of liver-qi was negative and statistically significant(P<0.05),and compared with tagnation of liver-qi,older patients are more likely to be diagnosed as qi stagnation transforming into fire.The regression coefficients of HAMA score of qi stagnation transforming into fire,tagnation of liver-qi and liver-qi and deficiency of spleen were all negative and statistically significant(P<0.05),and it indicates that patients with high HAMA score are more likely to be diagnosed as qi stagnation transforming into fire.There were differences in HDL distribution between tagnation of liver-qi and qi stagnation transforming into fire(P<0.05),and the proportion of increased HDL value in patients with tagnation of liver-qi was significantly higher than that of qi stagnation transforming into fire.The regression coefficients of TC value of qi stagnation transforming into fire,tagnation of liver-qi and liver-qi and deficiency of spleen were all positive and statistically significant(P<0.05),and it indicates that patients with normal TC value are more inclined to be diagnosed as tagnation of liver-qi and liver-qi and deficiency of spleen.The regression coefficients of LDL value of qi stagnation transforming into fire,tagnation of liver-qi and liver-qi and deficiency of spleen were all positive and statistically significant(P<0.05),and it indicates that patients with normal LDL value are more likely to be diagnosed as qi stagnation transforming into fire.3.HAMD-24 score was positively correlated with blood WBC(P< 0.05),and the regression equation could be expressed as(?)Y =3.07+0.10 X,R=0.22,R2=0.05;HAMD-24 score was negatively correlated with APTT(P < 0.05),and the regression equation could be expressed as(?)Y =31.20-0.16 X,R=0.13,R2=0.02;HAMD-24 score was positively correlated with FIB(P<0.05),and the regression equation could be expressed as(?)Y =1.68+0.03 X,R=0.17,R2=0.03.Conclusions:1.There are many TCM syndromes of clinical depression.The common TCM syndromes of depression are deficiency of both heart and spleen,stagnation of liver-qi,stagnation of phlegm-qi,liver-qi and deficiency of spleen and qi stagnation transforming into fire.2.TCM syndrome type of depression is correlated with disease course,age,HAMA score,HDL value,TC value and LDL value,which may be used as an indicator of TCM syndrome differentiation and classification of depression.The long course of disease,low HAMA score,normal TC value and abnormal(elevated)LDL value have certain reference value for the diagnosis of liver-qi and deficiency of spleen.Short course of disease,older age,high HAMA score,normal or lower HDL value,abnormal(elevated)TC value and normal LDL value have certain reference value for the diagnosis of qi stagnation transforming into fire.Short course of disease,younger age,low HAMA score,elevated HDL value,normal TC value and abnormal(elevated)LDL value have certain reference value for the diagnosis of stagnation of liver-qi.3.The higher the degree of depression,the more severe the inflammatory response and the faster the blood clots.