A Clinical Study On The Treatment Of Depression In The State Of Overthinking And Deficiency Of The Heart And Spleen By Combining Guipi Decoction Add-minus With Escitalopram

Objective: Based on the theory of "psychological disorders state in Chinese medicine",we created the Guipi decoction add-minus base on the original Guipi decoction after long-term clinical practice.This formula was used to verify the superiority of Guipi decoction add-minus in the treatment of depressed patients with overthinking state and deficiency of the heart and spleen,with a view to further improving the traditional system of zang-fu identification and treatment,constructing a clinical treatment concept with "psychological disorder state" as the core,and expanding the clinical treatment ideas and protocols of depression.Methods: The 64 patients who satisfied the inclusion criteria were randomly divided into two groups of 32 patients each.The trial group was treated with Guipi decoction add-minus combined with escitalopram,whereas the control group was treated with escitalopram alone.After 8 weeks of treatment,2 patients in each of the trial and control groups were excluded from this trial due to poor compliance and active withdrawal.The final statistical analysis of the efficiency and scores of the Hamilton Depression Scale(HAMD-17),the Chinese Medicine Overthinking State Rating Scale,and the Chinese Medicine Syndrome Scale of 60 patients before and after treatment,as well as the test of safety,was conducted to evaluate the superiority of combined application of Guipi decoction add-minus in the treatment of depression.Results:1 General informationBetween the two groups,there was no difference in age or gender(P>0.05).Before treatment,there were no significant differences in HAMD-17,the Chinese Medicine Overthinking State Rating Scale with its subscales,or the Chinese Medicine Syndrome Scale scores between the two groups(P>0.05).2 HAMD-17 scale2.1 Efficacy judgment: The trial group’s effective rate was 86.67%,compared to 63.33% for the control group,indicating that trial group’s efficacy was higher than the control group’s(P<0.05).2.2 Score: After treatment,the scores of the two groups were lower than before(P<0.05),and the scores of the trial group were lower than the control group(P<0.05).3 The Chinese Medicine Overthinking State Rating Scale3.1 Efficacy judgment: The trial group’s effective rate was 90%,compared to 66.67% for the control group,indicating that trial group’s efficacy was higher than the control group’s(P<0.05).3.2 Scores:3.2.1 Total Scale:After treatment,the scores of the two groups were lower than before(P<0.05),and the scores of the trial group were lower than the control group(P<0.05).3.2.2 Subscale Scale:In both groups,the scores on the five Chinese Medicine Overthinking State Rating Scale subscales were lower than before(P<0.05).The scores of "head and face discomfort" "psychological and behavioural changes" and "throat discomfort" in the trial group were lower than those in the control group after treatment,and there was a statistical difference(P<0.05).The scores of "discomfort in the middle gastrointestinal tract" and "neck,shoulder,and limb discomfort" were lower than those of the control group after treatment,but there was no statistical difference(P>0.05).4 The Chinese Medicine Syndrome Scale4.1 Efficacy judgment: The trial group’s effective rate was 80%,compared to 53.33% for the control group,indicating that trial group’s efficacy was higher than the control group’s(P<0.05).4.2 Score: After treatment,the scores of the two groups were lower than before(P<0.05),and the scores of the trial group were lower than the control group(P<0.05).5 Safety situationThe control group had two minor adverse events whereas the trial group had none,and there was no difference in safety between the two groups(P>0.05).Conclusion: The combination of Guipi decoction add-minus with escitalopram was effective in treating patients with depression in the state of overthinking and deficiency of the heart and spleen,further improving the symptoms of depression,alleviating psychological disorders(especially "head and face discomfort","mental behavioural changes" and "throat discomfort")and reducing the symptoms of deficiency of the heart and spleen in Chinese medicine than using escitalopram alone.It is safe for clinical use and deserves further promotion and in-depth study.