| The Bio-psycho-social medical model emphasizes that psychological and emotional activities can be closely related to multiple diseases.Acute myocardial infarction(AMI)and depression were public health problems that seriously endanger human health.Studies had shown that,depression was an independent risk factor for coronary heart disease and could increase the incidence of AMI.Depression after myocardial infarction was 35%to 45%.Severe depression accounts for 15%to 20%.Analysis had shown that patients with depressive and myocardial infarction have a 2-4 times increased risk of death from cardiovascular events.The treatment of Psycho-cardiacology was getting more and more important.Chinese patent medicine has the advantage of multiple targets.Many applications of Chinese medicine in the treatment of Psycho-cardiacology disease have achieved good clinical results.However,the explanation for its mechanism of action is insufficient.In the early research,it has been proved that SYD can reduce the myocardial protective effect of reperfusion injury of AMI from the aspects of biological morphology,serology,and molecular biology.On this basis,this study was to observe the effect of SYD on the emotional state of AMI patients and the behavioral pattern and 5-HT of AMI/depression rats.Through this study,we expect to provide new ideas and basis for the clinical application and mechanism of SYD.This study was divided into four parts:clinical research,basic research,literature review and systematic review.1.Clinical study:The effect of SYD on emotional state of AMI patients.[Objective]To observed the effect of SYD on emotional state in patients with AMI and depression.[Methods]Used a randomized controlled observational approach,the subjects were all inpatients with AMI and depressive status in the Department of Cardiology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University.56 patients were enrolled into the SYD group(n=26)and control group(n=30).Patients were treated with AMI standardized treatment.The SYD group was superimposed with SYD for 4 weeks.The clinical observation index was the HAMD-17.The observation time points were 0 weeks and 4 weeks.[Results]P<0.05 was considered statistically significant.There were no statistical difference between baseline in the control group and the SYD group.①Comparison of HAMD-17 scores:There were no statistically significant difference in HAMD-17 scores between the SYD group and the control group.After 4 weeks of treatment in the SYD group and control group,the score of HAMD-17 decreased compared with 0 week,and the difference was statistically significant.After 4 weeks of treatment,the HAMD-17 score of the SYD group was lower than that of the control group,and the difference was not statistically significant.②HAMD-17 efficacy analysis:The HAMD-17 scores of the SYD group and the control group were no statistically significance.Calculate the score reduction of the HAMD-17 scale after 4 weeks of treatment in both groups.HAMD-17 reduction rate in 25%-50%was effective,HAMD-17 reduction rate ≥50%is markedly effective.According to the effective number and effective ratio of the number of people in the same group to calculate the efficiency.The effective rate in the SYD group was 73.08%;the effective rate in the control group was 36.67%.The SYD group was more effective than the control group,and the difference was statistically significant.③HAMD-17 subgroup analysis:When the group was entered,the scores of the subgroups in the SYD group and the control group were no statistically significant.1)Anxiety/Somatization:After 4 weeks of treatment in the SYD group,the score of the subgroup was lower than 0 week,which was statistically significant.In the SYD group,the scores at the 4th weeks were lower than those in the control group.The SYD group had a higher reduction rate than the control group and the difference was statistically significant.2)Retardation:After 4 weeks of treatment in the SYD group,the score of the subgroup was lower than 0 week,and the difference was statistically significant.The difference between the two groups at 4 weeks has no statistically significant.The SYD group had a higher reduction rate than the control group and the difference has no statistically significant.3)Cognitive disorders:After 4 weeks of treatment in the SYD group,the score of the subgroup decreased compared with that of the group,and the difference was statistically significant.The scores of the subgroups at 4 weeks of treatment in the two groups were compared,and the trend in the test group was lower than that in the control group.The difference has no statistically significant.The SYD group had a higher reduction rate than the control group and the difference has no statistically significant.4)Sleep disorder:The scores of the subgroups at 4th weeks in the SYD group was lower than those in the group,and the difference was statistically significant.Compared two groups at the 4th week,the SYD group had a tendency to be lower than the control group,and the difference has no statistically significant.The SYD group had a higher reduction rate than the control group and the difference has no statistically significant.5)Weight:The scores of the SYD group at the 4th week were lower than those in 0 week,and the difference was not statistically significant.The scores of the two groups were compared between 4 weeks.The improvement degree in the experimental group was better than that in the control group.The difference was not statistically significant.The SYD group had a higher reduction rate than the control group and the difference has no statistically significant.[Conclusions]SYD may improve the clinical symptom of AMI patients with depression.2.Basic experiment:The effect of SYD on Behavior pattern and serum 5-HT in AMI/Depression Rats.[Objective]To observed the effect of SYD on behavioral pattern and neurohumoral fluid in AMI/depression rats.[Methods]24 SD rats were allocated into normal group,model group,H-SYD group and L-SYD group randomly.The model was established by coronary artery ligation with chronic mild unpredictable stimulation and feeding alone.After 18 day’s pretreatment with large dose of SYD,low dose of SYD or distilled water.Observe open-field experiment and sugar consumption test results of SD rats.5-HT in serum of the rats in different groups were be measured.[Results]P<0.05 was considered statistically significant.①Behavior pattern 1)Weight:Before the experiment,the weights of animals in each group were no significant difference.The weight of each group D18 increased compared with the same group D1,the difference was statistically significant.Compared with the normal group,the weight gain of the model group rats was small,and the difference was statistically significant.Compared with the model group,rats in the H-SYD group and L-SYD group had a large increase in body weight,the difference was statistically significant.There was no significant difference between H-SYD group and L-SYD group.2)Open-field experiment:Spontaneous activity scores in each group before the experiment were not statistically different.After modeling each group of rats,the score of open-field experiment activities was lower than that of the same group before the intervention,and the difference was statistically significant.The scores of horizontal and vertical movements in the model group were lower than those in the normal group.The scores of spontaneous activity in the H-SYD group and L-SYD group were higher than those in the model group,and the difference was statistically significant.There was no significant difference between H-S YD group and L-SYD group.3)Sugar consumption test:There was no significant difference in the degree of sugar-water preference between rats before experiment.The degree of sugar water preference in each group was lower than before,and the difference was not statistically significant.After the intervention of the SYD,the sugar consumption of the model group and the percentage of the sugar water preference decreased compared with the normal group.Compared with the model group,the percentage of sugar-water preference in the H-SYD group and the L-SYD group increased,and the difference was not statistically significant ② Serum 5-HT concentration:Compared with the normal group,the 5-HT concentration in the model group decreased,the difference was statistically significant.The serum 5-HT concentration in H-SYD group and L-SYD group were higher than those in the model group,and the difference was statistically significant.[Conclusions]SYD can improve the behavioral performance of AMI and depression animal models,while improving serum 5-HT concentration.3.Literature review:By summarizing the literature,to tell the mechanism of acute myocardial infarction and depression.To summarized the Chinese and Western medicine treatment.4.Systematic review:By summarizing information on the methodology,bias,and research objects of the literature on treatment of depression and depression in traditional Chinese medicine,the quality of current search literature is evaluated,and the efficacy index is to be evaluated by meta-analysis to evaluate its effectiveness. |
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