| Objective1.To explore the relationship between COPD complicated with depression(light,moderate and severe)and gender,age,course of disease,BODE index,CAT score and other factors,to compare the value of the various factors and degree of depression for COPD patients with early depression Prevention and intervention.2.To evaluate the effects of Qibai Pingfei Capsule on the general situation,lung function and the expression of 5-HT1 A / 5-HT2 C / 5-HT3 protein in hippocampus of rats with COPD complicated by depression.Methods1.the clinical part: Select January 2017 to October 2017 in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,respiratory syndrome diagnosed as COPD patients with 91 cases of depression,according to the SDS self-rating depression scale score is divided into COPD complicated by depression,Medium and heavy three groups.All patients were monitored for gender,age,educational level,six-minute walking distance,course of onset,number of exacerbations,BODE index,and CAT score.Finally,statistical analysis was used to analyze the association of factors that affected COPD.2.Animal experimental part: On the principle of random grouping,Wister male rats were divided into 6 groups: normal group,COPD group,COPD complicated with depression group,venlafaxine treatment group,Qibai Pingfei capsule treatment group,Wenla Faxin combined with Qibai Ping lung treatment group,15 rats in each group.The normal group did not give any routine intervention.In the COPD group,COPD rats were established by lipopolysaccharide(LPS)and smoked cigarettes.The remaining patients were treated by multiple factor modeling(smoked,intermittent dehydration,forced swimming,squirrel cage horizontal,large hemostatic clamp Rat tail,etc.)COPD with depression in rat model.Before and after modeling,the body weight and lung function of each group were observed.Western blot was used to detect the protein levels of 5-HT1 A,5-HT2 C and 5-HT3 in hippocampus of rats.Results Clinical part:(1)Among 91 patients with COPD complicated by depression,68 were males,accounting for 81.96% of the total number of females and 23 females,accounting for 25.27% of the total;53 were mild depression,accounting for 58.24% of the total;moderate depression 26 people,accounting for 28.57% of the total,12 patients with severe depression,accounting for 13.19% of the total number;23 cases were acute exacerbations within one year,25.27%,40 cases were 4 times,accounting for 43.96%,3times Of 25 cases,accounting for 27.47%,<= 2 times in 3 cases,accounting for 3.3%.Six people walk for less than 150 m in 17 minutes,accounting for 18.68%.There are 22 persons in 150 ~ 249 m,accounting for 24.18%.There are 28 persons in 250 ~ 349 m,accounting for 30.77%.There are 24 persons in> 350 m,accounting for 26.37%.A total of 17 patients with dyspnea score grade 4,accounting for 18.68%,58 with dyspnea level 3,accounting for 63.74%,16 with 17,or 17.58% with difficulty symptom level 2,44 with primary education,accounting for 48.35%,21 with junior high school education,accounting for 23.08%,15 with high school education,accounting for 12.09% and 11 with college degree or above,accounting for 12.09%.There are 41 people in GOLD level 2 accounting for 45.05%,26 in GOLD level 3 accounting for 28.57%,and 24 in GOLD4 level accounting for 26.37%.BMI body mass index of> 21 kg / m2(square meters unit correction)a total of 32 people,accounting for 35.16% of the total,<= 21 for 59,accounting for 64.83%.Patients cough and sputum within 10 years of a total of16 people,accounting for 17.58%,11 to 20 years a total of 41 people,accounting for45.05%,duration of 21 years to 30 years a total of 34 people,accounting for 37.36%.A total of 13 patients(14.29%)were involved in the course of shortness of breath during the period from 5 to 10 years.The duration of the disease ranged from 28.57% in 11 to15 years,29 in 15 to 20 years(31.87% A total of 23 people in 20 years,accounting for25.27%.(2)There was no significant difference in the intensity of COPD complicated with the gender,age and culture of patients(P> 0.05),but there was significant difference with MMRC,GOLD classification,BODE index,..(3)SDS scale score of 91 patients with COPD complicated by depression was taken as the dependent variable.The cough and sputum duration,the course of the episode of irritation,GOLD classification,6MWD,BODE index and MMRC grade,CAT score as independent variable,The results showed that the independent variables of depressive symptoms in descending order of BODE index,MMRC,6MWD,CAT score,GOLD grade,cough and sputum duration,duration of stroke also showed its influence,but relatively weak.The experimental part:(1)The content of 5-HT1 A / 5-HT2 C / 5-HT3 in the hippocampus of rats in QiBaiPingfei capsule group was higher than that in COPD group(P <0.01)The content of 5-HT receptor subtype in hippocampus of BaiPefei capsule combined with venlafaxine group was significantly lower than that of COPD complicated with depression(P <0.01).(2)Compared with COPD COPD group(FEV0.3,FEV0.3 / FVC),the pulmonary function parameters of QiBaiPingfei capsule group were significantly increased(P<0.01);QiBaiPing lung capsule combined Venlafaxine group compared with COPD complicated by depression,the difference was significant(P <0.01).(3)The tail-suspending time in COPD complicated depression group was higher than that in normal group and COPD group(P <0.01);the rats in Qibai Pingfei capsule combined with venlafaxine group had lower tail-suspension time than those in COPDSignificantly(p <0.01).Conclusion1.91 cases of COPD patients with depression,the severity of depression has nothing to do with gender,age and education level,but with the duration of cough and sputum,asthma course,MMRC and BODE index,GOLD grade was highly positively correlated with 6MWD 、BMI Moderately negative correlation.2.Qibai Pingfei Capsule can promote the level of 5-HT receptor subtypes in the hippocampus of rats with COPD and improve lung function in rats. |
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