| Objective:30 patients with moderate depression and 15 patients with liver depression and fire deficiency and 15 patients with kidney yang deficiency were selected.The duration of the disease was more than 2 weeks without taking antidepressant drugs.In addition,15 healthy persons were selected as normal control group according to the gender and age distribution of the patients.Their serum interleukin-18(IL-18)and some specified biochemical indicators were tested.Differential expression of IL-18 in serum of patients with depression and healthy controls to explore specific biological indicators of depression.By exploring the differences of serum IL-18 and some designated biochemical indicators in patients with depression of two different syndromes,the objective basis of TCM syndrome differentiation and typing of depression is sought,which can provide a reference for TCM research of depression.To study and analyze the correlation between the difference of clinical symptoms and the expression of IL-18,the difference of clinical symptoms and some biochemical indicators,and the characteristics of biomarkers closely related to specific clinical phenotypes(syndromes and diseases).Research methods:1.This study starts with the pathogenesis,pathophysiological process and main syndromes of depression in TCM.Referring to the diagnostic criteria of depression in the International Classification of Diseases,the criteria for selecting symptoms,severity,course of disease and exclusion of depression are formulated.According to the two characteristic TCM syndromes of depression,liver depression and fire syndrome and kidney yang deficiency syndrome,established by the tutor’s previous clinical study,the TCM syndromes of depression required for this study were formulated by referring to the TCM typing standards of depression formulated by the Chinese Society of Traditional Chinese Medicine and the Chinese Society of Integrated Traditional Chinese and Western Medicine.The authoritative Hamilton Depression Scale(24 items)and Hamilton Anxiety Scale(14 items),Young Mania Rating Scale,Social Function Deficiency Screening Scale,Chinese Medicine Syndrome Rating Scale for Depression(Liver Depression/Kidney Deficiency)and Yin-Yang Scale were used to ensure that the patients included in this study met the criteria for disease diagnosis.2.Sample collection should be arranged as soon as possible after the inclusion of the case.Participants were asked to collect 10 ml of venous blood on an empty stomach in the morning to test blood routine,liver and kidney function and other designated biochemical indicators respectively.Among them,5 ml blood samples were separated and packed separately,cooled in a refrigerator at 4C,and centrifuged in a centrifuge at 4C and 4000r/min for 10 minutes.Serum was separated and frozen-thawed Store in refrigerator at-80C.The levels of serum cytokine IL-18 in blood samples collected from different groups were determined by enzyme-linked immunosorbent assay(ELISA).Kits were purchased uniformly and centralized at the same time and in the same laboratory.3.The experimental data collected were analyzed by SPSS23.0 system,including the IL-18 content and the selected biochemical indicators,the correlation between Hamilton Depression Scale score and TCM symptom score,the correlation between TCM syndromes and serum biomarkers,depressive symptoms,the detection value of cytokine levels and selected biochemical indicators in moderate depression.Research findings:A total of 30 depressive patients were enrolled,including 15 in the liver-depression-fire group and 15 in the kidney-yang deficiency group.At the same time,15 healthy people matched in age,sex and education level were included as the normal control group.1.The correlation between age,sex and Hamilton Depression Scale(HAMD)score between depression group and normal control group was analyzed and compared.The results showed that there was no correlation between the general condition of the two groups and the severity of depression(P>0.05).2.The analysis of serum Hcy levels in liver depression group,kidney deficiency group and normal control group showed that there was a significant difference between the groups,(P<0.001),indicating that the elevated serum Hcy level was correlated with the incidence of depression.Comparing the difference of serum Hcy between the two groups,the results showed that t=0.353,P=0.33(P>0.05),indicating that there was no significant difference in the level of Hcy between the two groups,which could not be used as an objective index of TCM syndrome differentiation of depression.The correlation between HAMD score,TCM symptom score and serum Hcy level was analyzed.The results showed that there was no significant correlation between HAMD and TCM symptom score and Hcy(P>0.05).There was no correlation between Hcy level and the severity of depressive symptoms and TCM syndromes.3.The data of other biochemical indicators in three groups were analyzed.Compared with the normal control group,CK-MB level in the kidney-yang deficiency group decreased,and P<0.05;the level of rheumatoid factor(RF)increased(P<0.05).The results suggested that the incidence of depression with kidney-yang deficiency was related to the decrease of CK-MB and the increase of RF.There were significant differences in creatine kinase(CK)and creatine kinase isoenzymes(CK-MB)levels between the two groups.CK-MB in the liver-depression-fire group was higher than that in the Kidney-Yang-Deficiency group,but there was no significant difference between the two groups and the normal control group.4.The difference of serum IL-18 levels between the three groups was analyzed and compared.The results showed that there was a significant difference between the three groups(P<0.001),indicating that the elevated serum IL-18 level was related to the incidence of depression.By analyzing the difference of serum IL-18 levels between the two groups,it was concluded that there was significant difference in serum IL-18 levels between the two groups(P<0.001).5.The scores of Hamilton Depression Scale and TCM syndromes in depressive patients were analyzed with serum levels of IL-18,Hcy,CK,CK-MB and RF.The results showed that the levels of IL-18 were not directly correlated with the factors of HAMD scale,but positively correlated with the scores of TCM syndromes,namely liver depression(r=0.520,P=0.003),kidney deficiency(r=0.404,P=0.027).The levels of Hcy,CK,CK-MB and RF were not significantly correlated with the scores of HAMD scale and TCM syndromes(P>0.05).6.The ROC curve area(AUC)of serum IL-18,RF and Hcy were 0.942,0.753 and 0.870,respectively,suggesting that IL-18,RF and Hcy may be specific indicators of depression.Conclusion:1.Creatine kinase(CK),creatine kinase isoenzyme(CK-MB)and rheumatoid factor(RF)in moderate depression patients are related to the pathogenesis or pathological process of depression,which provides a new direction for the study of the pathophysiological mechanism of depression.2.The level of serum IL-18 in patients with depression is closely related to the pathogenesis and pathophysiological process of depression,and may be a specific biomarker for the diagnosis of depression.The exact level of serum IL-18 in patients with depression may be related to TCM syndrome typing,which may become one of the objective quantitative indicators for TCM dialectical typing of depression.3.In the aspect of TCM dialectical typing of depression,the difference of creatine kinase(CK)between the two groups is significant and statistically significant,which indicates that CK is related to TCM dialectical typing of depression,and may be an objective quantitative index of TCM syndrome of depression.4.The serum levels of IL-18,RF and Hcy in patients with depression were significantly different from those in normal individuals.It was not only related to the pathophysiological process of depression,but also had certain diagnostic value for moderate depression. |
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