| ObjectiveObjective to analyze the clinical data characteristics of 371 patients with depression,and provide some reference for clinical diagnosis and treatment of depression;to summarize turor’s clinical experience in treating depression with Kaixin Jieyu formula by using Peiyuan Kaiyu method and explore the molecular mechanism of Kaixin Jieyu formula in the treatment of depression based on network pharmacology,so as to lay the foundation for the follow-up research of Kaixin Jieyu formula in the treatment of depression.Methods(1)According to the purpose of the study to develop research programs;(2)according to the research program to develop the inclusion criteria,exclusion criteria,exclusion criteria of case collection.Objective To observe a large number of real patients in the Department of psychosomatic medicine,Department of psychology and Department of geriatrics of clinic from January 2017 to February 2020,and select the qualified patients according to the inclusion,exclusion and exclusion criteria;(3)input the collected data into and timely establish the data database of depression.At the same time,the second recording was carried out for proofreading;(4)statistical analysis of the case data;(5)summarizing the experience of using Peiyuan Kaiyu method to treat depression with Kaixin Jieyu formula from the aspects of the etiology,pathogenesis,diagnosis and treatment of depression by tutor;(6)inferring the possible molecular mechanism of Kaixin Jieyu formula in the treatment of depression based on the platform of network pharmacology.Results(1)General medical records:371 cases were collected and screened in this study,of which 94 were male,that’s 25 percent of the sum,277 female patients,accounting for 75 percent of the sum.There are 55 young people aged 18-34,accounting for 15 percent of the suml.There were 243 middle-aged groups aged 35-59,accounting for 65 percent of all cases studied.There were 73 elderly patients over 60 years old,accounting for about 20%of all eligible patients.The distribution of depression patients in low education(primary school)and high education(Master’s degree or above)was relatively small,26(7%)and 26(7%)respectively.The main depression patients were in junior high school,high school,junior college and undergraduate course,the proportion of them was 76(20%),75(20%),78(21%),90(24%).(2)Prevalence:the main symptoms of depression patients were depression,accounting for 98%of all patients,followed by insomnia accounting for 86%,inattention accounting for 81%,laziness accounting for 80%,internal tension accounting for 78%,loss of appetite accounting for 47%.The minimum suicide concept accounted for 9%.The degree of depression was decreased in order in the distribution of mild,moderate and severe.TCM syndrome types of depression patients were mainly distributed in heart qi deficiency and spleen qi deficiency(118 cases,about 32%of all observed cases),liver and spleen weakness at the same time(68 cases,accounting for 18%of all subjects),heart and gallbladder Qi deficiency(68 cases,accounting for 18%),kidney deficiency and liver depression(65 cases,accounting for 18%),followed by heart kidney non-intersection(42 cases,accounting for 11%)and hepatobiliary damp heat(10 cases,accounting for 3%).The most significant TCM syndrome type of mild depression patients is deficiency of both heart and spleen.In addition to 8 cases of damp heat syndrome type of liver and gallbladder,deficiency of both heart qi and spleen,imbalance of water and fire between heart and kidney,deficiency of Qi in heart and gallbladder,insufficiency of kidney qi,obstruction of liver qi,stagnation of liver meridian and spleen deficiency are more common,and the common TCM syndrome types are heart spleen deficiency,liver depression and spleen deficiency and kidney deficiency liver depression The main TCM Syndromes of severe depression were deficiency of heart and spleen,and no other TCM syndrome types were found.The main types of depression in the youth group are heart spleen deficiency and heart gallbladder Qi deficiency,the least of which is 1 case;The most significant TCM syndrome types of moderate depression patients are deficiency of both heart and spleen,and common TCM syndromes are deficiency of both heart and spleen organs,deficiency of qi stagnation of liver depression and deficiency of Qi and Qi of kidney,deficiency of kidney qi and stagnation of liver qi.The syndrome types of TCM syndrome are the coordination of heart fire,kidney water coordination and dampness and heat stagnation of liver and gallbladder meridian;the old group is depressed The syndrome types of TCM in patients with the disease are mainly deficiency of heart and spleen at the same time,deficiency of heart and spleen at the same time,kidney deficiency liver depression,liver depression and spleen deficiency are common TCM syndromes,while the TCM Syndromes of liver,gallbladder,damp and heat have not been found.In 371 cases,there are 14 kinds of pulse images,including fine pulse,weak pulse,string fine pulse,sinking pulse,fine number pulse and chord pulse as the main pulse of traditional Chinese medicine.The most are fine veins.The main pulse of 94 male depression patients were fine vein(36 cases)and weak pulse(22 cases),of which the fine pulse was the most important pulse;the main pulse of 277 female depression patients were fine vein(68 cases),weak pulse(62 cases),chordal fine vein(53 cases),and sinking pulse(33 cases),among which the fine pulse was the most important pulse.There are eight kinds of pulse images,including fine vein,weak vein,chord vein and stringed vein in 55 young depression patients,including fine vein,weak pulse,weak pulse as the main pulse;243 middle-aged depression patients have 14 kinds of pulse,including fine vein,weak vein,stringed fine vein,sinking vein and fine number pulse,and the main pulse is fine vein,weak vein,stringed fine vein and sinking pulse;13 elderly depression patients have 6 kinds of fine vein,weak vein,and stringed fine vein The main pulse is fine pulse and weak pulse.There were 14 kinds of pulse images,including fine vein,weak vein,stringed fine vein,sinking pulse and fine number pulse in 286 patients with mild depression,including fine vein,weak pulse and weak pulse as the main pulse;82 patients with moderate depression had 9 kinds of pulse,including fine vein,stringed vein,weak vein and chord pulse,and 3 patients with severe depression had 1 fine vein and 2 weak pulse.(3)Experience analysis:Tutor summarized that the etiology and pathogenesis of depression is "deficiency of Qi retention",which means that the essence,blood,body fluid and other related mobile substances are stagnated due to the deficiency of Yuan Qi,the decline of viscera function,which leads to the pathological process of qi stagnation,sputum condensation,blood stasis and blocked channels and collaterals.He emphasized that it is the dynamic pathological change characteristics of deficiency of true element,marked by material stagnation and stagnation due to deficiency.The syndrome elements are deficiency depression stagnation,which has the evolution characteristics of qi depression at the beginning,Qi deficiency at the origin,phlegm turbidity,blood stasis and toxic heat.The main treatment is to cultivate yuan and open depression.Kaixin Jieyu prescription is the main prescription for treatment.The main components of Kaixin Jieyu prescription are:Bupleurum chinense,radix paeoniae rubra,fried Fructus aurantii Immaturus,Yunling,Tripterygium wilfordii,ginseng,liquorice and aster.(4)Network pharmacology:① construct the network map of "chemical components target" of kaixinjieyu recipe,and screen the key components of kaixinjieyu recipe in the treatment of depression are quercetin,naphthol,luteolin,and so on ② 74 targets of kaixinjieyu prescription were speculated to be the treatment of depression,and 10 were identified after screening,namely CREB1,FOS,AKT1,IL6,TP53,TNF,VEGFA,ESR1,mapk1,cat;③ the core target go analysis showed that the biological functions of kaikaijieyu prescription included chemical synaptic transmission,blood circulation and cell to hormone The main cell components are:postsynaptic membrane,axon,membrane valve,receptor complex,etc.;the main biological activities are involved in G-protein coupling receptor activity,cytokine activity,protein homologous dimerization activity,egg white kinase binding,etc.;④ the main pathways of KEGG pathway analysis are cholinergic synaptic pathway and nutritional trust Access road,etc.Conclusion1.The age of onset was mainly concentrated in the middle-aged group of 35-59 years old,with the largest number of undergraduates.The most significant symptoms of depression were low spirits,poor sleep quality,inattention and fatigue.The incidence of mild depression was the most.The main TCM syndrome types are deficiency of both heart and spleen,which are mainly distributed in mild,moderate and severe depression,and in young,middle-aged and old age groups.The main characteristics of pulse condition are weak pulse condition such as pulse,and the main pulse condition is weak pulse condition in patients with depression of different gender,age and degree.2.Tutor summarized that the etiology and pathogenesis of depression is deficiency and stagnation of Qi,emphasizing the dynamic pathological change characteristics of deficiency and stagnation.The syndrome elements are deficiency depression stagnation,which has the evolution characteristics of qi depression at the beginning,Qi deficiency at the origin,phlegm turbidity,blood stasis and toxic heat.The main treatment is to cultivate yuan and open depression.Kaixin Jieyu Decoction was used as the main prescription for treatment3.Kaixin Jieyu recipe can treat depression through multiple targets and pathways.Its pharmacological mechanism may involve quercetin,kaempferol,luteolin,baicalein,etc.,acting on CREB1,FOS,AKT1 and other core targets,involving cholinergic synapse,nutrition signal and other pathways,intervening in chemical synaptic transmission,blood circulation,hormone level regulation,etc.,thus affecting neurotransmitter treatment of depression Disease. |
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