| Background:The incidence of depression is increasing year by year.It has the characteristics of high prevalence rate,high recurrence rate,high suicide rate and low recognition rate of medical treatment rate.It has become a global public health problem.At present,although the antidepressant western medicine is novel and varied,the patient’s symptoms and somatic symptoms can not be solved quickly because of poor compliance,low rate of treatment,side effects and slow onset time.In the clinical study of traditional Chinese medicine,a randomized controlled trial is used for short-term follow-up study of depressive patients.Although it has been proved that Chinese medicine is effective in the treatment of depression,the time,type and dose of drug use are different in the actual clinic,and it is difficult to effectively evaluate the long-term clinical efficacy of traditional Chinese medicine and therefore seek the prevention of traditional Chinese medicine.The long-term clinical effect of treating depression is particularly important.Objective:The purpose of this study is to evaluate the long-term effect of Yishen Qi regulating therapy for kidney deficiency and depression of liver depression by prospective cohort study,and to provide strong evidence for further clinical promotion.Method:We use prospective cohort study methods to meet the standard of the patients.According to the intervention factors,whether or not they accept TCM syndrome differentiation and treatment,three groups are naturally formed:Chinese medicine cohort,western medicine cohort,and the combination of Chinese and Western medicine.Three groups of patients were followed up for 3 months.The patient’s natural end was limited.The longest follow-up time was 1 years due to the limited time of the study.The treatment course,type and dose of the medicine receiving traditional Chinese medicine were not limited,but the records were recorded,and the queue changes were stratified in the statistical analysis.The Montgomerie depression scale,the evaluation scale of TCM syndrome of depression and the index of SDSS score were used to observe the long-term clinical effect of the kidney qi regulating method in the patients with depression.Result:1.statistical analysis of general clinical dataIn this study,206 cases of depressed people with kidney deficiency and stagnation of liver Qi syndrome were divided into 3 different queues,including 76 cases of traditional Chinese medicine,45 cases of Western medicine and 85 cases of Chinese and Western medicine.The demographic data of the three groups were collected as follows:sex,age,marriage,and marriage.Course of disease,income,education,place of residence,Montgomerie Depression Scale(MADRS)before treatment,and TCM syndrome rating scale before treatment.In the course of follow-up,there was a change in the cohort with the patients during the follow-up,so the baseline of three groups of queues was analyzed at each time point of follow-up,and the statistical analysis was not statistically significant(P<0.05),that is,there was no significant difference between the baseline indicators before and at each time point.2.Analysis of the long-term clinical effect of2.1 MADRS score2.1.1 Analysis of the effect of cohort transformationThis study is an observational study that does not interfere with the patient’s willingness to use drugs,so the three groups of queues will be transferred during the follow-up process due to changes in the patient’s medication,and a single factor analysis of variance is used to detect the average MADRS score in different teams of third,6,and 9 months.The results can be found.In the whole follow-up process,there was no difference between the traditional Chinese medicine queue and the western medicine queue to treat the kidney deficiency and stagnation depression.In third months and sixth months,the average of Chinese and Western medicine queues were significantly lower than those of the western medicine cohort and the traditional Chinese medicine cohort,which were statistically significant,that is,the method of the Chinese and Western medicine cohort for the kidney deficiency liver depression was superior to the other cohort.There was no significant difference in the MADRS score between the three groups in ninth months,that is,there was no difference between the three groups in the follow-up period of ninth months.However,due to the observation of the transfer of the crowd in the follow-up,it is impossible to observe the trend of migration in the cohort.2.1.2 The efficacy of cohort transformation was not analyzed duringIn order to evaluate the change trend of the MADRS score of the three groups of people during the long term follow-up,the observation population was stratified and analyzed,and the patients who were followed up to the end of the queue were evaluated.Repeated measurement variance was used to analyze the time interaction effect of MADRS score change.The results were as follows:1.the mean value of MADRS score in different follow-up times was statistically significant;2.the Chinese and Western medical queue and the traditional Chinese medicine queue treatment method could improve the MADRS score faster,and the Chinese and Western medicine queue was better than the other queue in the improvement of MADRS score,and the improvement of the curative effect of the TCM cohort for third months was better than the western medicine.There was no significant difference in the MADRS scores between the two groups.2.2 syndrome scale of Chinese medicine for depression2.2.1 Analysis of the effect of cohort transformationThis study is an observational study that does not interfere with the patient’s willingness to use drugs,so three groups of queues will be transformed in a cohort during follow-up,and the changes in the cohort are recorded and analyzed in detail at each follow-up point.By means of single factor analysis of variance,the average of TCM syndrome scores in three groups were compared in third months and 6 months and 9 months respectively.The results were as follows:1.in third months and sixth months were statistically significant,Chinese and Western medicine queues were superior to traditional Chinese medicine queues,and traditional Chinese medicine queues were superior to western medicine queues;2.Follow up to ninth months,there was no significant difference in TCM Syndrome Scale scores among all teams.However,because of the change of cohort,it is impossible to observe the trend of migration of cohort population over time.2.2.2The efficacy of cohort transformation was not analyzedBecause the team was easy to migrate during the follow-up process,the long-term effect evaluation was limited.Therefore,the observation group was stratified and analyzed,and the patients who were followed up to the end of the queue were evaluated.The results were as follows:1.the mean value of TCM Syndrome Scale in different follow-up times was statistically significant.2.Chinese and Western medicine queues and traditional Chinese medicine queue treatment methods could improve TCM syndrome score faster;3.Chinese and Western medical queue was not different from the Chinese traditional medicine queue at third months of follow-up,and-the Chinese and Western medicine.queues were treated in sixth months and 9 months.The method is superior to the traditional Chinese medicine cohort.2.3 SDSS scoreBecause of incomplete data recording,we only stratified the SDSS rating scale of 105 cases without cohort transformation.The results were as follows:1.the SDSS scores of the three groups were statistically significant at the different follow-up time points;there was no difference in the improvement of the curative effect between Chinese medicine and the western medicine queue in the course of 2.follow-up,and the improvement of the curative effect of the Chinese and Western medical queue SDSS score was better than the other queues for ninth months,and the statistical significance was statistically significant.The conclusions are as follows:This study is a phased efficacy analysis.1.in the follow-up period of the follow-up period in the follow-up period:in the third months and the 6 month follow-up time point,the best method of treating kidney deficiency and stagnation of depression by Chinese traditional Chinese and Western medicine in the treatment of kidney deficiency and stagnation of liver depression;there is no difference in the treatment of different queues in the follow-up period of ninth months.2.the analysis of the curative effect of no queue transformation during the follow-up period:during the whole follow-up process(MADRS,TCM Syndrome Scale score,SDSS score),the three groups were all effective.The method of TCM and Chinese and Western medicine for kidney deficiency liver depression can improve the curative effect of MADRS,TCM Syndrome score and S DSS score,and the traditional Chinese and Western medicine treatment method is better than other queues. |
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