Study Of Professor Wei Pinkang's Academic Thought About Xiao-tan-jie-yu Prescription On Cancer Concurrent Depression

1.ObjectiveMy tutor Professor Wei Pinkang put forward the theory of Identifing Cancer Concurrent Depression(CCD) based on Phlegm Syndrom of Traditional Chinese Medicine(TCM).In this study,we researched the name of disease,etiology and pathogenesis of CCD based on phlegm syndrom of TCM,summarized the clinical experience of treating CCD by the way of eliminating phlegm and relieving stagnation,observed the clinical efficacy and mechanism of Xiao-tan-jie-yu Prescription(XTJYP) invented by Professor Wei Pinkang on digestive cancer (DC) concurrent cepression.Above all contents belong to Professor Wei Pinkang's academic thought on CCD,we should inherit and develop it.2.MethodsThe study is made up of two parts:theoretical study part and clinical research part.In theoretical study part,we reviewed literatures about cancer,depression and phlegm syndrome of TCM,visited and learned with Professor Wei Pinkang, collected his TCM cases,recalled his medical experience and achievements, summarized his views on the name of diseases,etiology,pathogenesis,treatment, dietary and emotional nursing,induced his academic thought and clinical experience on CCD.In clinical research part,we diagnosed 141 patients with DC concurrent depression,observed and analyzed their symptoms and clinical characteristics of TCM.120 of 141 patients were chosen and divided into 3 groups according to prospective,randomized,and controlled ways.The 3 groups were treatment group(treatment with XTJYP,n=60),TCM controlled group (treatment with Xiao-yao-wan Pill,n=30) and Western medicine controlled group (treatment with Fluoxetine Collocystis,n=30).Before and after 6 weeks' treatment,the depressive symptoms,Karnofsky performance status (KPS),Self-Rating Depression Scale(SDS),Hamilton Rating Scale for Depression(HAMD,24) and TCM symptoms of patients were assessed,the level of serum T cell subsets and NK cells were also detected.3.Results3.1 Theoretical studies' results:(1)CCD belongs to generalized depression of TCM.(2)The etiological factor and pathogenesis of CCD include following:①internal malignant phlegm pathogen;②phlegm pathogen,qi pathogen and fire pathogen;③zang-fu organs' dysfunction;④phlegm pathogen destroying brain.(3)The basic therapeutic method treating CCD is eliminating phlegm and relieving stagnation,auxiliary dietary and emotional nursing.(4)As a patent Chinese medicine,XTJYP is effective,some preliminary pharmacological experiments of it had been done.3.2 Clinical researches' results:(1)Generally,patients with DC all have depressive emotions,the incidence of depression is 44.76%,and low to medium grade depression are the most common.The kind of cancer is different,the incidence of CCD is different. Whether or not to fall ill is related on education level and TNM stage of tumor. The families of patients with DC also commonly have depression emotions.(2)The common symptoms of TCM in patients with DC concurrent depression are:depression,fatigue,pale,neurolysis,like to lie down,static rather than dynamic,low mood,bradykinesia,pessimistic,sigh,insomnia,weight loss, loss of appetite,pain in waist and knee,sentimental,loss of libido,and so on.The common colors of tongue are red,carmoisine and light white.The common tongue coating are white and greasy coating,white and thin coating,yellow and greasy coating.The common pulses are thready and slippery pulse,slender pulse, thready pulse,thready and slender pulse,thready pulse.(3)XTJYP can improve clinical symptoms of patients with DC concurrent depression,reduce SDS and HAMD' scores,the total effective rate was 82.46%, better than in the controlled groups of TCM and western medicine(P＜0.05～0.01).(4)XTJYP can improve KPS of patients with DC concurrent depression.(5)XTJYP can elevate patients' CD3,NK and CD4/CD8 values,lower values of CD8. (6)XTJYP is safe and effective,has no obvious side effects and toxicities. 4.ConclusionsProfessor Wei Pinkang's academic thoughts of treating CCD include following:(1)CCD belongs to generalized depression of TCM,its basic etiological factor is inner malignant phlegm pathogen,which interferes zang-fu organs' function and destroies brain with qi pathogen and fire pathogen;(2)The basic therapeutic principle of treating CCD is eliminating phlegm and relieving stagnation;(3)XTJYP can improve the clinical symptoms and immune function of the patients with DC concurrent depression,improve the quality of life and reduce depression scales' score,it's safe and effective.