The Summarization Of Hu Guo-jun’s Academic Thought And Experience On Diagnosing And Treating Depression And Clinical Research

Chinese medicine is characteristic and advantage in the treatment of depression through the treatment based on syndrome differentiation. Professor Hu Guojun engaged in traditional Chinese medicine for more than forty years, he has accumulated rich clinical experience in the treatment of depression. This research is to trace to the source the of Professor Hu about the diagnosis and treatment of depression through the literature research and theoretical research; And further in-depth research, in order to extract the academic theory which has the guiding significance to the clinical work; Summarizes the clinical experience of Professor Hu’s treatment of depression through the form of teaching and learning; And then selected 112 patients with poststroke depression Randomly, treatment with decoction of supplementing qi and activating blood, compared with fluoxetine, to observer the clinical efficacy of both, in order to test the results.This research is divided into three parts.The first part:Professor Hu’s academic origin.Professor Hu Guojun was born in a family of traditional Chinese Medicine, His father Mr. Hu Qiaowu is an inheritor of the Xin’an Medical School. By carefully reading Professor Hu’s works and the articles, learning the knowledge from him and communicating with him day and night, I sum up the academic ideas of Professor Hu Guojun originating from the "Huang di Neijing", adhering to the Xin’an School of Medicine.The second part:The arrangement and research about the academic thought and clinical experience of Hu Guojun in diagnosing and treating depression.Professor Hu Guojun attaches great importance to the syndrome differentiation of zang-fu viscera in the process of diagnosis and treatment of depression.He thinks that depression and stagnation of QI is the pathological mechanism of depression syndrome in early stage;Qi stagnation and phlegm and stagnated QI transforming into fire are the result of further development of depression;The deficiency syndrome is the main clinical manifestation in the late stage of depression, for example, deficiency of yin and anaemia.1.We have summed the academic thought of Professor Hu’s diagnosis and treatment of depression. It includes "To treat depression by regulating Qi, liver Qi must be adjust first", "There is much more excessive syndrome than deficiency syndrome in the patients with depression", "Regulating Qi is the main method in the treatment of depression, but we must pay attention to protecting Yin-fluid". (1) To treat depression by regulating Qi, liver Qi must be adjust first:Professor Hu Guojun said that the attribute of the liver is wood, It is Like to be circulated and hates being suppressed. If liver Qi is suppressed, the liver vitality will be tired, liver Qi will not be fluent. As long as the patients with restless mood, it is most likely to produce liver involvement and Qi stagnation, liver Qi will reverse to Jueyin meridian. In addition, the liver Qi can regulate emotion function directly. If liver Qi is fluent, Qi and blood is harmony, the patient’s mood will be bright. (2) There is much more excessive syndrome than deficiency syndrome in the patients with depression:The pathogenesis of depression is changing with the development of the course of disease. Excessive syndrome is more than deficiency syndrome in the patients with depression. The stagnation of Qi is the pathological mechanism in the patients with depression early; If the stagnation can not be abreacted soon, the stagnation of Qi will further cause sputum concentration, blood stagnancy and stagnated Qi transforming into fire. At this stage, Qi, fire, sputum, blood are main pathological factors. There are most the deficiency syndromes in the late stage of the disease. For example, deficiency of yin and blood, heart-spleen deficiency. (3) Regulating Qi is the main method in the treatment of depression, but we must pay attention to protecting Yin-fluid:Professor Hu Guojun believes that the idea of the protection of Yin-fluid should be carried through the whole process of the treatment of depression. In the depression early, stagnation of Qi Is the main pathological mechanism. In this period, We should use the herbal medicine which can abreact liver Qi and promote Qi circulation and removing obstruction in the collateral to treat depression. But these herbs are not suitable for long term use, in order to avoid the loss of body fluid and produce other lesions. For the sputum concentration, blood stagnancy and stagnated Qi transforming into fire, While clearing heat-fire and reducing phlegm and resolving masses, we should be accompanied by some nourishing goods, in order to protect Yin-fluid.. If the heat evil further aggravate, burning the liquid, meanwhile, the long time use of the aromatic and febrile herbs, all the patients will present with Yin-fluid deficiency. In this time, The use of nourishing Yin treatment of Yin-fluid deficiency is a pressing matter of the moment, avoid using the aromatic and febrile herbs.2. In addition, we also have summed the experience of Professor Hu Guojun in the treatment of peri menopausal depression, dyssomnia, hysteria, renal mass.(1) Peri menopausal depression:Professor Hu Guojun believes that patients with depression in the peri menopausal period is usually manifested as the two syndrome. One is to be restless, anxious, restless mood is the main performance, the other is in the mood of depression, depression, poor speech as the main performance. Although the peri menopausal depression can show two different symptoms, but the Qi stagnation is a common pathogenesis, however, depression and stagnation of QI is different. Peri menopausal depression manifested irritability, anxiety symptoms due to the stagnation of liver qi, disease located in the liver, we should treat liver with the method of dispersing stagnated liver qi for relieving qi stagnation; The melancholy symptoms and Low spirits which Appear in Peri menopausal period is related to the lung, disease located in the lung, we should treat lung with the method of opening lung Qi.(2) Insomnia caused by depression:Professor Hu Guojun said that depression itself is a kind of emotional diseases, and also is a cause of insomnia. There is a common pathological mechanism between insomnia and depression. With the continuous development of society, people’s life, learning, work rhythm continues to accelerate, increasing the pressure of the spirit, the insomnia caused by depression is more and more. Through the treatment of depression and improve insomnia, it is a embodiments of searching for the primary cause of disease in treatment. It is also a supplement to the method of treating insomnia according to syndrome differentiation.(3) The experience in the treatment of hysteria:Professor Hu Guojun believes that although the clinical manifestation of hysteria is complicated, but the restless mood or spiritual stimulation is the main pathological mechanism. The long time hysteria can produce other diseases, the most common Complication is the Yang Deficiency and Gas removal caused by excessive breathing; Otherwise excessive sweating and tears can lead to yin deficiency. The treatment principle of, hysteria is psychological counseling, drug therapy is an auxiliary.(4)Drop and converge the adversely ascending Qi of thoroughfare vessel to treat the renal mass: Professor Hu Guojun think that the symptoms of renal mass can appear in a variety of diseases. The critical pathological mechanism is inverse gas and internal limb spasm, there is a close relationship between the renal mass and the organs of liver, lung and kidney. For the treatment of renal mass, when we use the method of conditioning viscera is invalid, we should treat the renal,, mass by dropping and converging the adversely ascending Qi of thoroughfare vessel, it may be able to get immediate results.3.Through finishing the medical record of 208 patients with depression and the data mining of traditional Chinese medicine using frequency, we have summed up 10 kinds of syndromes of depression. It includes the type of depression of liver-QI, the type of stagnated QI transforming into fire, the type of liver-fire invading the stomach, the type of Qi stagnation and blood stasis, the type of stagnation of phlegm and Qi, the type of lung loses Xuan Su, the type of deficiency of yin and blood, the type of deficiency of both the heart and spleen, the type of deficiency of liver-yin and kidney-yin, the type of spleen deficiency and Qi stagnation.There are 13 kinds of traditional Chinese medicine which frequency of use is more than 100 times, It includes bupleurum, fructus aurantii, turmeric, raw keel, raw oysters, poria with hostwood, pinellia ternate, polygala root, astragalus membranaceus, caulis polygoni multiflori, semen zizyphi spinosae, atractylodes, radix scutellariae; There are 24 kinds of herbal medicine used in 40-100 times, it includes radix pseudostellariae, gardenia, prepared radix glycyrrhizae, coptis chinensis, radix paeoniae alba, rhizoma anemarrhenae, coix seed, cassia twig, platycodon grandiflorum, semen boitae, licorice, eclipta alba, figwort, poria cocos, inula flower, tortoise plastron, rhizoma atractylodis, mother-of-pearl, radix rehmanniae recens, rhizoma cyperi, the root of kudzu vine, pericarpium trichosanthis, amber, cortex albizziae,;fritillaria roylei hooker; There are four kinds of herbal medicine with a ratio of over 50%, it includes upleurum, fructus aurantii, radix curcumae, poria cocos.The third part:Clinical study treating poststroke depression using methods of tonifying qi,activating blood circulation and dispel melancholy.Observed by applying the method of yiqi huoxue and resolve depression treatment of poststroke depression clinical curative effect, provide clinical basis for prevention and treatment of poststroke depression of Chinese medicine.Select 112 cases in line with the diagnostic criteria, inclusion criteria of patients with poststroke depression. Randomly divided into treatment group (n= 57), uses the method of supplementing Qi and activating blood circulation and resolve depression treatment; the control group (n= 55), treated with fluoxetine hydrochloride, all courses is six weeks. Observed two groups of HAMD score, NIHSS score, Barthel score before and after therapy, evaluate the clinical efficacy of yiqi huoxue resolve depression soup. The results is HAMD scores, NIHSS score, Barthel score of the two groups before treatment is no difference, P>0.05; HAMD scores, NIHSS score, Barthel score of the two groups after six weeks treatment, compared with before treatment, has the obvious difference, P< 0.01. Patients’ HAMD scores, NIHSS score, Barthel score of treatment group after 6 weeks treatment, improved significantly than control group, compared two groups, P< 0.01.Those remits Indicate that the Chinese medicine-yiqi huoxue resolve depression soup can obviously improve patients’ HAMD scores, reduce depressive symptoms, improve the neurological deficit symptoms in patients with stroke, and improve the capacity of the patients’dailylife. Compared with fluoxetine hydrochloride, it has more advantages in improving patients with depressive symptoms, nervous function recovery and improving life ability.