S-ET Analysis And Differentiation Of TCM For Depression Patient

1. The background of researchDepression is a sort of ordinary disesse,it is a cluster of clinical symptom which is made of self-experience around low-spirited.A German expert on Depression consider that Depression is inhibitory state of Psychology and Physiological function.It bring bad negative influence.According to the information of WHO,various Depression sufferers account for 3 %~5% of population all over the world.According to U.S.A ECA epidemiological investigation,Depression is already the most familiar PsychoPathy.Depression is under the tenth Position inside of all common disease on the earth,and that 10% ~ 15 % suicide rate is more and more valued by people.According to information of WHO on burthen of disease all over the world,6.9% of Depression sufferers lose their life,is on second position of all diseases.Depend on WHO report,a copy of statistical datum of Republic Health Institute estimated that Depression will be first disease resulting on females death and deformity ,or be second disease resulting on human.An epidemiological investigation showed that the incidence of Depression was 10%—23%,was similar to fremdness ,that aiming at the elderly in Beijing in 2000.U.S.A loses five million work days and 10 thousand million dollars every year because of depression,loses 43.7 thousand million dollars.In England and Cambria,it takes directly off 4.3 hundred million pounds on depression every,outright exPense will beyond 35 hundred million pounds.Depend on 1996s datum of WHO,Depression was second disease in all diseases' economic burthen,accounting for 6.2%.Of sorts investigation showed that 33% patients in hospital,36% aged patients in hospital,56% — 80% malignancy patient,47% cerebral apoplexy patient and 39% Parkinson's disease patient was depression patient.And that depression patient's desire to be up and about again wass obviously falling.Upwards of 50% medicine sufferers suffered from depression at same time,2/3 of them was out of diagnoses,were not treated.15% depression patient suicided,2/3 of which were treated suffered from depression again.Cerebral apoplexy patient with depression increase thire death threefold. 40% coronary heart disease and 45 % myocardial infarction was with depression, depression could cause myocardial infaction,and caused coronary heart disease's death rate to increase 80 % .60 % vegetative neurosis and 80 % neurasthenic was dePression.2. Objective of researchWhereas incidence of depression presents the up-trend now,but its recognition rate and diagnosticate was low,suicide rate and relapse rate was high.In order to improve its recognition rate and diagnosticate,we make the comparison with thenormal Person's S-ET and the sufferer's.Expect to find the difference between depression and ordinary person on S-ET,and explore the differentiation between Traditional Chinese Medicine types on S-ET,and comparison various types sufferer's S-ET with normal person.To Provide a piece of impersonal reference for the diagnose of depression and Treatment determination based on syndrome differentiation.Comparison Chinese herbal medicine with the curative effect of the western medicine and observe medicine to the influence of sufferer's S-ET. 3. Filtration criterion of The depression sufferer and the normal man3.1 Filtration criterion of The depression sufferer Medicine diagnostic criterion refer to CCMD-3.TCM syndrome differentiation criterion refer to "syndrome differentiation criterion of psychosis"and "The Chinese medicine disease certificate examines a patient the curative effect standard". Five type:liver qi stagnation,liver depression and spleen deficiencies,liverdepression and phlegm obstruction,deficiencies of both the heart and spleen,noninteraction of heart and kidney.SDS and GDS Criterion: SDS or GDS.as filtration tool,SDS=40 ( < 60 year) orGDS=9 ( > 60year) .Obviation criterion:6) Exclude apparatus mental disorder,Mental Disorders Associated with Psychoactive Substance Abuse.7) Exclude grievous cerebral apoplexy and brian apparatus disease.8) Exclude grievous with liver and kiney disease.9) Exclude grievous heart disease,for examPle :acute myocardial infarction,cardiac functional insufficiency;instability angina,rheumatc heart disease, Pulmonary heart disease.10) Exclude diabetes.3.2 Filtration criterion of ordinary PersonAnamnesis one was health,no apparatus mental disorder,Mental Disorders Associated,blood vessel of brain,brian apparatus disease,for example cerebral infarction,cerebral hemorrhage sequela. Exclude grievous with liver and kiney disease. Exclude grievous heart disease,for example :acute myocardial infarction,cardiac functional insufficiency;instability angina,rheumatc heart disease, pulmonary heart disease. Exclude diabetes and insomnia.EEG isnormal,and SDS<35 (<60year)orGDS<7 (>60year) . 4. Clinic datum analyzeCollect the 65 cases totally,a majority of case is medium degree and bad degree depression sufferers (89.23%) . Liver qi stagnation 12 cases (18.46%) ,liver depresion and spleen deficiencies 13 cases(20%),liver depression and phlegm obstract ionl6 cases (24.62% ) deficiencies of both the heart and spleen 12 cases (18.46 %) ,noninteraction of heart and kidneyl2 cases (18.46%) .The degree among various types is no difference (P > 0.05 ) . Liver depression and spleen deficiencies is younger than other types (P < 0.05) ,liver depression and phlegm obstruction is older than other types (P<0.05) .There are 48 ordinary person in comparison grounp. The age is no differebce between sufferer and ordinary person (P < 0.05) . 5. The depression sufferer with the normal Person S—ET comparison5.1 Objective: Contrast sufferer's S-ET with the normal man's ,study the difference between them,and comparison various tyPes sufferer's S-ET with normal Person.5.2 Method: Measure the sufferer and the normal person's S-ET,deal with the data by SPSS 13.0 statistics software.53 Result: Constract with the normal man,sufferers 5-HT,DA,NE whole brain average activate level distinct fall (P < 0.05) ° The difference also show on brain area,for example:C4 (Ach) ,T5 (NE) ,02 (INH, DA, NE, EXE) ,T3 (DA, NE) ,T4 (5-HT, DA, NE) ,T5 (DA) (P<0.05) ?There is obvious difference between various types and the normal man.The details are as follows:Liver qi stagnation mainly showed the difference on C4 (Ach) ,T5 (Ach) ,08 (EXE) ,T5(5-TH and DA) (P<0.05) .Liver stagnation and spleen deficiencies mainly showed the difference on Ach (F4,C4,P3,P4) andNE (C3,P3,P4) (P<0.05) .Liver stagnation and phlegm obstraction mainly showed the difference on F3 (Ach) ,C4 (INH,EXE) ,08 (5-HT,DA) (P<0.05) .Deficiencies of both the heart and spleen mainly showed the difference on F4 (INH, NE, EXE) ,P3 (Ach, DA, NE, EXE) ,T3 (INH, DA, NE, EXE) ,T4 (INH, 5-HT, DA, NE, EXE) ,T5 (DA, NE, EXE) (P<0.05) .Noninteraction of heart and kidney mainly showed the difference on P3 (Ach) ,08 (INH, DA, EXE) ,T5 (EXE) (P<0.05) . 6.Clinical study on treatment determination based on syndrome differentiation of depression and medicineeffect on S-ET6.1 Objective: Observe the difference on the effect of Treatment determination based on syndrome differentiation and drug.Compare the treatment in front and back the difference of the sufferer's S-ET,and compare the treatment in front and back with the difference of normal person's S-ET.Explore medicin' effect on S-ET.6.2 Method: Random sample as comparison grounp,Treat other sufferers determination based on syndrome differentiation.The sufferers in comparison grounp take fluovetine,other sufferers take Chinese herbal medicine. Compare the treatment in front and back the score of sufferers',and evaluate respectively the effect.Compare the treatment in front and back the difference of the sufferer's S-ET, analyse their variational character. Compare the treatment in front and back with the difference of normal person's S-ET,research the difference among them.Compare the treatment in front and back the differences of liver function and kidney function.6.3 Result: The difference on effect is no distinct between treatment determination based on syndrome differentiation and drug (P > 0.05) .Sufferer's S-ET is obviously improved,showing on 08 ( 5-HT,DA) ,T5 (5-HT,DA) (P<0.05) .7. Conclusion7.1 S-ET is different from normal person of sufferer,various types sufferer's S-ET are different, and various types are different.We infer that abnormal neurotransmitter could be one of substantial foundations of determination based on syndrome differentiation.7.2 Pathogenesis of depression could be correlative to the lower function of neurotransmitter.The pathogenesis could be diference among various types.7.3 S-ET will be potential to helP diagnosing depressionas an objective assistance indes,and frame of reference to determination based on syndrome differentiation,but it is necessary to measure and observer large samPle.7.4 Sufferer's S-ET is improved after treatment determination based on syndrome differentiation.Hereby,we speculate on that traditional Chinese medicine, especial those medicine provided with the function of dispersing and rectifying the depressed liver-energy and tranquilization could work by acting on some site of action of central nervous system and/or peripheral nervous system.They operate by working on the metabolism of nerve cell.After treated,various types are improved in various brain area,showing vaious medicines could be different on the pathway and target point.But need the medicine reason research proof.