Liver And Kidney Tongzhi Law Treatment Of Depression Clinical Observation

Depression is an emotional disorder;it is not the same as a passing blue mood but a server depressive mood,which is also the main symptom of this mental illness. Clinical symptoms of depression include pessimism,slow thinking,reduction of body gesture,loss of interest in work,excessive guilt,and self-criticism,and often suicidal tendencies.Depression is a major global mental health issue and is commonly seen in every society.It is harmful and hazardous to individuals,families and societies. With today's fast growing economy and accelerated pace of life,the day to day stresses of life and emotional impacts have increased significantly.As a result,the number of people who suffered from depression has escalated so rapidly that it became an issue which could not be avoided and needed to be addressed.Depression as an emotional disorder was never defined by Traditional Chinese Medicine.However,quite a few numbers of historical records showed that depression was found,diagnosed and treated by Traditional Chinese Medicine. Some of the records found indicated symptoms such as Yu disease(郁证),Lily disease(百合病),hysteria(脏躁),epilepsy,Benton qi(奔豚气) and Globus hystericus(梅核气).Since most of the records found related to Yu disease that we can assume Yu disease could be the historical name for Depression in ancient Traditional Chinese Medicine.Yu disease can be referred as a syndrome in both broad and narrow term.In a broad sense,Yu(郁) can be referred as exogenous disease caused by the six climatic exopathogens(六淫),internal damage caused by the excess of seven emotions(七情),injury due to diet and overstrain which all cause dysfunction of a human body hence lead to sickness.A broad definition of Yu(郁) can be found in Huangdi Neijing and the theory of the six Yu by Zhu Danxi(朱丹溪).In the Ming and Qing Dynasties,Zhang Jingyue gave Yu a much narrower definition.It referred specifically to poor health as a result of depression and stagnation of qi's movement (气机郁滞),which trigger depression and emotional restless.Based on historical clinical cases,Yu disease can damage one's physiological function and circulation system through exogenous disease caused by the six climatic exopathogens and internal damage caused by the excess of seven emotions and injury due to diet and overstrains.Both Zhu Danxi and Zhang Jingyue(张景岳) have made specific diagnoses and kept records on the pathogenesis.Zhu Dan Xi made most of his theories from excessive pathogen(实邪),the pathology was mostly caused by the depression and stagnation of qi's movement,hence become varies types Yu disease.This could be showed up as a sole symptom or accompany by other server symptoms.On the other hand,Zhang Jingyue in Ming Dynasty made clear about and emphasized on the pathogenesis of intermingled deficiency and excess. Ye Tianshi's in Qing Dynasty collected all types of clinical cases on varies types of changes on excess and deficiency and perfectionized the pathogenesis of Depression.Depression can be categorized into the deficiency and excess.Most of the depression started with the excessive syndromes then involved of the weaknesses of heart,the blinder and kidney hence the entire circulation system.Some of the syndromes include the syndrome of stagnation of liver qi and spleen deficiency,the syndrome of stagnation of liver qi and phlegm,the syndrome of deficiency of heart and spleen,the syndrome of yin deficiency of liver and kidney,the syndrome of stagnation of liver qi and blood stasis,the yang deficiency of spleen and kidney and the syndrome of deficiency of liver and gallbladder.Some of the excess symptoms were actually caused by the deficiency.Evidence showed that Chinese medicine is much more advanced than Western medicine on depression treatments.While Western medicine for depression treatment is still at an initial stage,Chinese medicine has a long-term treatment experience on Depression already.Western treatments mainly focus on medication, which could be slow in progress,expensive,and patients may experience side effects. With a long history of treating Depression,Chinese treatments include the treatment based on syndrome differentiation,symptomatic medication selection and acupuncture,which focus on the overall body condition.These treatments can minimize the possible side effects and may also cure other illness and improve one's overall health.This all natural,non-toxic treatment,therefore,has a great research value.Based on the research results and the clinical cases,the syndrome of stagnation of liver qi and it's movement(肝郁气滞) was the most commonly seen cases. Studies shown that many doctors treated it with Xiaoyaosan(逍遥散) and got good results.Under the guidance of Professor Zhou Shaohwa,this study plan to use Xiaoyaosan as the base along with Shudihuang(熟地黄),Shanzhuyu(山茱萸),Tusizi(菟丝子) to tonify and nourish the kidney essence.Chinese medicine believe that the theory of the homogeny between liver and kidney,if there is the syndrome of the insufficiency of kidney fluid which will cause the kidney failing to nourish the liver then the liver qi and it's movement will be stagnation.Difficulty in Communication between heart and kidney will cause of the fire flaring up of heart. Injuring the heart blood would result a variety of psychiatric symptoms.Based on the homogeny of liver and kidney theory,dispersing stagnated liver qi for relieving qi's stagnation along with nourishing the kidney should provide better effects.The experience was based on the "mother-son(母子) "theory of"bone marrow from kidney(肾生骨髓),liver from bone marrow(髓生肝)" from "Huangdi Neijing".The experience was also conducted based on the high correlation between brain functions and depression,therefore emphasized the importance of one's kidney. The theory was supported by the "brain is the collection of marrow(脑为髓海)" mentioned in the "Huangdi Neijing" and "brain is the key ones' consciousness(脑为 元神之府)" mentioned in "An Outline Treatise of Medical Herbs",compiled by Li Shizhen.The theory was enhanced by Lee Zhongzhi's theory of "The homogeny of the liver and kidney(乙癸同源)","Mind kidney and liver at the same time(肾肝同治)",and "Prevention before illness(未病先防)".The experience took reference from "Si Ming Xin Fa(四明心法)"from Qing Dynasty and created a medicine by using a combination of the soup of Shu Gang Yi Sheng(疏肝益肾汤),the soup of Zi Shue Qin Gang(滋水清肝饮),the soup of Zi Sheng Shen Gang(滋肾生肝饮),the soup of Liu Wei Di Huang(六味地黄汤) and the Xiaoyaosan(逍_遥散).The prescription also used "Liu Wei" to tonify and nourish the kidney essence and "Xiaoyaosan" to disperse the stagnated liver qi.In addition,under the guidance of Professor Zhou Shaohwa in use of prescription drugs Xiaoyaosan accompanied Shudihuang 30g,Shanzhuyu 10g,Tusizi 10g,to accomplish the Yin and Yang of the use of drugs.The addition and subtraction of Xiaoyaosan was controlled during the experience.This will further prove if the method of nourishing kidney essence accompanied dispersing the stagnated liver qi would be more efficient than the simple method of dispersing the stagnated liver qi.The experimental was conducted with patients suffered from liver qi stagnation syndrome depression and came to the Neurology Department in the China Academy of Chinese Medical Sciences Xi Yuan Hospital for treatments.After dividing the patients into two groups randomly,one group was given the drugs of nourishing kidney essence accompanied dispersing the stagnated liver qi,and the another was given the drugs of Xiaoyaosan plus or minus to study the differences between two groups and the different prescriptions may have on the patients.Patients were evaluated with Self-rating Depression Scale(SDS),Hamilton Depression Rating Scale(HAMD) and the syndrome of Chinese Medicine Evaluation Form. Software SPSS 17.0 was used to run the statistics for the evaluation.This study is a randomized controlled trial.Observations made on of 60 cases in total,30 cases of the treatment group and 30 cases of the control group with treatment time for six weeks.Hamilton Depression Rating Scale(HAMD), Self-rating Depression Scale(SDS),the syndrome of Chinese Medicine Evaluation Form were conducted after two weeks,four weeks and six weeks to observe and compare the before and after treatment effects.Experimental results showed that both the treatment group and control group made good results.The SDS showed a major treatment result of the method of nourishing the kidney accompanied dispersing the stagnated liver qi.According to the syndrome of SDS,HAMD and Chinese Medicine,the method of nourishing kidney essence accompanied dispersing the stagnated liver qi could be more efficient than the simple method of dispersing the stagnated liver qi on some specific symptoms.The results showed that the effects of the method of nourishing kidney essence accompanied dispersing the stagnated liver qi could be faster than the simple method of dispersing the stagnated liver qi on some symptoms.Review and prospects:(1) The timing and sample size of is experiment was insufficient.A more robust result could be achieved with longer time frame and larger sample size.(2) It was obvious that the method of nourishing kidney essence accompanied dispersing the stagnated liver qi was more efficient and more effective in improving the patients' overall physical condition and certain symptoms. More focus can be put on the etiology and pathogenesis of depression and the use of prescription drugs to achieve better treatment results of Chinese medicine on depression treatment.