Study Of The Clinical Effect And Heart Rate Variability Of Depression Patients Using Fluxetine Combined With Shuganjieyu Capsule

BackgroundAs a common psychiatric disorders, depression has been the primary cause of leading disability. With the improvement of social economic level and too much life stress, its morbidity among the city people is increasing. When face the depression patients, clinician usually pay more attention on core symptoms and psychological symptoms. However, there is a large number of patients who has physical symptoms rather than emotional symptoms according to their self-reported symptoms. As a result, these patients are misdiagnosed or missed. Research show that drugs need more time to start working among patients with physical symptoms. The patients'core symptoms will improve slowly and they are easy to recrudesce. Therefore, it is very important to emphasize the improvement of depressive patients'physical symptoms. Depressive patients who have physical symptoms usually have autonomic nervous dysfunction. Heart rate variability is the key target to evaluate autonomic nervous dysfunction.Objective1. To investigate the early clinical curative effect of fluoxetine combined with Shuganjieyu Capsule on depressive patients2. To compare the difference of the influence on heart rate variability of Shuganjieyu Capsule combined fluoxetine and fluoxetine alone, as to provide theoretical basis for the clinical treatment of depression.3. To investigate the side-effect of Fluoxetine combined with Shuganjieyu capsule on depressed patients.MethodsTotal 64 depressive patients were random selected according to standard of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and Chinese Internal Medicine on the diagnosis of depression, in accordance with the random number table, were divided into observation group and control group,32 in each group. Two groups:the control group and the experimental group. The patient only took fluoxetine to treat depression in the control group while the experimental group used fluoxetine combined with Shuganjieyu Capsule. The treatment period for the two groups lasted for 6 weeks. Both groups were examined at baseline HAMD24, HAMA14 and HRV, and then examined with HAMD24 and TESS at the second, forth and sixth week, with safety indexes before and after the treatments.Results1. Sixty patients finished these clinical trials and 30 cases in each group actually. There's no significant difference of sex, age, nation, faith, courses of disease, annual earnings, vegetative, cultural structure, family structure, emotion situation and scores of HAMD24,HAMA14,HRV between the two groups (P> 0.05).2. Comparison of HAMD24 grades:the grades of HAMD of observation group who used fluoxetine combined with Shuganjieyu Capsule reduced more than the control one, with a significant difference (P<0.05),which prompt that fluoxetine combined with Shuganjieyu Capsule can improve the patients' clinical symptoms. And after the treatment, the therapeutic grades of the observation group were better than the control one with HAMD scores as indicators of clinical outcome with a significant difference (P<0.05).Two groups in the treatment of 2 weeks, combination of HAMD scores decreased more obviously, compared with fluoxetine group had significant difference (P< 0.05), suggesting combination had rapid onset compared with fluoxetine group.3. Comparison of HRV analysis:both can promote the HRV analysis. The therapeutic grades of the observation group were better than the control one with a significant difference (P< 0.05).4. The relationship of HRV and HAMD:HRV and HAMD have some relationship with somatization or not, which with somatization was better than the without one.5. Comparison of the treatment emergent symptom:There were TESS inordinately of the two groups. There were not significant differences of TESS among the second, forth and sixth week (P> 0.05).Conclusions1. Obvious therapeutic effect were observed when using fluoxetine combined with Shuganjieyu Capsule in the early treatment.2. SDNN, HF and LF/HF of the HRV have a positive correlation with HAMD, but LF had a negative correlation with HAMD. The relationship were much closer for the patient with physical symptoms.3. The therapeutic effect of fluoxetine combined with Shuganjieyu Capsule is reliable. It's better than using fluoxetine only, also can effectively shorten the working time and it doesn't increased side effects.