Clinical Observation Of Kaijie Jieyu Decoction On Vascular Depression And Its Mechanism Of Action Based On FALFF

Research purposes:The Clinical Curative Effect Observation of Kaixin Jieyu Fang on Vascular Depression,Using HAMD Factors and Decreasing Scores of Each Symptom,Discusses the Differences between Traditional Chinese and Western Medicines in the Treatment of Vascular Depression,Based on fALFF to explore the possible brain function mechanism to treat VD.methods:Clinicalcurative effect observation:From September 2014 to October 2017,90 patients with vascular depression who were eligible for inclusion and exclusion were screened from Guang'anmen Hospital of China Academy of Chinese Medical Sciences,Department of Geriatric Outpatient Clinic and Psychology Clinic.The actual completion of 79 cases,59 cases of traditional Chinese medicine group,Western medicine group of 20 cases.The general data of the two groups were not statistically significant(p>0.05);the Chinese medicine group was treated with Kaixin Jieyu Fang and the daily one dose was taken twice;the western medicine group was given Baiyou solution,20 mg qd.Eight weeks after drug intervention,the HAMD Scale,TCM Symptom Score Scale,and the total score of the statistical scale were measured at the baseline,2nd,4th,and 8th weekends.The score of HAMD was reduced,and the efficacy index was calculated.Rate,the rate of reduction in the symptoms of each TCM.Mechanism of Brain Function:From the clinical efficacy observation group,select the patients that meet the nuclear magnetic group inclusion and exclusion criteria,Chinese medicine group 10 cases,western medicine group 7 cases,and select from the surrounding community to meet the criteria of healthy control group 13 cases.The three groups of general information have no statistics In the sense and healthy control group,brain magnetic resonance imaging scan was performed only once in the group;Chinese medicine group and western medicine group were performed a brain functional magnetic resonance scan when they were enrolled in the group;a brain functional magnetic resonance scan was performed at the end of the 8th week.Statistical Analysis of fALFF in Resting State Functional Magnetic Resonance Data.Research result:Clinical efficacy observation:(1)Comparison of efficacy indexes between the two groups:The total efficiency of the Chinese medicine group was 79.66%,and the total efficiency of the western medicine group was 85.00%.There was no difference between the two groups in the improvement of TCM symptoms and efficacy index(P>0.640).After 8 weeks of TCM treatment,TCM symptom scores decreased significantly(p<0.005),and the results had significant statistical differences.After 8 weeks of TCM treatment,TCM symptom scores decreased significantly(p<0.005),and the results had significant statistical differences.(2)Comparison of HAMD scales:The total effective rate of the Chinese medicine group was 86.44%;the total effective rate of the western medicine group was 80%.There were differences in clinical efficacy between the two groups(p<0.05).After 8 weeks of treatment in Chinese Herbal Medicine group,the HAMD amount showed a significant decrease in total score(p<0.005),and the results had significant statistical differences;after 8 weeks of western medicine treatment,the score of HAMD scale significantly decreased(p<0.005),and the results were significant.Statistical differences.(3)Comparison of the score reduction rate of HAMD factors:There was no statistical difference between the two groups in factor 1(anxiety/somatization)and factor 6(sleep disorder)score reductions at the 2nd,4th,and 8th weekends(P<0.05).>0.05);There was no statistical difference in factor 3(cognitive impairment)and factor 5(hysteresis,retardation)score reductions between the two groups at the 4th week of treatment(P>0.05).(4)Comparison of the score reduction rate of each symptom in TCM:There was no statistical difference in the declining mood and the rate of weakness of the core symptoms in the two groups(P>0.05).There was a statistical difference in the reduction rate of the two groups' lack of interest in core symptoms(P).<0.05);There was no statistical difference between the two groups in the subtraction rate of minor symptoms(p>0.05).(5)Safety evaluation:59 cases of VD patients in the Chinese medicine group had only 2 cases of spontaneous sweating,and the adverse reaction rate was 3.90%;20 cases of western medicine group had 2 cases of dietary loss,1 case of dizziness,and the adverse reaction rate was 15%.Brain function mechanism:(1)Prior to treatment,compared with the control group,the fALFF value of the left central tarsal groove cap and right cerebellar vermis increased;the right occipital gyrus(BA 19)fALFF decreased;the western medicine group right cerebellum upper and left insula fALFF Increased value.(2)After treatment,compared with before treatment,the value of fALFF in the right occipital gyrus(BA 19)increased,and the value of fALFF in the left middle frontal gyrus(BA8)decreased.(3)After treatment,compared with the control group,the fALFF value in the left cerebellum and the left cerebellum of the Chinese medicine group increased;the left cerebellum,the left cerebellum,and the right cerebellum fALFF values increased in the western medicine group,and the left side of the middle amount The fALFF values were reduced in the gyrus,right fusiform gyrus(BA37),right lingual gyrus,and left lower temporal frontal gyrus.After treatment,the fALFF value in the left middle frontal gyrus(BA8),the left anterior leaf anterior gyrus,and the right frontal gyrus(BA10)were higher in the Chinese medicine group than in the western medicine group,and the right phrenic pole:the fALFF value in the middle gyrus was reduced.Analysis conclusion:(1)Kaixin Jieyu Fang has antidepressant effect,and the total effective rate is 86.44%;among them,the effect of improving the anxiety/somatization and sleep disorders is equivalent to Western medicine fluoxetine hydrochloride;(2)Kaixin Jieyu Fang is equivalent to fluoxetine hydrochloride in relieving symptoms of traditional Chinese medicine,but has fewer clinical adverse reactions,which reflects the therapeutic advantages of multiple Chinese medicine targets.(3)Compared with the healthy control group,there were abnormal brain function changes in some brain regions in patients with vascular depression;(4)After treatment with antidepressant,some brain regions also have changes in fALFF.The change of brain regions is related to the regulation of depression emotions,suggesting that these brain function changes may be one of the brain functional mechanisms of antidepressant efficacy.