The Intervention Research Of Gandouling For Phlegm And Blood Stasis Wilson Disease Combined Major Depression Disorder

Objectives:1.Mastering the clinical features of Wilson's disease with Major depressive disorder(MDD).2.Assessing the clinical efficacy and safety of gandouling in Wilson's disease with depression.3.According to relevant serological indicators,explore the pathogenesis of Wilson's disease with MDD from that monoamine neurotransmitter metabolism,neuroplastic and immune inflammation.Methods: 1.Observing the HDRS-24 scores of 120 patients and summarize the clinical features.2.120 patients were compared with the healthy group and two groups were observed the serum index level of 5-HT?BDNF?MT?MIF?IL-6?IL-4?IL-10.3.120 patients were divided into treatment group and control group,60 people in each group,according to the actual condition to protect liver function,discharge copper,antidepressant treatment.The treatment group used gandouling more than the control group.After eight weeks,observing the evaluation scale?blood indicators and the adverse reactions.4.According to pre-set TCM syndrome scale of Wilson's disease with MDD,assessing the total efficacy before and after treatment.Results: 1.Most Wilson's disease patients are moderately and mildly depressed(90.83%),which is most common in retardation(72.50%),insomnia(51.66%)and despair(31.66%).2.The serum levels of 5-HT,MT,BDNF,IL-4 and IL-10 in 120 patients were lower than health group,which has significant statistical differences(P<0.01);Serum MIF and IL-6 levels were higher than those in the healthy group,and there was also a statistically significant difference(P<0.01).3.Efficacy:(1)After the treatment,in the treatment group,21 cases were markedly improved,35 cases were improved,4 cases were ineffective,no cases were aggravated.The total effective rate is 93.33%;The control group was markedly effective in 18 cases,improved in 30 cases,ineffective in 10 cases,and worsened in 2 cases.The total effective rate is 80%.There is significant statistical differences between groups(P<0.01).(2)There has statistically significant difference in UWDRS scores in two groups before and after treatment(P<0.01);After the end of the treatment,the difference between the two groups was statistically significant(P<0.05).(3)The difference of HDRS-24 scores exist significant statistical difference before and after treatment(P<0.01);Comparing the HDRS-24 scores at the end of the treatment,the difference was statistically significant(P<0.05).The difference in factor structure of somatization,body weight,Cognitive impairment between the two groups was statistically significant before and after treatment;At the end of the treatment period,the difference of despair factor and delay factor between the treatment group and the control group was statistically significant.(4)The scores of TCM syndromes before and after treatment were compared between the two groups,and the difference was statistically significant(P<0.01);At the end of the treatment,the scores of the two groups were statistically significant(P<0.05).4.Effect on serum indicators:(1)HT:There was a statistically significant difference in serum 5-HT levels before and after treatment(P<0.01);At the end of the treatment,there was a statistically significant difference in serum 5-HT between the two groups(P<0.01).(2)MT:There was a statistically significant difference in the difference of serum levels before and after treatment with serum MT(P<0.01);At the end of the treatment,there was a statistically significant difference in serum MT levels between the two groups(P<0.01).(3)BDNF:There was a statistically significant difference of therapy group in the levels of serum BDNF before and after treatment(P<0.01),and the indicators in the control group are meaningless.There are significant differences in serum BDNF between the two groups after the treatment(P<0.01).(4)MIF:There was a statistically significant difference in serum MIF levels in the treatment groups before and after treatment(P<0.01),this comparison was also statistically significant in the control group(P<0.05);The MIF levels after treatment were compared between the two groups,and the difference was statistically significant(P<0.01).(5)IL-6:By comparing the levels of serum IL-6 before and after treatment,the difference was statistically significant(P<0.01);And the the reduction of serum IL-6 in the treatment group was more significant(P<0.05).(6)IL-4:There was a statistically significant difference of serum IL-4 in the treatment groups at the end of treatment(P<0.01),the same statistical significance also exist in control group(P<0.05).After 8 weeks,Serum IL-4 increased significantly in the control group(P<0.05).(7)IL-10:Serum IL-10 levels in the treatment group were statistically significant before and after treatment(P<0.01),and Serum IL-10 levels in the control group were significant before and after treatment(P<0.05);The serum IL-10 levels of the two groups were compared after the end of the treatment period,which was statistically significant(P<0.05).Conclusion: 1.Wilson's disease combined with MDD is mostly expressed as mild to moderate,which clinical features including retardation(72.50%),insomnia(51.66%)and despair(31.66%).2.Gandouling can improve the clinical symptoms of Wilson's disease,and it significantly reduced HDRS-24 scores effectively improved retardation compared with the control group.3.Improvement in MDD of WD associated with that gandouling can increase the levels of 5-HT,MT,IL-4,IL-10 and reduce the levels of MIF,IL-6.4.Pathogenesis of WD with MDD involves multiple aspects.It may be related to adjustmenting serum monoamine neurotransmitters and cytokines,and regulating neural plasticity.5.Gandouling is safe for Wilson's disease.