Study On The Early Improvement Of Jiawei Xiaoyao Granule Combined With Sertraline In The Treatment Of Depression And The Relationship With Intestinal Bacteria

Objects:To investigate the early Improvement of Jiawei Xiaoyao Granule combined with sertraline in the treatment of mild to moderate depression of liver stagnation and spleen deficiency and its relationship with intestinal bifidobacteria and Escherichia coli(E.coil).Methods:A randomized,double-blind and controlled experimental was performed for 2 weeks.95 patients meeting ICD-10 criteria for mild to moderate depressions of liver stagnation and spleen deficiency were recruited from the inpatient clinic of GuangZhou Brain Hospital and randomly divided into Chinese medicine group(49 cases)and placebo group(46 cases),while 45 healthy workers were recruited as normal control group.Low to middle dose Sertraline was given to patients after admission.On this basis,the Chinese medicine group was treated with Jiawei Xiaoyao Granule,while the placebo group was only treated with placebo.Both groups were observed for 2 weeks.Firstly,Baseline demographic data and the difference of colony forming units of bifidobacteria and E.coil among the three groups were analyzed by analysis of variance(ANOVA)or chi-squ,are test;then the changes of Hamilton Depression Scale(HAM-D17)and intestinal Bifidobacterium and E.coil colonies were analyzed by analysis of covariance(ANCOVA)after the second week of treatment,and the early improvement rate between the two medication group was analyzed by chi-square test.finally,Logistic regression analysis was used to analyze the early improvement in patients with mild to moderate depression of liver depression and spleen deficiency?The adverse drug reactions were recorded.Results:1.There was a statistically significant difference of colony forming units of bifidobacteria between the three groups(F=36.83,P<0.001).7.99(log 10cfu/g wm)in the Chinese medicine group and 8.01(loglOcfu/g wm)in the placebo group were significantly lower than 9.09(log 10cfu/g wm)in the normal control group(P<0.001),but there was no significant difference between Chinese medicine group and placebo group(P=0.869).2.There was a statistically significant difference of colony forming units of E.coil between the three groups(F=31.58,p<0.001).8.66(loglOcfu/g wm)in the Chinese medicine group and 8.78(loglOcfu/g wm)in the placebo group were significantly higher than 7.99(log10cfu/g wm)in the normal control group(P<0.001),but there was no significant difference between Chinese medicine group and placebo group(P=0.258).3.After adjustment according to the baseline HAM-D17 score,the score of the Chinese medicine group(14 points)was significantly lower than that of the placebo group(17 points)(F=71.39,P<0.001).4.The early improvement rate(score reduction rate of HAM-D17 in the second weeks of the treatment)20%)of the patients was statistically significant(?2=22.109,P<0.001),which in the Chinese medicine group(91.8%)was significantly higher than that in the placebo group(47.8%).5.After adjusting the baseline Bifidobacterium colony forming units,there was no significant difference of Bifidobacterium colony forming units between the Chinese medicine group and the placebo group(F=2.108,P=0.150).6.After adjustment according to the baseline E.coli colony-forming units,the E.coli colony forming units in the Chinese medicine gro up(8.49 log 10cfu/g wet feces)was significantly lower than that in the placebo group(8.71 loglOcfu/g wet feces)(F=4.774,P=0.031).7.Binary logistic regression showed that the combination of Jiawei Xiaoyao granules and early improvement was positively correlated(or=20.03,P<0.001)after adjusting the influence of total score of HAM-D17(or=1.84,P=0.002)before treatment,but no correlation was found with the change of E.coli content(or=19.95,P=0.403).Conclusion:1.Jiawei Xiaoyao granule assisted with sertraline can better improve the early symptoms of patients with mild and moderate depression of liver depression and spleen deficiency.Therefore,the treatment scheme of Jiawei Xiaoyao granule assisted with sertraline in patients with mild and moderate depression of liver depression and spleen deficiency deserves clinical promotion application;2.There are imbalances of intestinal flora in patients with mild and moderate depression of liver depression and spleen deficiency type,which is the decrease of bifidobacteria and the increase of E.coli.The treatment of Jiawei Xiaoyao granule combined with sertraline can better improve the early E.coli imbalance in such patients;3.The improvement of early E.coli maladjustment has no significant effect on the early improvement rate of patients with mild to moderate depression of liver depression and spleen deficiency.The next research needs to analyze other intestinal microbial pathways of early improvement rate of such patients.