Based On Real-world Research To Explore The Regularity Of Clinical Medication In The Treatment Of Depression

Objective:To collect information on the diagnosis and treatment of depression patients in Guang'an men Hospital of Chinese Academy of Traditional Chinese Medicine,and explore the clinical medication rules of depression under the real world research method,so as to provide reference for the treatment of depression.Methods:Depression patients who met the inclusion and exclusion criteria from the geriatrics department,psychosomatic medicine department and psychosomatic clinic of Guang'an men Hospital of Chinese Academy of Traditional Chinese Medicine in March 2017 and December 2018 were enrolled in the queue of traditional Chinese medicine group,western medicine group and Chinese and Western medicine group according to the actual medication situation.After introducing the diagnosis and treatment information into the APP of Bo Shi medical cloud and verifying the integrity of the database information,the data fields needed by the research,such as patient's age,gender,course of disease,cost occupation,educational level,traditional Chinese medicine,western medicine,Chinese patent medicine,etc.,are reported to the data management center,and the data fields are imported into the excel table to obtain the data infor-mation of the research.Standardized data processing,formulation of medical records i-nformation rules,man-machine integration after consolidation and integration into the data warehouse,data cleaning,disassembly.SPSS20.0 statistical analysis software was used to describe the general data and medication information of 188 depressive patien-ts,and excel was used to assist in drawing.The data mining platform of TCM scient-ific research information sharing system data analysis and mining was used in the res-earch room of renowned veteran TCM in Guang'anmen Hospital to mine the law of-TCM medication.Complex network analysis software was used to get core prescription-ns by node degree and core sub-network structure,and at the same time to analyze t-he rule of medication between symptoms-traditional Chinese medicine,syndrome-traditional Chinese medicine.Point mutual information analysis was used to describe the correlation between drugs and drugs,and weight relationship was used to rank them to obtain commonly used pairs of traditional Chinese medicine.And pop up the results and diagram.Results:1.Gender and age:188 effective cases were included from March 2017 to December 2018.There were 44 male patients(23.4%)and 144 female patients(76.6%).Women outnumber men.The peak age of women is 45-59 years old,and that of men is 18-44 years old.2.General data and treatment plan:188 patients with depression were included in this study.According to patients'willingness and doctor's evaluation of the condition,TCM treatment,TCM-WM combination therapy and Western medicine treatment plan were selected.The differences among the three treatment schemes were analyzed from the angles of patients' age,gender,course of disease,educational level,cost,degree of illness and history of treatment.There was no significant difference in gender,age,occupation,educational level and cost between the two groups(P>0.05),suggesting that gender,age,educational level,occupation and cost may not be considered in the choice of treatment options.There were significant differences in the severity of depression and the history of treatment among the three groups(P<0.01),suggesting that the severity of depression and the history of treatment may be considered factors in the choice of treatment options for clinicians.3.Drug use regularity:(1)Among the 9 Western medicines used in this study,citalopram,fluoxetine,sertraline,flupentixol,melitracen and duloxetine are the top five.According to the mechanism of action,SSRIs,SNRI and atypical antidepressants rank the top three in the use frequency;(2)Twenty-four kinds of Chinese patent medicines were included in this study,including soothing liver and relieving depression.Capsules and St.John's Grass Extract Tablets(Lu Youtai)were used more frequently than other drugs;Chinese patent medicines with frequencies less than 10 times were used to classify the efficacy of drugs.The results showed that tranquilizing mind,tranquilizing heart,activating blood circulation and removing blood stasis,benefiting qi,resolving phlegm,tonifying kidney and nourishing blood were commonly used drug efficacy types;(3)193 herbal medicines were used in this time,and the frequency of Chinese traditional medicines was in the first 20 flavors Ling,Radix Polygalae,Fried Jujube Seed,Bupleurum,Acorus calamus,Licorice,Angelica Sinensis,Salvia Miltiorrhiza,Radix Paeoniae Rubra,Tulip,Radix Rehmanniae,Alisma Alismatis,Peony Bark,Pearl Mother,Puerariae Root,Calcined Oyster,Radix Morindae,Fried Rhizoma Atractylodis Macrocephalae with Bran,Fried Fructus Aurantii with Bran and Peel.It embodies the main therapeutic methods of soothing liver and strengthening spleen,benefiting qi and phlegm,soothing mind and benefiting intelligence,and promoting blood circulation and yin.It can be seen that the outpatient depression patients in this study use more prescriptions for Kaixinsan,Guipi Decoction and Kaixinjieyu Formula.The results of meridian tropism and efficacy analysis of traditional Chinese medicine showed that the main function of traditional Chinese medicine was calmness,followed by warmth and cold,the least used products of severe cold and heat,the main five flavors were sweetness,bitterness and bitterness,followed by liver meridian,heart meridian,spleen meridian,lung and kidney,and the efficacy was spleen-invigorating,blood-activating,tranquilizing,heat-clearing,qi-benefiting,heart-cooling,blood-cooling,water-diversifying and dampness-seeping.The results of point mutual information method showed that fried jujube kernel-poria cocos,prepared polygala-poria cocos,Poria cocos-bupleurum,prepared Morinda officinalis-ginseng were commonly used drug pairs,among which prepared Morinda officinalis-ginseng had the highest mutual trust value(10.123639),and fried jujube kernel-poria Cocos(86 times)had the highest frequency of use.Besides the core prescription,Radix Paeoniae Rubra-ginseng,Radix Ginseng-bran stir-fried Fructus Aurantii,Radix Paeoniae Rubra-licorice are also commonly used.Depression,lack of interest,lack of motivation,irritability,fatigue,insomnia and apathy are the core symptoms of depression.The related medicines with the core symptoms are Poria cocos,Polygala tenuifolia,Salvia miltiorrhiza,Bupleurum,Acorus calamus,Tulip,fried jujube seeds,Angelica sinensis and licorice,which are basically consistent with the core prescriptions.This study included six depression syndromes,which are ShenXuGanYu type,GanYuPiXu type,XinPiLiangXu type,XinDanQiXu type,XinShenBuJiao type and GanDanShenRe type,except GanDanShenRe typetype.According to the complex network analysis method,the remaining syndrome type gets the result of medication and pops up the complex network diagram,and carries on the dialectical medication according to the clinical specialty.The results are:GanYuPiXu type:core prescription and Liuwei Dihuang pill(raw Rehmannia are used);XinPiLiangXu type:core prescription and Guipi decoction;GuYuPiXu type:core prescription combined XiaoYaoSan decoction,and XiaoChaiHuTang decoction is partial to the type of GanWeiBuHe.Addition and subtraction;XinDanQiXu type:core prescription addition and subtraction;XinShenBuJiao type:core prescription and liuwei Dihuang pill and jiaotai pill addition and subtraction(raw Rehmannia instead of cooked Rehmannia).Conclusion:1.The incidence of depression is related to age and gender,and most of them are middle-aged women.2.The severity of the disease and the history of treatment may be the factors for clinical doctors to choose the treatment plan.3.Western medicine is mainly SSRIs,which basically conforms to the guidelines for clinical depression;Chinese patent medicine Shugan Jieyu capsule is mainly;core prescriptions are obtained by complex network analysis method.It can be seen that Shugan Jieyu,Ningxin Anshen,Yiqi Tan,Huoxue Kaiqiao are the core treatment methods for outpatient depression patients.Blood nourishing,kidney tonifying,Yin nourishing,heat clearing and dampness removing methods are given according to syndrome differentiation.