| Objective:to observe the efficacy and safety of modified xiaochaihu decoction combin ed with mirtazapine in the treatment of persistent depression with liver-kidney Yin def iciency.Methods:a total of 64 patients with persistent depression who visited the department of traditional Chinese medicine of Navy General Hospital hospital from June 2018 to February 2019 were selected and divided into two groups by random number table me thod.Among them,32 patients in the control group were treated with flavored xiaoch aihu decoction.In the treatment group,32 cases were treated with modified xiaochaihu decoction combined with mirtazapine.The duration of intervention was 12 weeks.Before treatment and at the 12th weekend after treatment,zung self-rating scale for depressi on,TCM syndrome scale and adverse reaction scale were used for evaluation.Blood sa mples were taken before and at the end of the 12th week after treatment for tumor n ecrosis factor-alpha,interleukin-6,and c-reactive protein.SPSS 20.0 was used for statist ical analysis of the data obtained.Serum TNF-α,interleukin-6,and c-reactive protein were collected from the two groups before treatment and at the end of the 12th week of treatment.Paired test was performed on the scores of the self-rating scale for depres sion and the TCM syndrome scale for two groups of samples respectively.The differe nce values were in line with the normal distribution,and paired t-test was used.Before using the linear Pearson correlation analysis treatment serum tumor necrosis factor al pha and interleukin-6,and c-reactive protein respectively with depression self rating sc ale scores and the correlation between,correlation coefficient r,said | r | value in:0.8-1.0 said both is highly relevant,0.6-0.8 said both strong correlation,0.4-0.6 said both moderate related,said the weak correlation between 0.2 0.4,0.0-0.2 said weak correl ation or no correlation between them.The scores of the self-rating scale of depression before and after treatment were analyzed by anova,the counting data were expressed by percentage(%),and the chi-square test was used.P<0.05 was considered statistica lly significant.1.64 patients were enrolled in the study,2 in the treatment group and 4 in the contro 1 group,and 30 in the final treatment group and 28 in the control group.(note:the nu mber of abscission patients is small and all of them are completely random deletion,so the abscission data is directly excluded).Two groups of patients after 12 weeks of t reatment,the control group cured 2 cases(17.85%),significantly 9 cases(32.14%),im proved 11 cases(39.29%),the total effective rate of 78.57%;In the treatment group,10 cases were cured(33.33%),11 cases were significantly effective(36.67%),8 cases were improved(26.67%),and the total effective rate was 96.67%.The chi-square test s howed that the treatment group was significantly superior to the control group in clini cal cure rate and total effective rate(p<0.05).2.After 12 weeks of treatment,the scores of TCM syndrome scale in both groups wer e lower than before treatment,and the difference before and after treatment in the tre atment group was significantly better than that in the control group,and the difference was statistically significant(p<0.01).However,compared with the control group,the i mprovement of fatigue(72%vs31.82%),dry mouth(90.48vs52.63%),insomnia(96.43%vs44%)and delayed belching(100%vs52.63%)in the treatment group was particularly significant(p<0.01).In into the group of patients,from two groups patients complained of somatic symptoms distribution,insomnia(91.38%),languid(81.03%),gas stay(70.69%),bitter mouth(dry)(68.97%),pain(63.79%)accounted for the biggest five sympt oms,suggesting that the persistent depressive disorder often insomnia,fatigue,stay ga s,bitter mouth(dry)and pain symptoms or as the "chief complaint" to see a doctor,prompt clinicians should carefully identify,so as to avoid misdiagnosis and misdiagnos is.3.Adverse reaction scale score was assessed at the 12th weekend after treatment in th e two groups.The treatment group had a score of(9.4=12.55)and the control group ha d a score of(5.86±1.06).By t test,the difference between the two groups was not st atistically significant(p>0.05),indicating that the safety of the combined treatment g roup was consistent with that of the pure Chinese medicine control group.4.Among the enrolled patients,only 6 of them(22.22%)obtained the test results of t umor necrosis factor-alpha,interleukin-6 and c-reactive protein before treatment in som e patients.Interleukin-6 was abnormal in 1 patient(3.70%).C-reactive protein abnormalit y in 1 patient(note:the abnormality of the three indicators is higher than the normal range).After using Pearson correlation analysis,the correlation coefficient r values were 0.174,0.103 and-0.01 respectively,and |r| values were all within the range of 0-0.2.Therefore,it can be concluded that the above three inflammatory indicators are not c orrelated with the depression self-rating scale score or the correlation is very weak.5.Among the 58 patients with persistent depressive disorder,53 patients were accomp anied by insomnia.Among the 53 patients,middle sulcus tongue(either deep or shall ow)was seen in all the patients,and only 1 patient without insomnia had middle sulc us tongue.lt is suggested that there may be some relationship between persistent depre ssion,insomnia and mid-sulcus and tongue.Conclusion:modified xiaochaihu decoction combined with mirtazapine in the treatment of persistent depressive disorder has reliable efficacy,high efficiency and safety,better efficacy than the traditional Chinese medicine group,with clinical promotion value;The middle sulcus tongue is closely associated with persistent depressive disorder or chro nic insomnia,which deserves further study. |
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