Clinical Observation Of Modified Xiaoyao San In The Treatment Of Patients With Chronic Obstructive Pulmonary Disease Complicated With Depression And Anxiety

Purpose:This paper analyzes the clinical efficacy and safety of Modified Xiaoyao San on COPD patients with depression and anxiety(liver depression and spleen deficiency syndrome),and analyzes the potential mechanism of action of drugs and prescriptions,so as to guide clinical practice.Materials and Methods: Select patients who attended the Respiratory Department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine between September 2019 and September 2020,that they were diagnosed with COPD combined with depression and anxiety(Stagnation of the liver and deficiency of the spleen).We screened out90 patients into the group according to the inclusion criteria and exclusion criteria,and divided them into 30 cases in each group according to the principle of randomization.Each group was given the basic treatment of COPD,which is to continue the current treatment plan of COPD.This treatment plan includes oxygen inhalation,application of bronchodilators,hormones,etc.,and it can also be other.The medication regimen of the Chinese medicine group is based on the addition of Modified Xiaoyao San;Its usage is one dose,twice a day,after dissolving with boiling water,orally.The medication plan of the western medicine group is to add Extract of St.John's Wort Tablets 300 mg to the basic treatment,1 tablet orally twice a day.The intervention plan of the comprehensive group is to add to the basic treatment,add Modified Xiaoyao San twice a day to melt it with hot water and take it orally,and at the same time take Extract of St.John's Wort Tablets 300 mg twice a day for a total of 4 weeks.At the beginning of the trial,when the drug was used for 4 weeks,and when the drug was stopped for four weeks.We will measure and record TCM syndrome scores,HAD,SAS,SDS,CAT scores,FEV1%pre,FEV1/FVC,5-HT,NE,etc.And use EXCEL forms to store and organize them.We will use SPSS software version 22.0 to perform statistical analysis on these data.Results:1.Due to the loss of cases during the trial,87 patients were finally included in the trial,that they include 30 cases in the traditional Chinese medicine group,28 cases in the western medicine group,and 29 cases in the comprehensive group.There was no statistical difference in baseline data of the three groups of patients in gender,age,course of disease,and condition(P>0.05).2.In the evaluation of the efficacy of TCM syndromes,the total effective rate of the TCM group is better than that of the western medicine group(P<0.05),and the total effective rate of the combination group is significantly better than the other two groups(P<0.05).3.Modified Xiaoyao San had better curative effect than the western medicine group in improving insomnia and forgetfulness(P<0.05);the curative effect of the combined group was significantly better than the other two groups(P<0.01).In terms of full chest tightness,the curative effect of the traditional Chinese medicine group and the combination group was equivalent(P>0.05);and both were better than the western medicine group(P<0.01).Except for these two,there was no significant difference between the traditional Chinese medicine group and the western medicine group after the integral therapy(P>0.05);the other combined group after the integral therapy decreased significantly compared with the other two groups(P<0.01).4.In terms of improving the evaluation of depression and anxiety status,there was no statistical difference in the total effective rate of each group after treatment(P>0.05).5.In terms of reducing HAD,SAS,and SDS,Modified Xiaoyao San has the same efficacy as the western medicine group(P>0.05),and the comprehensive group has better efficacy than the other two groups(P<0.05).6.In terms of reducing the impact on the quality of life,Modified Xiaoyao San has the same effect as the western medicine group(P>0.05);the combined group is significantly better than the other two groups(P<0.05).7.In terms of lung function improvement,for FEV1%pre,Modified Xiaoyao San has the same effect as the western medicine group(P>0.05);however,the effect of the combined group after treatment is better than the two groups that of(P<0.05).For the FEV1/FVC index,the efficacy of the three groups after treatment was equivalent(P>0.05).8.In terms of improving neurotransmitter indexes(5-HT,NE),Modified Xiaoyao San has the same curative effect in the traditional Chinese medicine group and the western medicine group(P>0.05).Compared with the groups,the combined group improved more significantly(P<0.05).9.At the 8th week of follow-up,the observation indicators of the three groups were significantly improved compared to before treatment(P<0.05);the indicators of the traditional Chinese medicine group at follow-up were better than those after treatment in terms of less appetite,fatigue,and belching.(P<0.05);There was no significant change in the indicators of other groups compared with the 4th week at follow-up(P>0.05).Conclusion:1.Modified Xiaoyao San can better treat COPD combined with depression and anxiety,and has significant efficacy in TCM syndrome evaluation,and is superior to St.John's Wort extract tablets;the combined treatment of the two increases its total effective rate and has good safety.2.Modified Xiaoyao San can effectively reduce the emotional and physical symptoms of patients with COPD combined with depression and anxiety,and improve lung function,thereby improving the quality of life and reducing the risk of acute attacks.3.Modified Xiaoyao San may improve the levels of neurotransmitters in COPD patients with depression and anxiety,thereby improving the mood of COPD patients,such as tension and depression.