Based On 5-HT Pathway To Explore The Mechanism Of Action Of Chaihu Jia Longgu Muli Decoction In The Treatment Of Type 2 Diabetes Patients With Depression

Objective: To observe the clinical efficacy and safety of Chaihu Jia Longgu Mu LI Decoction in the treatment of type 2 diabetes mellitus with depression,and to explore the possible therapeutic mechanism based on 5-HT,so as to enrich the treatment methods and theoretical basis of type 2 diabetes mellitus with depression.Methods:65 patients with type 2 diabetes complicated with depression were randomly divided into two groups.The basic treatment group was given standardized hypoglycemic treatment according to The Chinese Guidelines for the Prevention and Treatment of Type 2Diabetes 2020 edition,and the Chaihu-jia-Longgu-Muli-Decoction was added in the combined treatment group.Before treatment,1 week after treatment,2 weeks after treatment and 4 weeks after treatment,glycated albumin value,HOMA-IR value,serum 5-HT value,HAMD-17 score and TCM clinical syndrome score of 2 groups were recorded and comprehensively analyzed and compared.Results:(1)During treatment,there was no significant change in serum 5-HT level in the basic treatment group.After 1 week of treatment,there was no significant change in serum 5-HT level in the combined treatment group.After 2 weeks of combined treatment,serum 5-HT level continued to increase(P < 0.05).After 4 weeks of treatment,the level of 5-HT in the combined treatment group was higher than that in the basic treatment group(P < 0.05).(2)After 1 week of treatment,there were no significant changes in GA and HOMA-IR in 2 groups.After 2 weeks of treatment,GA and HOMA-IR in the combined treatment group were continuously decreased compared with before treatment(P < 0.05),and GA in the combined treatment group was lower than that in the basic treatment group(P < 0.05).After4 weeks of treatment,HOMA-IR in the combined treatment group was lower than that in the basic treatment group(P < 0.05).(3)During treatment,HAMD-17 score and TCM syndrome score in 2 groups were decreased(P < 0.05),and the decrease was greater in the combined treatment group than in the basic treatment group(P < 0.05).The ham D-17 score of the combined treatment group was better than that of the basic treatment group(P < 0.05).The combined treatment group was better than the basic treatment group(P < 0.05).(4)During treatment,there were no obvious abnormalities in liver and kidney functions,electrocardiogram,allergic reactions or other serious adverse events in 2 groups.Conclusion:(1)Chaihu-jia-Longgu-Muli-Decoction can significantly increase the level of 5-HT in patients with type 2 diabetes mellitus complicated with depression.(2)Chaihu-jia-Longgu-Muli-Decoction can promote the improvement of blood glucose and insulin resistance in patients with type 2 diabetes mellitus combined with depression,and reduce the HAMD-17 score and TCM syndrome score,with obvious clinical efficacy.(3)According to the changes of serum 5-HT level,GA value,HOMA-IR,HAMD-17 score and TCM syndrome score of patients,it is suggested that Chaihu-jia-Longgu-Muli-Decoction may improve insulin resistance,promote blood glucose regulation and relieve depression symptoms and TCM clinical symptoms of patients by increasing the serum 5-HT level of patients with type 2 diabetes complicated with depression.It is worthy of extensive clinical application.