Modified Xiaoyao Erxian Decoction in Treatment of Mood Disorders in Perimenopausal Syndrome / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of modified Xiaoyao Erxian decoction in the treatment of mood disorders among perimenopausal syndrome due to kidney deficiency and liver depression and its effects on monoamine neurotransmitters and brain-derived neurotrophic factor （BDNF）. Method:According to the random number table， 108 patients were divided into a control group （54 cases） and an observation group （54 cases）. Control group were treated with Shugan Jieyu capsule orally， two capsules per time， two times per day， while those in the observation group received the modified Xiaoyao Erxian decoction， one bag per day， for 12 consecutive weeks. Before and after treatment， the Hamilton Anxiety Scale （HAMA）， 17-item Hamilton Depression Rating Scale （HAMD-17）， modified Kupperman Index （KI）， Pittsburgh Sleep Quality Index （PSQI）， Menopause-specific Quality of Life （MENQOL） and kidney deficiency and liver depression syndrome scores were calculated. The levels of estradiol （E₂）， follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， BDNF， 5-hydroxytryptamine （5-HT）， norepinephrine （NE）， and dopamine （DA） were detected， followed by safety evaluation. Result:The HAMA， HAMD-17， KI， kidney deficiency and liver depression syndrome， PSQI， and MENQOL scores of the observation group were lower than those of the control group （<italic>P</italic><0.01）， whereas the 5-HT， E₂， DA， NE， and BDNF levels in the observation group were higher （<italic>P</italic><0.01）. The clinical efficacy of the observation group was superior to that in the control group （<italic>Z</italic>=2.184， <italic>P</italic><0.05）. No adverse reactions occurred after the oral administration of Chinese medicinal preparations. Conclusion:The modified Xiaoyao Erxian decoction effectively alleviates the mood disorders and other related symptoms of perimenopausal syndrome due to kidney deficiency and liver depression by regulating the monoamine neurotransmitters， BDNF， and E₂， without inducing obvious side effects.

Research on Medication Rules of Depression Syndrome Based on Ancient Medical Records / 中国实验方剂学杂志

Objective::To analyze and excavate the medication rules of ancient physicians in the treatment of depression syndrome, so as to provide reference for clinical treatment of depression syndrome. Method::The ancient medical records of depression syndrome sorted out in Yian Leiju were retrieved and collated, the data of traditional Chinese medicine (TCM) prescriptions in medical records were extracted, the obtained data of TCMs in prescriptions were standardized, and the data mining function of the ancient and modern medical records cloud platform V1.5 was adopted to carry out frequency statistics, cluster analysis, association analysis and complex network analysis of TCM data, the common drugs used by ancient physicians for treatment of depression syndrome, properties and classifications of commonly used medicines, pairs of commonly used medicines and core prescriptions were obtained. Result::After screening, a total of 364 medical cases, 461 visits and 439 prescription data of TCM were included, involving 67 ancient books. A total of 607 Chinese medicines were involved, and the total frequency of medication was 4 127.High frequency medicines included Poria (186 times), Citri Reticulatae Pericarpium (115 times), Glycyrrhizae Radix et Rhizoma (113 times), Ginseng Radix et Rhizoma (101 times), Angelicae Sinensis Radix (98 times), Atractylodis Macrocephalae Rhizoma (94 times), etc. The main properties and flavors of commonly used Chinese medicines were warm, flat, bitter and acrid, which were mainly attributed to the four meridians of spleen, lung, heart and liver. Commonly used couplet medicines were Atractylodis Macrocephalae Rhizoma-Poria, Poria-Glycyrrhizae Radix et Rhizoma, Poria-Angelicae Sinensis Radix, Atractylodis Macrocephalae Rhizoma-Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma-Poria, etc. The core prescription was based on the addition and subtraction of Danzhi Xiaoyaosan. Conclusion::In the treatment of depression syndrome, ancient physicians adopt the principles of invigorating the spleen, nourishing Qi and blood, soothing the liver and regulating Qi, nourishing the heart and tranquilizing the mind, giving consideration to both Qi and blood, and harmonizing the liver, spleen and heart.

Clinical research progress in stroke-associated pneumonia / 中华危重病急救医学

Stroke-associated pneumonia (SAP) is a spectrum of pulmonary infections in non-mechanical ventilation patients within 7 days of stroke. SAP is one of the most common complications after stroke, with an incidence of 7%-38%, which is significantly associated with poor prognosis of stroke. Stroke-induced immune-depression syndrome (SIDS) is one of the main pathogenesis of SAP, which is closely related to autoimmune, sympathetic nervous system (SNS), hypothalamic-pituitary-adrenalin axis (HPA axis), parasympathetic nervous system (PNS), and damage-related molecular patterns (DAMPs). It is unclear how the lungs and brain interact during the development of SAP. Some clinical studies have found that some clinical indicators such as monocyte human leukocyte antigen-DR (mHLA-DR), neutrophil to lymphocyte ratio (NLR) and heart rate variability (HRV) can be used to predict SAP occurrence. Old age, male, and diabetes are currently considered risk factors for SAP. Furthermore, a variety of SAP risk scales such as A2DS2 scale (age, atrial fibrillation, dysphagia, gender and stroke severity), preventive antibacterial therapy in acute ischemic stroke (PANTHERIS) scale, acute ischemic stroke-associated pneumonia scale (AIS-APS), and ISAN scale (pre-stroke independence, gender, age, and stroke severity) have been developed. According to the opinion of Pneumonia in Stroke Consensus in 2015, it is recommended to use the modified Centers for Disease Control and Prevention (CDC) pneumonia clinical diagnostic criteria for the diagnosis of SAP. Prevention of SAP is the most important part of clinical practice. Preventive antibiotics are not recommended, and once SAP is diagnosed, the antibiotic strategies should be followed. Neuroprotective and anti-inflammatory treatments are still being studied.

Clinical research progress in stroke-associated pneumonia / 中华危重病急救医学

Stroke-associated pneumonia (SAP) is a spectrum of pulmonary infections in non-mechanical ventilation patients within 7 days of stroke. SAP is one of the most common complications after stroke, with an incidence of 7%-38%, which is significantly associated with poor prognosis of stroke. Stroke-induced immune-depression syndrome (SIDS) is one of the main pathogenesis of SAP, which is closely related to autoimmune, sympathetic nervous system (SNS), hypothalamic-pituitary-adrenalin axis (HPA axis), parasympathetic nervous system (PNS), and damage-related molecular patterns (DAMPs). It is unclear how the lungs and brain interact during the development of SAP. Some clinical studies have found that some clinical indicators such as monocyte human leukocyte antigen-DR (mHLA-DR), neutrophil to lymphocyte ratio (NLR) and heart rate variability (HRV) can be used to predict SAP occurrence. Old age, male, and diabetes are currently considered risk factors for SAP. Furthermore, a variety of SAP risk scales such as A2DS2 scale (age, atrial fibrillation, dysphagia, gender and stroke severity), preventive antibacterial therapy in acute ischemic stroke (PANTHERIS) scale, acute ischemic stroke-associated pneumonia scale (AIS-APS), and ISAN scale (pre-stroke independence, gender, age, and stroke severity) have been developed. According to the opinion of Pneumonia in Stroke Consensus in 2015, it is recommended to use the modified Centers for Disease Control and Prevention (CDC) pneumonia clinical diagnostic criteria for the diagnosis of SAP. Prevention of SAP is the most important part of clinical practice. Preventive antibiotics are not recommended, and once SAP is diagnosed, the antibiotic strategies should be followed. Neuroprotective and anti-inflammatory treatments are still being studied.

Reliability and Validity of the Malay Version of Edinburgh Postpartum Depression Scale (EPDS) When Administered to Postpartum Mothers at Two Points in Time

@#Introduction: Edinburgh Postpartum Depression Scale (EPDS) is a tool used to assess the risk of postpartum depression (PPD). In this study we determined the reliability and validity of the Malay version of EPDS when administered at two different time points in the postpartum period. Materials and Methods: This cross-sectional study design was carried out between May and September 2017 at three government primary healthcare clinics located in Batang Padang district, a suburban area of Perak state in Peninsular Malaysia. We recruited a total of 89 women; 41 women were in the early postpartum period (1-30 days) and 48 women were in the late postpartum period (31-120 days). Cronbach's alpha coefficient, inter-item correlation, and corrected item-total correlation were used to assess the internal consistency. The concurrent validity was assessed using Spearman’s correlation. The data were analyzed using SPSS version 20 and R 3.4.2. Results: The Cronbach’s alpha for the first and second group was 0.78 and 0.62, respectively, which indicated satisfactory reliability. At both time periods, removing Item 2 from the scale resulted in a significant increase in Cronbach’s alpha (to 0.847 and 0.709, respectively). As expected, the EPDS scores correlated moderately with the BDI-II scores (1−30 days: Spearman's rho = 0.65, p < 0.01; 31−120 days: Spearman's rho = 0.73, p < 0.01). Conclusion: The Malay version of the EPDS is a reliable screening instrument for detecting postpartum depression. It showed reasonability and feasibility and can be used in postpartum clinical settings or for assessing intervention effects in research studies. Furthermore, as our results indicated, removing Item 2 from the Malay version would increase the internal consistency of the EPDS.

Efficacy of Jiajian Yijing Decoction on improving clinical symptoms and pregnancy rate of patients with diminished ovarian reserve and kidney deficiency and hepatic depression syndrome / 实用医学杂志

Objective To observe the clinical efficacy of Jiajian Yijing Decoction on improving clinical symptoms and pregnancy rate of patients with diminished ovarian reserve(DOR)and kidney deficiency and hepat-ic depression syndrome. Methods Patients with DOR and kidney deficiency and hepatic depression syndrome were randomly divided into traditional Chinese medicine group(n = 33)and western medicine group(n = 34). Patients in TCM group were treated with Jiajian Yijing Decoction and those in western medicine group with artificial periodic therapy(Progynova 2 mg/d+Dydrogesterone 20 mg/d).All cases were treated with 3 menstrual cycles.The improvement of clinical symptoms of DOR and kidney deficiency and hepatic depression syndrome and pregnancy rate were observed. Results The improvement of clinical symptoms of DOR and kidney deficiency and hepatic depression syndrome after treatment in TCM group was more obvious than that in western medicine group(P<0.05 or P < 0.01). The pregnancy rate after treatment in TCM group was higher than that in western medicine group, but it had no statistic difference(P>0.05).Conclusions Jiajian Yijing Decoction can obviously improve the clin-ical symptoms of patients with DOR and kidney deficiency and hepatic depression syndrome and increase the preg-nancy rate in infertile patients.It is worthy of clinical popularization.

From the "WANG Zhongqi Cases" to Analyse WANG Zhongqi Kuxin Method Experience / 浙江中医药大学学报

[Objective] From the five aspects of WANG Zhongqi medical case, such as Qi syndrome, vomiting, cough, epigastric pain, wet temperature and so on, WANG Zhong Qi's bitterness in the treatment of various diseases, in order to learn and inherit the essence of WANG's academic thought and the characteristics of clinical diagnosis and treatment. [Methods] On the basis of the medical case contained in "WANG Zhongqi's Medical Cases", combined with classic treatise and academic thought of "Neijing", "Treatise on Typhoid Fever", ZHANG Jingyue, LI Dongyuan, YE Guangxi and WANG Zhongqi, this paper illustrates WANG's experience in the treatment of disease with "bitterness method" and analyzes the characteristics of the diagnosis and treatment. [Results] WANG inherited the experience and understanding of ZHANG Zhongjing, YE Tianshi and other doctors in the use of the method of bitterness, but didn't learn without change, depression causing Qi stagnation and bitter opening the pivot; Qi reverse vomiting, bitter descending pungent openning and promoting Qi function; cough of Qi inverse, pungent and bitter having catharsis to purge the lung Qi; for epigastric stomach pain, bitterness regulating middle warmer; damp heat diffusing, light bitter micro pungent regulating Qi function. [Conclusion] WANG's referred to "Neijing", Zhongjing, Dongyuan and YE Gui and had many innovations and flexible methods. It is worthy of further study to apply the method of bittern to the treatment of a variety of dysfunctional diseases of Qi, through the effect of the gasification and blood flow for regulating Qi function, to remove the pathogenic pathogenic factors in the body.

FU Huazhou's Clinical Thought for Making Interventions in Tumor-associated Depression / 浙江中医药大学学报

[Objective] To sum up Pro. FU Huazhou's clinical thought for making interventions in tumor-associated depression.[Method]By following the supervisor clinic,sorting out the related medical materials and tumor-associated depression's literature data.Summarize the supervisor's academic view and clinical thinking in the differentiation and treatment of tumor-associated depression.[Results] In professor FU Huazhou's opinion, tumor-associate d depression is the pathological depression or syndrome in the process of diagnosis and treatment of malignant tumor, which is closely related to tumor. Pro. FU's theory is based on the exploration of the etiology,emotion guidance of TCM,Chinese medicine treatment of somatization disorder.Through the guidance of emotion, improving the symptoms of somatization disorder, the life quality of tumor patients can be improved.[Conclusion] Pro. FU Huazhou makes interventions in the treatment of tumor-associated depression by using emotion guidance of TCM and putting forward the principle of"Treatment of tumor-associated depression, it is necessary to treat tumor, relieving the depressed liver as a supplement". The treatment of both mind and body shows curative effect,worth learning and promotion.

Appreciation of the Depression Syndrome Cases of the Zhejiang Famous Doctor RUAN Huaiqing / 浙江中医药大学学报

[Objective]We select the cases of the famous doctor RUAN Huaiqing in Zhejiang, hoping to provide reference for the modern clinical treatment of depression.[Methods]In view of the collation and study of ancient famous medical records,this article analyzes the cases about depression syndrome in Ruan Shi Yi An,including the gynecologic and miscellaneous diseases medical cases,and evaluates the treatment experience of them at the same time. [Results]RUAN Huaiqing considers the location of this disease belonging to the three viscera of heart, liver and spleen. For the most part, he uses Yueju Wan,Guipi Tang and Xiaoyao San as a treatment, and pays more attention to emotional adjustment.[Conclusion] RUAN Shi Yi An can reflect the clinical experience of RUAN Huaiqing,and he inherited the academic viewpoints and experience of diagnosis and treatment of the former. The discussion and treatment experience of RUAN Huaiqing about depression syndrome, is worthy learning and being applied to clinic.

Appreciation of the Depression Syndrome Cases of the Zhejiang Famous Doctor RUAN Huaiqing / 浙江中医药大学学报

[Objective]We select the cases of the famous doctor RUAN Huaiqing in Zhejiang, hoping to provide reference for the modern clinical treatment of depression.[Methods]In view of the collation and study of ancient famous medical records,this article analyzes the cases about depression syndrome in Ruan Shi Yi An,including the gynecologic and miscellaneous diseases medical cases,and evaluates the treatment experience of them at the same time. [Results]RUAN Huaiqing considers the location of this disease belonging to the three viscera of heart, liver and spleen. For the most part, he uses Yueju Wan,Guipi Tang and Xiaoyao San as a treatment, and pays more attention to emotional adjustment.[Conclusion] RUAN Shi Yi An can reflect the clinical experience of RUAN Huaiqing,and he inherited the academic viewpoints and experience of diagnosis and treatment of the former. The discussion and treatment experience of RUAN Huaiqing about depression syndrome, is worthy learning and being applied to clinic.

Comparison of the effects of single emotional stimulus and complex emotional stimuli on the rat model of liver depression syndrome / 中国比较医学杂志

Objective To compare the effects of single and complex emotional stimuli on animal model of liver depression syndrome,in order to find out an animal model of liver depression syndrome with more similar clinical manifestations.Methods Based on the previous screening work,different methods,i.e.tail clamping,limb binding,putting a cangue on the neck,were used respectively,or using the three methods in combination to establish rat models of liver depression syndrome.A comparison table of human and rat liver depression syndrome was prepared,a mark sheet of evaluation criteria was made,general condition was observed and body weight was measured,and positive response to drugs and changes of hormonal levels were evaluated to identify whether the models were established successfully.Results Rats in the control group grew well and showed no abnormalities.There were lots of abnormal phenomena in the model group especially in the complex emotional stimulus modeling group.They were maniac with acute stress or depressive with chronic stress,had dry hair,small and less feces,many of the rats had hair loss,red eyes and shortness of breath symptom.They showed a significantly lower body weight gain and higher levels of CRH in hypothalamus and plasma ACTH and CORT.The manifestations were much more severe in the complex-emotional stimuli-induced model group than that in the single-stimulus prepared model groups.The drug-treated group showed considerable alleviation of the symptoms and improvement of the parameters closing to normal levels.Conclutions Establishing the rat model of stagnation of liver depression syndrome by complex emotional stimuli modeling method has good stability,with a short preparation period and high success rate,and presenting a better consistence with clinical liver stagnation of depression syndrome,so as to provide a suitable tool for TCM research.

Research Progress in TCM Non-medicine Therapies for Depression Syndrome / 中国中医药信息杂志

Depression in modern medicine belongs to the depression syndrome in TCM. As early as the pre-Qin period, the ancient doctors recognized depression syndrome as a kind of disease associated with the function of visceral organs or emotional stimulation, which showed mood disorders and a variety of physical symptoms. The doctors in the past dynasties had explored different kinds of non-medicine therapies except for general medicine therapies, such as acupuncture and moxibustion, tuina, music and emotional therapy etc., which had obtained definite therapeutic effects. This article reviewed the non-medicine therapies for depression syndrome in ancient literatures and modern clinical researches, in order to provide some references for the treatment of depression.

Dynamic Observation on Change of T3, T4 and TSH in PMS Patients with Liver-qi Invasion Syndrome and Liver-qi Depression Syndrome in Each Phase of Menstrual Cycle / 世界科学技术-中医药现代化

This study was aimed to reveal the roles of biological factors T3, T4 and TSH in the pathogenesis of liver-qi invasion syndrome and liver-qi depression syndrome of premenstrual syndrome (PMS) in the body. Thus, we may expound the connotation of conceptpotential stagnation ofqi and blood. Female workers of Jinan and Qingdao were selected as target groups by epidemiological cross-sectional survey. And specially trained investigators were responsible for screening patients referred to criterion on the international diagnostic standards and syndrome diagnosis of PMS. Patients' blood was taken as samples during the follicular phase (6 to 14 days), luteal phase (15 to 23 days), premenstrual phase (24 to 28 days) and the menstrual phase (1 to 5 days), respectively. Blood samples were disposed according to requirements of radioimmunoassay. Single factor analysis of variance was used in the comparison with the level of T3, T4 and TSH in menstrual blood for different time intervals of the case group and the normal group by SPSS 10.0 statistical software. The results showed that T3 levels of patients with either syndrome were significantly reduced during the premenstrual phase and the menstrual phase (P < 0.05). There were no significant changes on the level of serum T4 and TSH before and after the occurrence of the disease. Both of them were significantly increased during each phase of the menstrual cycle. It was concluded that changes of T3, T4 and TSH were one of the mechanisms in disease with liver-qi invasion syndrome and liver-qi depression syndrome. The micro change was the essence ofpotential stagnation of qi and blood, which was the body condition of this disease.

Application of fMRI Technology in Exploration of Central Brain Localization among Premenstrual Syndrome Patients with Liver-qi Depression in Resting-state / 世界科学技术-中医药现代化

This study was aimed to explore brain regions which were closely related to the disease onset of premenstrual syndrome (PMS) with liver-qi depression. The BOLD-functional magnetic resonance imaging (fMRI) was used in the study. The processing of imaging data was based on the SPM 8 software and the REST software of the matlab platform. Each cluster was more than 389 continuous voxel. The brain region with single voxel of P < 0.05 (corrected) was defined as region with statistical significance. The 2 Sample T-Test was applied in the case group and the control group. The results showed that compared with the normal control group, the frontal lobe, occipital lobe, insula, limbic lobe, basal nuclei, and cingulate gyrus were activated in the PMS with liver-qi depression cases. It was concluded that the disease onset of PMS with liver-qi depression cases was related to brain regions such as frontal lobe, occipital lobe, insula, limbic lobe, basal nuclei, and cingulate gyrus.

Study of Pathogenic Characteristics of Hepatic Depression Syndrome through Clinical Epidemiologic Survey / 中国中医药信息杂志

Objective To study the pathogenic characteristics of hepatic depression syndrome (HDS) through clinical epidemiologic survey. Methods By using the method of epidemiologic cluster sampling, the cases complicated with HDS from the hospitalized cases from January 2000 to December 2001 of the First Affiliated Hospital, the Second Affiliated Hospital and the Third Affiliated Hospital of Hunan University of TCM, and survey forms were fiUed. The data was counted and analyzed by using SPSS statistical analysis software. Result By the method of epidemiologic survey, the pathogenic characteristics of HDS were demonstrated as follows: universality-HDS could occur in many dieases, complexity-HDS often changed into other syndromes, orientation-HDS often influenced the function of spleen and stomach. Conclusion The method is an effective way to study pathogenesis of TCM. It is objective, truthful and consistent with the clinical situation.