ABSTRACT
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 （E<sub>2</sub>）， 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， E<sub>2</sub>， 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 E<sub>2</sub>， without inducing obvious side effects.
ABSTRACT
Objective:To observe the clinical efficacy and mechanism of Shugan Bushen Huoxue decoction in the treatment of perimenopausal perio syndrome （PPS） with kidney deficiency， liver depression and blood stasis syndrome. Method:One hundred and twelve patients were randomly divided into control group and observation group according to random number table. Both groups took Remifemin orally， 1 tablet/time， by swallowing in the morning and evening. The patients in control group additionally took Fuke Yangrong capsules， 4 capsules/time， 3 times/day. The patients in observation group additionally took Shugan Bushen Huoxue decoction， 1 dose/day. The course of treatment was 12 weeks in both groups. Before and after treatment， scores were graded for modified Kupperman index （KI）， traditional Chinese medicine （TCM） syndromes， menopausal quality of life scale （MENQOL）， self-rating depression scale （SDS） and self-rating anxiety scale （SAS）. Follicle stimulating hormone （FSH），luteinizing hormone （LH），serum estrogen （E<sub>2</sub>）， 5-hydroxytryptamine （5-HT）， dopamine （DA）， norepinephrine （NE）， 5-hydroxyindole acetic acid （5-HIAA）， endothelin （ET）， and nitric oxide （NO） levels were detected before and after therapy. Result:In the observation group， scores of KI， TCM syndrome， SDS and SAS were lower than those in the control group （<italic>P</italic><0.01）. All dimensions of MENQOL scores in the observation group were lower than those in the control group （<italic>P</italic><0.01）. FSH and LH levels in the observation group were lower than those in the control group， and the E<sub>2</sub> level was higher than that of the control group （<italic>P</italic><0.01）. The levels of 5-HT， 5-HIAA， DA and NE in the observation group were higher than those in the control group （<italic>P</italic><0.01）. The ET level in the observation group was lower than that in the control group， and the NO level was higher than that of the control group （<italic>P</italic><0.01）. In observation group，the clinical efficacy was superior to that in control group （<italic>Z</italic>=2.073<italic>，P</italic><0.05）， and the efficacy of TCM syndromes was also superior to that in control group （<italic>Z</italic>=2.086<italic>，P</italic><0.05）. Conclusion:Shugan Bushen Huoxue decoction in the treatment of PPS in patients with kidney deficiency and liver depression and blood stasis can significantly reduce clinical symptoms， depression and anxiety， regulate the sex hormones， vasomotor factors and monoamine neurotransmitters levels， and improve the quality of life， with obvious clinical efficacy and high safety， so it is worthy of clinical use.
ABSTRACT
OBJECTIVE@#To compare the therapeutic effect of acupuncture combined with wheat-grain moxibustion and oral fluoxetine hydrochloride capsule on perimenopausal depression with kidney deficiency and liver depression.@*METHODS@#A total of 60 patients of perimenopausal depression with kidney deficiency and liver depression were randomized into an observation group and a control group, 30 cases in each one. Acupuncture combined with wheat-grain moxibustion were adopted in the observation group. Acupuncture was applied at Baihui (GV 20), Yintang (GV 29), Fengchi (GB 20), etc. for 30 min. Wheat-grain moxibustion was applied at Ganshu (BL 18), Shenshu (BL 23), Mingmen (GV 4) and Yongquan (KI 1), 3 moxa-cones for each acupoint. The treatment in the observation group was given once every 2 days, 3 times a week. Fluoxetine hydrochloride capsule was given orally in the control group, 20 mg each time, once a day. Treatment for 8 weeks was required in the both groups. The scores of Hamilton depression scale (HAMD) and modified Kupperman scale were observed in the both groups before and after treatment, and at 1, 3, 6-month follow-up. The therapeutic efficacy was evaluated after treatment.@*RESULTS@#Compared before treatment, the scores of HAMD and modified Kupperman scale after treatment and at each time point of follow-up were decreased in the both groups (@*CONCLUSION@#Acupuncture combined with wheat-grain moxibustion can effectively treat perimenopausal depression with kidney deficiency and liver depression, and have more stable and sustained therapeutic effect compared with oral fluoxetine hydrochloride capsule.