SUBSCRIBE
Search JIM Advanced Search

Journal of Chinese Integrative Medicine ›› 2010, Vol. 8 ›› Issue (5): 427-431.doi: 10.3736/jcim20100505

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Characteristics of traditional Chinese medicine syndromes in post-stroke depression

 Hui Hana,b, Li-min Wuc, Wen-ming Yanga, Mei-xia Wanga, Jing-jing Tanga, Han Wanga, Zhi-xiu Liua, Rong-zhi Liua, Ting Donga, Juan Zhanga, Bo Yanga, Ming-xiang Hana,d   

  1. a Department of Neurology, First Affiliated Hospital, Anhui University of Traditional Chinese Medicine, Hefei 230031, Anhui Province, China
    b Department of Geriatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100029, China
    c Medical Research Center, Anhui Provincial Hospital, Hefei 230001, Anhui Province, China
    d School of Professional and Continuing Education, University of Hong Kong, Hong Kong, China
  • Received:2009-08-31 Accepted:2010-02-20 Online:2010-05-20 Published:2010-05-15
  • Contact: Hui Han E-mail:chinaxyh@mail.hf.ah.cn

RichHTML

1

PDF (PC)

59

Like

Objective

To explore the main characteristics of syndromes in traditional Chinese medicine (TCM) in post-stroke depression (PSD) and to provide basis for treatments with TCM herbs.
Methods

According to diagnostic criteria of PSD, stroke patients and depression patients from Department of Neurology, First Affiliated Hospital, Anhui University of Traditional Chinese Medicine were assigned into cerebral stroke group (150 cases), depression group (151 cases) and PSD group (123 cases). Neuropsychological assessments and imaging and biochemical analyses were conducted. TCM syndrome differentiation for these diseases was performed. We also determined the characteristics of TCM syndromes of PSD, relative risk of the syndromes and their correlations with ages as well.
Results

Scores of qi stagnation and blood stasis, liver qi depression, and transformation of fire due to qi stagnation in PSD group were significant higher than those in cerebral stroke group (P<0.05, P<0.01). In cerebral stroke group, majority of the patients displayed one syndrome, while in PSD and depression groups, the patients had three or more syndromes. Of these syndromes, the incidence rate of syndrome of liver qi depression complicated with transformation of fire due to qi stagnation or flaring of fire due to yin deficiency was high. The syndrome of liver qi depression occurred much more frequently in PSD group and depression group than in cerebral stroke group (P<0.05, P<0.01). The logistic regression analysis showed that the syndrome of qi stagnation and blood stasis had high relative risk to PSD. The syndrome of deficiency of heart and spleen was positively correlated with age in cerebral stroke group.
Conclusion

The main TCM syndromes of PSD and depression are qi stagnation and blood stasis, liver qi depression, and transformation of fire due to qi stagnation. The syndrome of deficiency of heart and spleen is closely related to age among the stroke patients. The syndrome of qi stagnation and blood stasis serves as an independent risk factor for PSD. The more complicated the syndromes are, the more serious depression becomes.

Key words: Cerebral stroke, Depression, Qi stagnation, Blood stasis, Liver qi depression

"

TCM syndrome TCM syndrome score
Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
Qi stagnation and blood stasis 10.33±3.12 12.85±2.99** 11.55±2.54*△
Transformation of fire due to qi stagnation 8.73±1.69 10.65±1.75* 9.58±2.54*
Anxiety impairing spirit 8.72±1.50 8.81±2.00 8.95±1.45
Deficiency of heart and spleen 8.88±2.54 9.13±2.33 9.02±2.48
Flaring of fire due to yin deficiency 9.45±3.34 9.77±3.13 9.78±3.55
Liver qi depression 9.22±3.27 11.92±3.22** 11.63±2.79**
Stagnation of phlegm and qi 9.55±3.66 9.74±2.99 9.56±3.70

"

TCM syndrome Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
Qi stagnation and blood stasis 43 (28.7) 63 (41.7)** 51 (41.5)**
Transformation of fire due to qi stagnation 50 (33.3) 76 (50.2)** 56 (45.5)*
Anxiety impairing spirit 13 (8.7) 30 (19.7)** 12 (9.8)
Deficiency of heart and spleen 42 (28.0) 41 (27.2) 33 (26.8)
Flaring of fire due to yin deficiency 41 (27.3) 39 (25.8) 33 (26.8)
Liver-qi depression 76 (50.7) 94 (62.3)* 75 (61.0)*
Stagnation of phlegm and qi 10 (6.7) 10 (6.6) 8 (6.5)

"

TCM complicated syndrome Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
Single syndrome 61(40.6) 32 (21.2)* 31 (25.2)
Two syndromes 54(36.0) 60 (39.7) 40 (32.5)
Three or more syndromes 35(23.3) 59 (39.1)* 52 (42.3)*

"

TCM syndrome Cerebral stroke group (n=150) Depression group (n=151) PSD group (n=123)
<60 years ≥60 years <60 years ≥60 years <60 years ≥60 years
Qi stagnation and blood stasis 8.95±1.35 8.48±2.45 9.69±1.88 10.66±2.76 10.45±3.02 9.76±2.46
Transformation of fire due to qi stagnation 11.55±2.44 11.27±2.97 11.48±2.87 11.77±3.35 11.35±2.21 11.29±2.97
Anxiety impairing spirit 10.77±2.00 10.17±1.98 9.91±2.20 10.15±1.95 10.35±3.12 10.37±2.52
Deficiency of heart and spleen 10.16±2.73 12.24±3.50▲▲ 11.37±2.80 11.45±2.94 12.24±3.50 11.06±3.05
Flaring of fire due to yin deficiency 9.59±3.10 9.54±3.11 10.14±2.05 9.78±2.00 9.35±3.44 10.05±3.17
Liver-qi depression 10.54±2.95 10.07±2.60 10.13±2.56 10.58±2.45 9.62±1.95 9.80±2.43
Stagnation of phlegm and qi 8.89±1.87 9.02±2.00 9.48±2.78 9.08±2.37 9.82±2.03 9.25±2.35
[1] Feigin VL, Lawes CM, Bennett DA, Anderson CS . Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century[J]. Lancet Neurol, 2003,2(1):43-53
doi: 10.1016/S1474-4422(03)00266-7
[2] Lipsey JR, Robinson RG, Pearlson GD, Rao K, Price TR . Nortriptyline treatment of post-stroke depression: a double-blind study[J]. Lancet, 1984,1(8372):297-300
[3] Sinyor D, Amato P, Kaloupek DG, Becker R, Goldenberg M, Coopersmith H . Post-stroke depression: relationships to functional impairment, coping strategies, and rehabilitation outcome[J]. Stroke, 1986,17(6):1102-1107
doi: 10.1161/01.STR.17.6.1102
[4] Andersen G, Vestergaard K, Riis J, Lauritzen L . Incidence of post-stroke depression during the first year in a large unselected stroke population determined using a valid standardized rating scale[J]. Acta Psychiatr Scand, 1994,90(3):190-195
doi: 10.1111/acp.1994.90.issue-3
[5] Whyte EM, Mulsant BH . Post-stroke depression: epidemiology, pathophysiology, and biological treatment[J]. Biol Psychiatry, 2002,52(3):253-264
doi: 10.1016/S0006-3223(02)01424-5
[6] Carod-Artal FJ . Post-stroke depression(Ⅰ). Epidemiology, diagnostic criteria and risk factors[J]. Rev Neurol, 2006,42(3):169-175
[7] Andersen G, Vestergaard K, Ingemann-Nielsen M, Lauritzen L . Risk factors for post-stroke depression[J]. Acta Psychiatr Scand, 1995,92(3):193-198
doi: 10.1111/acp.1995.92.issue-3
[8] Burvill P, Johnson G, Jamrozik K, Anderson C, Stewart-Wynne E . Risk factors for post-stroke depression[J]. Int J Geriatr Psychiatry, 1997,12(2):219-226
doi: 10.1002/(ISSN)1099-1166
[9] Bush BA . Major life events as risk factors for post-stroke depression[J]. Brain Inj, 1999,13(2):131-137
doi: 10.1080/026990599121791
[10] Robinson RG, Kubos KL, Starr LB, Rao K, Price TR . Mood disorders in stroke patients. Importance of location of lesion[J]. Brain, 1984,107(Pt 1):81-93
doi: 10.1093/brain/107.1.81
[11] The Fourth National Conference in Cerebrovascular Diseases of Chinese Medical Assosciation. Scoring criteria of clinical neurological function defect in patients with stroke(1995)[J]. Zhonghua Shen Jing Ke Za Zhi, 1996,29(2):379-381
中华医学会第四次全国脑血管病学术会议. 脑卒中患者临床神经功能缺损程度评分标准(1995)[J]. 中华神经科杂志, 1996,29(2):379-381
[12] Wang YY, Li DL. Internal medicine of traditional Chinese medicine today(Ⅲ)[M]. Beijing: People's Medical Publishing House, 1997: 56-57
王永炎, 栗德林 . 今日中医内科学(下册)[M]. 北京: 人民卫生出版社, 1997: 56-57
[13] Liu ZY, Li C . Study progress of post-stroke depression syndromes[J]. Hua Bei Mei Tan Yi Xue Yuan Xue Bao, 2008,10(3):330-332
柳真裕, 李春 . 脑卒中后抑郁的研究进展[J]. 华北煤炭医学院学报, 2008,10(3):330-332
[1] Ming-min Xu, Pei Guo, Qing-yu Ma, Xuan Zhou, Yu-long Wei, Lu Wang, Yue Chen, Yu Guo. Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis. Journal of Integrative Medicine, 2022, 20(4): 305-320.
[2] Si-chun Gu, Jie Zhou, Qing Ye, Can-xing Yuan. Pingchan granule for depressive symptoms in Parkinson’s disease: A randomized, double-blind, placebo-controlled trial. Journal of Integrative Medicine, 2021, 19(2): 120-128.
[3] Leandro Lucena, Cristina Frange, Ana Claudia Amorim Pinto, Monica Levy Andersen, Sergio Tufik, Helena Hachul. Mindfulness interventions during pregnancy: A narrative review. Journal of Integrative Medicine, 2020, 18(6): 470-477.
[4] Toktam Sadat Firoozeei, Majid Barekatain, Mehrdad Karimi, Arman Zargaran, Shahin Akhondzadeh, Hossein Rezaeizadeh. Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial. Journal of Integrative Medicine, 2020, 18(5): 409-415.
[5] Bosch Peggy, van den Noort Maurits, Yeo Sujung, Lim Sabina, Coenen Anton, van Luijtelaar Gilles. The effect of acupuncture on mood and working memory in patients with depression and schizophrenia. Journal of Integrative Medicine, 2015, 13(6): 380-390.
[6] Sheng Wei, Jin-liang Hou, Yu-bin Chao, Xi-yang Du, Shao-bo Zong . Analysis on content of serum monoamine neurotransmitters in macaques with anger-in-induced premenstrual syndrome and liver-qi depression syndrome. Journal of Chinese Integrative Medicine, 2012, 10(8): 925-931.
[7] Ze-long Dai, Hui Chen, Xiao-ying Wu . Relationship between cytochrome P450 2C19*17 genotype distribution platelet aggregation and bleeding risk in patients with blood stasis syndrome of coronary artery disease treated with clopidogrel. Journal of Chinese Integrative Medicine, 2012, 10(6): 647-654.
[8] Chun Li, Yong Wang, Yu-lin Ouyang , Wen-jing Chuo , Qi Qiu , Shu-zhen Guo, Wei Wang. Effects of a compound Chinese herbal medicine Yixin Jiedu Formula on haemodynamic in rats with heart failure of qi-deficiency and blood stasis syndrome. Journal of Chinese Integrative Medicine, 2012, 10(5): 577-583.
[9] Li Xiao-hong, Li Jing-jing, Liu Yue-yun, Chen Jia-xu. Central neurobiological mechanism of liver depression and spleen deficiency syndrome based on chronic stress: a review. Journal of Chinese Integrative Medicine, 2012, 10(1): 1-6.
[10] Sui Yue Hu, Su E Wang, Chun Hu Zhang. Relationship between symptom stratification and syndrome differentiation of traditional Chinese medicine for depressive episode. Journal of Chinese Integrative Medicine, 2011, 9(9): 933-936.
[11] Yong Wang, Shu-zhen Guo, Chun Li, Jian-xin Chen, Wen-jing Chuo, Fang Dong, Wei Wang, Ying-feng Wang. Analysis of plasma metabonomics of mini-swines with qi deficiency and blood stasis syndrome due to chronic myocardial ischemia. Journal of Chinese Integrative Medicine, 2011, 9(2): 158-164.
[12] Jian-peng Du, Da-zhuo Shi , Tian-chang Li, Hao Xu, Hao Chen. Correlation between blood stasis syndrome and pathological characteristics of coronary artery in patients with coronary heart disease. Journal of Chinese Integrative Medicine, 2010, 8(9): 848-852.
[13] Xuan Liu , Qing-qi Wang. Professor Wang Qingqi's experience in treating senile diseases based on the theory of blood stasis. Journal of Chinese Integrative Medicine, 2010, 8(5): 486-488.
[14] Li-juan Xiu, Pin-kang Wei, Hui-ming Lin, Bin Pang. Effects of Xiaotan Jieyu Recipe on behaviors of tumor-bearing rats with chronic mild stress and the mechanism. Journal of Chinese Integrative Medicine, 2010, 8(2): 138-144.
[15] Xin-jun Wang, Ling-ling Wang . A mechanism of endogenous opioid peptides for rapid onset of acupuncture effect in treatment of depression. Journal of Chinese Integrative Medicine, 2010, 8(11): 1014-1017.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[3] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[4] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50
[5] . Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication (Chinese version, part two). Journal of Chinese Integrative Medicine, 2010, 8(11): 1001-1005
[6] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[7] Hong Liu , Guo-liang Zhang, Li Shen , Zhen Zeng, Bao-luo Zhou, Cheng-hai Liu, Guang Nie . Application and evaluation of a pseudotyped virus assay for screening herbs for anti-H5Nl avian influenza virus. Journal of Chinese Integrative Medicine, 2010, 8(11): 1036-1040
[8] Zhao-guo Li . A discussion of English translation of 1995 and 1997 Chinese National Standards of Traditional Chinese Medical Terminologies for Clinical Diagnosis and Treatment. Journal of Chinese Integrative Medicine, 2010, 8(11): 1090-1096
[9] Rui Jin, Bing Zhang. A complexity analysis of Chinese herbal property theory: the multiple formations of herbal property (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(11): 1198-1205
[10] Hui-min Liu, Xian-bo Wang, Yu-juan Chang, Li-li Gu. Systematic review and meta-analysis of randomized controlled trials of integrative medicine therapy for treatment of chronic severe hepatitis. Journal of Chinese Integrative Medicine, 2012, 10(11): 1211-1228
Journal of Integrative Medicine, ISSN: 2095-4964 CN 31-2083/R
Copyright © Journal of Integrative Medicine
Powered by Beijing Magtech Co. Ltd
沪公网安备31010602003416号      沪ICP备18017633号-3