The clinical efficacy of Shugan Jieyu Capsule in treating poststroke depression of liver depression and spleen deficiency type based on the brain-gut axis theory
Objective To explore the clinical efficacy of Shugan Jieyu Capsule in the treatment of post-stroke depression(PSD)of liver depression and spleen deficiency type based on the theory of"brain-gut axis".Methods 118 PSD patients were randomly divided into study group(n=59)treated with routine medications combined with Shugan Jieyu Capsule and control group(n=59)treated with routine medications.The treatment lasted for 12 weeks.The clinical efficacy,scores of 24-items Hamilton Depression Scale(HAMD-24),National Institute of Health Stroke Scale(NIHSS),Activities of Daily Living(ADL)and levels of serum substance P(SP),5-hydroxytryptamine(5-HT),neuropeptide Y(NPY)were compared between two groups,and their safety was evaluated.Pearson's test was used to analyze the relationships among serum SP,NPY,5-HT and HAMD-24.The relationships among serum SP,NPY,5-HT and PSD treatment efficacy were analyzed through ROC analysis.Results The total effective rate of clinical efficacy in study group was significantly higher than that in control group(P＜0.05).At the ends of 4th and 12th weeks after treatment,the ADL score,NPY,and 5-HT in both groups significantly increased compared with those before treatment(P＜0.05),while the HAMD-24 score,NIHSS score,and serum SP significantly decreased compared with those before treatment(P＜0.05);the ADL score,NPY,and 5-HT in study group were higher than those in control group(P＜0.05),while the HAMD-24 score,NIHSS score,and serum SP in study group were lower than those in control group(P＜0.001).Pearson's correlation test showed that the HAMD-24 score in PSD patients was positively correlated with serum SP(P＜0.001),and negatively correlated with NPY and 5-HT(P＜0.001).Compared with the effective group,the ineffective group showed a significant increase in serum SP level upon admission(P＜0.05),while the levels of NPY and 5-HT decreased significantly(P＜0.05).The ROC curve showed that the AUC,sensitivity,and specificity of the combined prediction of serum SP,NPY,and 5-HT for PSD treatment efficacy were 0.841,85.00％,and 87.01％,respectively.Conclusion Shugan Jieyu Capsules can help improve depression symptoms,neurological function,and daily living activities in PSD patients with liver depression and spleen deficiency,regulate the levels of various brain-gut peptide factors,and improve the disorder of the brain-gut axis in the body.Moreover,the levels of brain-gut peptide factors SP,NPY,and 5-HT are closely related to the condition and efficacy of PSD.
Brain-gut axisShugan Jieyu CapsulesLiver depression and spleen deficiency typePost-stroke depressionSubstance P5-hydroxytryptamineNeuropeptide Y
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