Efficacy of Guipi Decoction combined with escitalopram oxalate tablets for patients with major depressive disorder and its ef-fect on intestinal flora
Objective To investigate the efficacy of Guipi Decoction combined with escitalopram oxalate tablets in the treatment of major depressive disorder(MDD)and its effect on intestinal flora.Methods Senventy eight MDD patients with traditional Chinese medicine(TCM)syndrome of heart and spleen deficiency were enrolled in the First Affiliated Hospital of Ningbo University between December 2021 to July 2022,and 30 healthy individuals served as a control group.Patients were randomly assigned into three groups with 26 cases in each group:group A received Guipi Decoction and escitalopram oxalate tablets,group B received bifid triple viable and escitalopram oxalate tablets,and group C received escitalopram oxalate tablets alone.All groups underwent an 8-week treatment course.Hamilton Depression Scale(HAMD-17)scores and Hamilton Anxiety Scale(HAMA)scores were evaluated,and 16S rDNA intestinal flora tests were performed before treatment and at week 1,2,4,and 8 of treatment.Results The group A had better clinical response at weeks 2,4,and 8 of treatment compared to the group C(all P＜0.05).At weeks 2,4,and 8 of treatment,the group A showed a significant decrease in HAMD-17 scores compared to the group C,and a significant decrease in HAMA scores compared to the groups B and C(all P＜0.05).Alpha diversity,as measured by Chao1 and observed species index,increased in the group A after 8 weeks of treatment compared to that before treatmetn(all P＜0.05).Beta diversity analysis showed that healthy subjects had greater species diversity compared to MDD patients,and all three groups had increased diversity after treatment(all P＜0.05).Compared to healthy subjects,the abundance of Proteobacteria,Enterobacteriaceae,Escherichia-Shigella,Klebsiella in MDD patients increased(all P＜0.05),while Bacteroidota,Clostridia decreased relatively(all P＜0.05).The abundance of Firmicutes,Oscillospiraceae,Ruminococcaceae,and Clostridia in the group A increased from the baseline(all P＜0.05),while Proteobacteria,Enterobacteriaceae,Klebsiella,and Escherichia-Shigella were relatively decreased(all P＜0.05).After treatment with antidepressants alone,the abundance of Butyricicoccaceae,Coprococcus,and Oscillospirales increased from the baseline(all P＜0.05),while Erysipelotrichaceae decreased relatively(P＜0.05).The abundances of Prevotellaceae,Coprococcus,and Clostridia in the group B were increased from the baseline(all P＜0.05),while Akkermansiaceae and Enterobacter were relatively decreased(all P＜0.05).Conclusion Guipi Decoction combined with antidepressants can improve intestinal flora diversity,increase beneficial bacteria and decrease harmful ones,enhancing clinical efficacy and it is more effective than using antidepressants alone for MDD patients with TCM symdrom of heart and spleen deficiency.
Major depressive disorderHeart and spleen deficiencyGuipi DecoctionIntestinal flora
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维普
