There are many kinds of Chinese medicine treatment for depression, among which especially the evidence-based treatment and holistic view of Chinese medicine have advantages in the treatment of depression.
(I) The evidence-based treatment of Chinese medicine.
As early as in the Nei Jing, there are discussions, such as “those who are sad and worried, the qi is closed and does not work”, and then proposed “wood depression, fire depression. After studying the etiology and pathogenesis of depression, Li Baoling [3] concluded that it should be divided into five types of symptoms: liver qi stagnation and fire, heart failure to hide the spirit, gallbladder failure to make decisions, heart-lung yin deficiency, and spleen failure. Chen Zhujiao [4] treated 22 cases of geriatric depression according to two types of evidence: heart and spleen deficiency and yin deficiency and fire, and achieved satisfactory results. The treatment for the heart and spleen deficiency type was to strengthen the spleen and nourish the heart, benefit the qi and nourish the blood, and the formula was added and subtracted with GuiSpleen Tang. After treatment, the efficiency of the heart and spleen deficiency type reached 86.7%, and the efficiency of the yin deficiency and fire type was 71.4%; Guo Yaming et al [5] divided depression into four types of treatment, including 15 cases of liver-depression and spleen-deficiency type, treated by detoxifying the liver and relieving depression, regulating qi and strengthening the spleen, with the formula of Chai Hu Shu Hepat San plus or minus; 10 cases of liver-blood stagnation type, treated by activating blood stasis, regulating qi and relieving depression, with the formula of Blood Mansions and Blood Stasis Tang plus or minus; 8 cases of heart and spleen deficiency type, treated by strengthening the spleen Among the 38 patients, 23 were cured, 8 were significantly improved, 4 were improved and 3 were invalid, with a total effective rate of 81.58%. Han Xu et al [6] used evidence-based treatment for depression by typing.
(1) Qi-depressed phlegm knot, obscuring the heart orifice: legislation: moving Qi, resolving phlegm, relieving depression and opening the orifice, with the formula of Hanxia Houpu Tang plus flavor.
(2) Liver fire with phlegm, disturbing the heart and mind: legislation: clearing liver fire, resolving phlegm and relieving depression.
(3) Deficiency of Qi and Blood, loss of nourishment of the mind and spirit: legislation: benefiting Qi and nourishing Blood, calming the mind and fixing the will, formula Bazhen Tang with addition and subtraction.
(4) Qi stagnation and blood stasis, disturbance of the mind and spirit: legislation: promoting Qi and blood circulation, resolving blood stasis and calming the mind.
(5) Deficiency of both heart and spleen, loss of nourishment of the mind: legislation: strengthening the spleen and nourishing the heart, benefiting Qi and replenishing blood, formula Guei Spleen Tang with addition and subtraction.
(6) Non-interaction between heart and kidney, Yin deficiency and fire: legislation: nourishing Yin and clearing heat, nourishing Blood and tranquilizing the mind; formula Tien Wang Tonic Heart Dan with addition and subtraction.
(7) Deficiency of heart and gallbladder qi, mental disturbance: legislation: nourishing the heart and tranquilizing the mind, formula Gan Mai Da Zao Tang with addition and subtraction. After treatment, 26 cases were clinically cured, accounting for 52%, 5 cases were apparently effective, accounting for 12%, and 7 cases were ineffective, accounting for 14%, with an overall effective rate of 86%. Guo Xiaoqing [7] divided depression into seven types of evidence, including liver qi stagnation, liver fire, qi stagnation and phlegm accumulation, qi stagnation and blood stasis, qi and blood deficiency, yin deficiency and internal heat, yang deficiency and cold dampness; You Kun et al [8] treated 120 depression patients into liver depression and spleen deficiency type, heart and spleen deficiency type and liver and kidney yin deficiency type. The liver-depressed and spleen-deficient type was treated with the combination of prolotherapy and reduction of prolotherapy, which is used to regulate qi and relieve depression, and to strengthen the spleen and stomach.
After treatment, 74 cases (61.6%) were cured, 24 cases (20%) were significantly improved, 16 cases (13.3%) were improved, and 6 cases (5%) were ineffective, with an overall efficiency of 95%. The results of a nationwide expert questionnaire survey by Zhang H. N. et al [9] showed that the higher cumulative total scores of various TCM symptoms of depression were in the following order: liver depression and qi stagnation, liver depression and spleen deficiency, liver depression and phlegm obstruction, heart and spleen deficiency, and liver depression and blood stasis, and the above scores were basically similar in the questionnaires of both TCM and TCM experts.
(II) Treatment by addition and subtraction of basic formulae.
(1) Self-prepared formula plus or minus: Qin Junling used self-prepared formula to treat 174 cases of post-stroke depression; Li Jiansheng [11] used the formula of tonifying the kidney and benefiting the spirit to treat 26 cases of elderly depression.
(2) Addition and subtraction of adult formulae: Li Invention used Xiao Chai Hu Tang to treat 90 cases of depression.
(3) Combined Chinese and Western medicine treatment.
Zhao Hongtao et al. treated 60 cases of menopausal depression with Boloxin and Blood Mansions and Blood Stasis Capsules in a controlled manner; Ma Yunzhi [14] applied the Chinese medicine Shu Yu Tiao Shen Tang with the Western medicine Prozac to treat 40 cases of depression after cerebral infarction.
(iv) Proprietary Chinese medicine.
Zhang Meiru [15] used Yubishu punch to treat 36 cases of depression in old age; Zhang Linna et al. used Ginkgo biloba to treat 81 cases of depression in old age.
(v) Single herbal medicine therapy.
Jing Xianfang [17] reported that goldenseal infusion (which is actually the extract of Kanye Lianjia) was effective in the treatment of mild and moderate depression; Zhang Hua reported that the antidepressant efficacy of Kanye Lianjia extract was positive and the incidence of side effects was low.