Refractory depression has the following characteristics: 1. Long duration of illness, the total duration of the patient’s illness can reach 20-30 years, an episode of symptoms lasting 1-2 years can not be relieved. 2, early age of onset, some patients have mood problems at the age of 10 or so; or middle-aged and elderly onset, the elderly may be more prone to refractory depression syndrome. 3, heavy symptoms, patients spend the whole day sad face, even to tears, often accompanied by serious suicidal ideas and suicidal behavior. 4. The disease fluctuates due to life events, and the little healing effect achieved after careful treatment will be wiped out by trivial negative life events. 5. Positive family history. 6.Companied by personality disorder. 7.Loss of confidence in treatment. 8.Drug side effects are more obvious due to long-term high dose use of antidepressants. 9, Long-term disease will be deficient, so refractory depression deficiency is common; but often due to mental stimulation and antidepressant side effects and other factors lead to deficiency mixed with reality. ⑩ The lesions mostly involve the heart, liver, spleen, kidney, gallbladder and other internal organs. The classification is common: liver depression and spleen deficiency, liver and kidney yin deficiency and fire, heart and spleen deficiency, and spleen and kidney yang deficiency. The treatment formula is based on 10g of vinegar Chai Hu, 10g of yujin, 30g of white peony, 30g of angelica, 30g of raw earth, 30g of fried jujube, 30g of wolfberry, 10g of Chen Pi, 10g of sand, and 30g of Jiao Sanxian. The combination of Chinese herbal medicine treatment without changing the western medicine treatment can achieve better results. The HAMD-17 and HAMA total scores at the end of the fourth and sixth week in the Chinese and western medicine treatment group were significantly lower than those in the western medicine control group, and there was a significant difference. The severity of disease in the post-treatment Chinese and Western medicine treatment group was significantly lower than that in the control group, with a significant difference.