AIM: To observe the curative effect of Chinese medicine prescription and acupuncture combined with western antidepressant drugs on differentiation of symptoms and signs of patients with depression. METHODS: (1) 100 inpatients with depression admitted to the Mental Health Center, First Hospital of Hebei Medical University between January 2004 and May 2005 were selected and randomly divided into integrated treatment group and antidepressant drug group with 50 cases in each group. All the patients signed the agreement, and they were accordance with the diagnosis criteria of CCMD-3 depression. No significant difference was found in the baseline data such as sex, age and course of disease (p > 0.05). (2) The patients in the antidepressant drug group were only given routine antidepressant drug Paroxetine 20 mg per pallet, 20 to 40 mg daily (produced by the Tianjin Sino-America Squibb Pharmaceutics Co, Ltd No 0401351). Additional to Seroxat, the patients in the integrated treatment group orally took one dose of Chinese prescription and acupuncture (retaining the needle for 30 minutes every time) once daily with 15 days as one course of treatment, and 5 days relaxed between two courses for 3 courses. (3) The differentiation of symptoms and signs included liver stagnated phlegm (the prescription was composed of Caihu Sugan San, and acupunctured Hegu, Taichong, Zhongwan, Fenglong and Neiguan), fire-transmission due to stagnation of qi (the prescription was composed of Dan Zhi Xiaoyao Wan, and acupunctured Hegu, Taichong, Qimen and Shenmen), stagnancy of qi and blood stasis (the prescription was composed of Xuefu Zhuyu Tang, and acupunctured Ganshu, Keshu, Xuehai and Sanyinjiao), deficiency of liver-yin and kidney-yin (the prescription was composed of Zishui Qinggai Yin, and acupunctured Taixi, Zhaohai, Sanyinjiao, Baihui, Ganshu and Shenshu), stagnation of the liver-qi and deficiency of the spleen (the prescription was composed of Yueju Wan, and acupunctured Taichong, Taibai, Zhongwan, Zusanli and Shenmen). (4) The two groups were treatment for 8 weeks. The curative effect on depression and anxiety was evaluated by the same person after trained with Hamilton Depression Scale (HAMD included anxiety, somatization, body mass, cognitive disorder, change of day and night, blockage, sleeping disorder, feeling of despair with 5-grade system: 0 meant no symptoms, 1 meant mild, 2 meant moderate, 3 meant serious and 4 meant very serious), Hamilton Anxiety Scale (HAMA, composed of somo- and psycho-anxiety, the grade and criteria was the same to HAMD) before and 2, 4, 8 weeks after treatment. Meanwhile, the adverse reaction in the two groups was observed after treatment. RESULTS: 100 patients were involved in the result analysis. (1) Comparison of depression and anxiety between the two groups before and after treatment: Before treatment, the scores of HAMD and HAMA of the two groups were similar (37.75 +/- 5.51, 36.71 +/- 5.59 scores, t = 0.937, p > 0.05; 31.74 +/- 3.78, 32.96 +/- 4.75 scores, t = 1.421, p > 0.05); 8 weeks later, the scores of the integrated treatment group were lower than the control group (13.12 +/- 2.14, 16.33 +/- 4.37 scores, t = 4.665, p < 0.01; 13.46 +/- 4.75, 16.33 +/- 5.21 scores, t = 3.139, p < 0.01). (2) Clinical observation after 8 weeks treatment: The low emotion of patients in the integrated treatment group was significantly improved, their activities were increased and sleeping condition was better. The low emotion of patients in the control group was improved, they did activities under supervision and sometimes sleeping condition was unstable. (3) Bad events and adverse reaction: In the integrated treatment group, there were 3 cases with dry mouth, 3 with nauseated, 2 with dysuria, 1 with decreased food appetite and 1 with constipation; in the control group, there were 5 insomnia, 4 with dry mouth, 4 with nauseated, 2 with dysuria, 2 with decreased food appetite and 2 with constipation. CONCLUSION: According to the rules of promoting blood circulation by removing stagnation, tranquilization, relieving rigidity of muscles and activating collaterals, the therapy with Chinese prescription and acupuncture combined with antidepressant drugs can relieve symptoms, improve the dependence of patients, decrease the adverse reaction of drugs and improve the curative effect.

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