Depression is a common disease that affects physical and mental health and imposes a considerable burden on afflicted individuals and their families worldwide. Depression is associated with a high rate of disability and suicide. It causes a severe decline in productivity and quality of life. Unfortunately, the pathophysiological mechanisms underlying depression have not been fully elucidated, and the risk of its treatment is still presented. Studies have shown that the expression of autophagic markers in the brain and peripheral inflammatory mediators are dysregulated in depression. Autophagy-related genes regulate the level of autophagy and change the inflammatory response in depression. Depression is related to several aspects of immunity. The regulation of the immune system and inflammation by autophagy may lead to the development or deterioration of mental disorders. This review highlights the role of autophagy and neuroinflammation in the pathophysiology of depression, sumaries the autophagy-targeting small moleculars, and discusses a novel therapeutic strategy based on anti-inflammatory mechanisms that target autophagy to treat the disease.

Objective: To analyze the characteristics of the objective parameters of the tongue image in depression patients with liver stagnation and spleen deficiency syndrome and explore the application value of tongue diagnosis parameters in the diagnosis of this disease and syndrome, so as to provide an objective basis for the clinical diagnosis of this disease and syndrome. Methods: Daosheng DS01-B tongue and face diagnostic instrument was used to collect tongue pictures of patients with depression, and the differences in objective parameters of tongue color and coating color between liver stagnation and spleen deficiency syndrome and non-liver stagnation and spleen deficiency syndrome were extracted and analyzed. The application value of tongue diagnosis parameters in the diagnosis of disease and syndrome was explored by binary Logistic regression analysis method. Results: A total of 329 patients with depression were collected, including 75 cases of liver stagnation and spleen deficiency syndrome, and 254 cases of non-liver stagnation and spleen deficiency syndrome. The comparison results of tongue color parameters showed that the whole tongue Lab-L value, the middle tongue Lab-L value, the tongue root Lab-L value, the tongue edge-left Lab-L value and the tongue tip Lab-L value in the liver stagnation and spleen deficiency syndrome group were significantly higher than those in the non-liver stagnation and spleen deficiency syndrome group（P＜0.05, P＜0.01）. The whole tongue Lab-a value, the middle tongue Lab-a value, the tongue edge-left Lab-a value, the tongue edge-right Lab-a value, the tongue tip Lab-a value and the tongue tip Lab-b value in the liver stagnation and spleen deficiency syndrome group were significantly lower than those in the non-liver stagnation and spleen deficiency syndrome group（P＜0.05, P＜0.01）. The comparison results of fur color parameters showed that the whole tongue, the tongue edge and the right tongue edge of fur in the liver stagnation and spleen deficiency syndrome group were significantly higher than those in the non-liver stagnation and spleen deficiency syndrome group（P＜0.05）. The final binary Logistic regression model was statistically significant（P＜0.01） and the prediction effect was good. Conclusion: Compared with patients with non-liver stagnation and spleen deficiency syndrome, the characteristic parameters of tongue images in depression patients with liver stagnation and spleen deficiency syndrome are different, and it is feasible to construct a diagnosis model of depression with liver stagnation and spleen deficiency syndrome based on tongue diagnosis parameters.

目的:评估近5年我国人群抑郁情绪检出情况.方法:应用计算机检索各大数据库中有关中国各类人群中抑郁情绪检出率的横断面研究.由2名研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险,采用R 4.03软件进行Meta分析.结果:共有38篇文献纳入Meta分析;根据AHRQ评分,纳入的文献中等质量37篇,高质量1篇;纳入文献存在发表偏倚.38篇文献的总样本量为22152例,被调查者来源于医院和社区;调查地区分布在我国东部、中部和西部;Meta分析结果显示,近5年我国抑郁情绪检出率为31.57％(95％CI:25.51～37.63);我国西部地区抑郁情绪检出率(35.30％)高于中部地区(29.96％)、东部地区(27.79％);基于医院检出率(33.54％)高于社区(21.42％);慢性躯体疾病患者抑郁情绪检出率(36.62％)高于产后抑郁(29.88％)、老年抑郁(17.85％).结论:近5年我国抑郁情绪检出率较高,尤其多发于慢性躯体疾病患者.

Review question / Objective: 1. Are the Chinese herbal medicine

Review question / Objective: Understand the distribution and characteristics of TCM syndromes of depression, and provide r e f e r e n c e s f o r c l i n i c a l s y n d r o m e differentiation, treatment and related research.Rationale: Following the evidence-based medicine method, this study conducted a meta-analysis of all published literature data of TCM syndrome-type studies of depression in China that meet certain standards, in order to further clarify the d i s t r i b u t i o n o f T C M s y n d ro m e s o f depression.Condition being studied: Depression is a c o m m o n m e n t a l d i s o r d e r, a n d i t s prevalence is increasing year by year.It is predicted that by 2030, depression will INPLASY

抑郁症是目前的研究热点之一,众多证据表明抑郁症的发病具有季节性,并于春季高发.肝郁脾虚型抑郁症是抑郁症的主要中医证型,其呈现四季高发、春季突出的流行病学特征.故本文以证候为本,以肝木关系为基、以魂意相生为要,从肝旺于春枢机阴阳、春病延夏脾湿为盛、金木相制收敛肃杀、水不涵木封藏郁闭4个方面,分别论述了肝郁脾虚型抑郁症四时的发病机理.论述了肝郁脾虚型抑郁症季节性发病的病机,主要由3方面因素构成,一是脏腑的阴阳属性和功能特点,二是肝、脾两脏在机体中发挥的基础和调理作用,三是各脏腑之间紧密的生理病理关联.并依据抑郁症的发病特点和季节特性,给予了中医防治建议,即机体应顺应四时规律饮食作息,其次四季均要以顾护脾胃为主.

目的 分析针药结合治疗抑郁症的临床选穴及用药规律.方法 检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(维普网)、中国生物医学文献数据库(CBM)2000年1月—2019年12月针刺结合中药治疗抑郁症的文献,运用Exce12016建立处方数据库并进行频次分析,采用Weka3.8.4和SPSS23.0软件对高频药物和腧穴进行关联规则分析和聚类分析.结果 使用频率最高的腧穴和中药分别为百会、柴胡,腧穴与中药相关性最高的是百会-太冲-白芍-柴胡,聚类分析得出重点腧穴与中药有效聚类群7个.结论 针药结合治疗抑郁症紧扣肝失疏泄这一核心病机,调补肝、脾、心三脏,并调和气血.

《难经》第七十五难提出东方实、西方虚之病证,首创以泻南方、补北方的方法来治疗,还提到“子能令母实,母能令子虚”“不能治其虚,何问其余”.此难的病机为东方实、西方虚,肝、肺两脏的自身本质决定了肝易实而肺易虚,并无其他脏器因素的影响,且当以东方实为主、为标,西方虚为次、为本;泻南方、补北方可从多个角度达到治疗东方实、西方虚的目的,前期应侧重于泻南方治东方实,后期应侧重于补北方以治西方虚.“子能令母实,母能令子虚”中母均为水(木之母),子均为火(木之子).“子能令母实”与泻南方相对应,指泻南方火,使南方火虚,水更容易克火,水的消耗减少了,是为“子能令母实”.“母能令子虚”与补北方相对应,指补北方水,北方水盛则克火之力大,火气更虚,从而“母能令子虚”.“治虚”为治西方虚及北方虚,具体做法则是补北方水,通过子不食母,补北方水的同时使西方金慢慢恢复.泻实容易而补虚难,泻南方待东方木实证已去,仍需继续补北方,缓缓图之,西方金、北方水充足,方才使东方实、西方虚的情况不再容易发生,故言“不能治其虚,何问其余”.