Article(id=1304414817347989729, tenantId=1146029695717560320, journalId=1302319053441957962, issueId=1304414798482010221, articleNumber=null, orderNo=null, doi=10.7501/j.issn.0253-2670.2026.05.017, pmid=null, cstr=null, oa=null, hot=0, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1763654400000, receivedDateStr=2025-11-21, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1788926327310, onlineDateStr=2026-09-09, pubDate=null, pubDateStr=null, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1788926327310, onlineIssueDateStr=2026-09-09, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1788926327310, creator=13701087609, updateTime=1788926327310, updator=13701087609, issue=Issue{id=1304414798482010221, tenantId=1146029695717560320, journalId=1302319053441957962, year='2026', volume='57', issue='5', pageStart='1597', pageEnd='2008', issueExtLink='null', onlineDate='null', pubDate='1773244800000', pubDateStr='2026-03-12', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1788926322813, creator='13701087609', updateTime=1788926625459, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1304416067925864795, tenantId=1146029695717560320, journalId=1302319053441957962, issueId=1304414798482010221, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1304416067925864796, tenantId=1146029695717560320, journalId=1302319053441957962, issueId=1304414798482010221, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1787, endPage=1797, ext={EN=ArticleExt(id=1304414817796780259, articleId=1304414817347989729, tenantId=1146029695717560320, journalId=1302319053441957962, language=EN, title=Study on correlations between traditional Chinese medicine syndromes and neurotransmitters following Jiaotai Pill in treatment of depression with heart-kidney non-interaction syndrome and efficacy predictive model, columnId=null, journalTitle=Chinese Traditional and Herbal Drugs, columnName=null, runingTitle=null, highlight=null, articleAbstract=Objective To preliminarily explore the correlation between changes in traditional Chinese medicine (TCM) syndromes and peripheral neurotransmitter levels in patients with depression of heart-kidney non-interaction syndrome treated with Jiaotai Pill (交泰丸, JTW) alone or in combination with selective serotonin reuptake inhibitors (SSRIs), and to exploratorily develop efficacy prediction models. Methods This post-hoc analysis utilized data from a randomized controlled trial (n = 91). Patients were divided into the JTW group (n = 31), JTW combined with SSRIs group (n = 30), and SSRIs group (n = 30). Response after eight weeks of treatment was defined as a ≥ 50% reduction rate in the Hamilton depression scale (HAMD) score. Changes in neurotransmitter levels and TCM syndrome scores before and after treatment were compared among the three groups. Spearman correlation analysis was used to assess the associations between changes in individual TCM syndrome scores and changes in neurotransmitter levels of 5-hydroxytryptamine (5-HT), norepinephrine (NE), and dopamine (DA). Firth's penalized-likelihood logistic regression, adjusted for confounders such as age and sex, was employed to analyze the independent associations between baseline characteristics and treatment response within each group, identifying potential predictors. Predictive models were constructed based on statistically significant predictors. Bootstrap internal validation (1 000 repetitions) was performed to correct for overfitting, and the optimism-corrected area under the curve (AUC) was reported to evaluate the discriminatory performance of the models. Results No statistically significant difference in response rates was observed among the three groups (P > 0.05). Comparisons before and after treatment showed that 5-HT and NE levels, as well as most TCM syndrome scores, improved significantly from baseline in all three groups (P < 0.05). Correlation analysis revealed that in the JTW group, Δ5-HT was positively correlated with Δinsomnia/dreamfulness (r = 0.521, P = 0.003) and Δdry throat and mouth (r = 0.438, P = 0.014). Multivariate analysis indicated that in the JTW group, baseline “forgetfulness” was a negative predictor of efficacy (OR = 0.60, P = 0.022). In the combination group, baseline “palpitations” was a positive predictor (OR = 1.62, P = 0.029), while “spermatorrhea or irregular menstruation” was a negative predictor (OR = 0.22, P = 0.007). Notably, the symptom of “spermatorrhea or irregular menstruation” itself did not show significant improvement after treatment. Predictive model analysis showed that in the JTW group, the model based on “forgetfulness” had a corrected AUC of 0.669 (original AUC = 0.838). In the combination group, the composite model including both “palpitations” and “spermatorrhea or irregular menstruation” demonstrated the best predictive performance, with a corrected AUC of 0.809 (original AUC = 0.937), suggesting preliminary discriminatory ability but also indicating potential overfitting. Conclusion By exploring the associations between TCM syndromes and neurotransmitter changes in depressed patients with heart-kidney non-interaction syndrome treated with JTW and by developing efficacy prediction models, this study provides preliminary evidence to guide treatment selection for clinical subtypes predominantly characterized by “exuberance of heart fire” or “kidney essence deficiency”. These findings offer exploratory clues for the precise application of JTW, though its predictive performance requires further validation in prospective and large-scale studies., authors=YANG Tong, HUANG Mengnan, HE Yuanyuan, LEI Qina, XU Qiang, YU Chunquan, authorsList=YANG Tong, HUANG Mengnan, HE Yuanyuan, LEI Qina, XU Qiang, YU Chunquan, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1304414817582870754, articleId=1304414817347989729, tenantId=1146029695717560320, journalId=1302319053441957962, language=CN, title=抑郁症心肾不交证中医证候与神经递质的相关性及交泰丸疗效预测模型研究, columnId=1304140191707456168, journalTitle=中草药, columnName=药理与临床, runingTitle=null, highlight=null, articleAbstract=目的 探讨交泰丸单用及联用选择性5-羟色胺再摄取抑制剂（selective serotonin reuptake inhibitors，SSRIs）治疗抑郁症心肾不交证时，中医证候与外周血神经递质水平变化的相关性，并探索性构建疗效预测模型。方法 基于随机对照试验的事后分析集（n ＝91），分为交泰丸组（n ＝31）、交泰丸联合SSRIs组（n ＝30）和SSRIs组（n ＝30）。治疗8周后，以汉密尔顿抑郁量表减分率≥50%定义应答。比较3组治疗前后神经递质与中医证候变化。采用Spearman相关分析评估中医证候变化值与神经递质5-羟色胺（5-hydroxytryptamine，5-HT）、去甲肾上腺素（norepinephrine，NE）和多巴胺（dopamine，DA）变化值的关联。采用Firth惩罚似然Logistic回归（校正年龄、性别等混杂因素）分析各组基线特征与应答的独立关联，筛选潜在预测因子。基于有统计学意义的预测因子分别构建预测模型，并采用Bootstrap法（1 000次重复）进行内部验证以校正过拟合，报告乐观校正后的曲线下面积（area under curve，AUC）评估模型判别效能。结果 3组间应答率无统计学差异（P ＞0.05）。治疗前后比较显示，3组患者5-HT、NE水平及大部分中医证候评分均较基线显著改善（P ＜0.05）。相关性分析显示，交泰丸组5-HT变化值与失眠多梦变化值（r ＝0.521，P ＝0.003）、咽干口燥变化值（r ＝0.438，P ＝0.014）呈正相关。多因素分析显示，交泰丸组基线“健忘”（OR＝0.60，P ＝0.022）是疗效的负向预测因素；交泰丸联合SSRIs组基线“心悸”是疗效的正向预测因素（OR＝1.62，P ＝0.029），“遗精或月经不调”是负向预测因素（OR＝0.22，P ＝0.007），但后者在治疗后其症状改善不显著。预测模型分析显示，交泰丸组基于“健忘”的模型校正后AUC为0.669（原始AUC＝0.838）。交泰丸联合SSRIs组中同时包含“心悸”与“遗精或月经不调”的复合模型预测效能最佳，其校正后AUC为0.809（原始AUC＝0.937），提示具有初步的区分潜力，但也提示存在过拟合现象。结论 通过探索交泰丸治疗抑郁症心肾不交证患者的中医证候与神经递质变化关联及疗效预测模型，为临床以“心火亢盛”和“肾精亏虚”为主的抑郁症心肾不交证亚型的治疗方案选择提供了初步依据，为交泰丸的精准应用提供了探索性线索，但预测效能需在前瞻性大样本研究中进一步验证。, authors=杨彤1 , 黄梦楠2 , 何媛媛1 , 雷祺娜1 , 徐强3 , 于春泉1 , authorsList=杨彤, 黄梦楠, 何媛媛, 雷祺娜, 徐强, 于春泉, authorCompany=1 天津中医药大学, 天津 100071; et al . The mediation role of sleep quality in the relationship between cognitive decline and depression[J]. BMC Geriatr , 2022, 22(1): 178.et al . Internet use among patients with schizophrenia and depression[J]. Int J Environ Res Public Health , 2022, 19(9): 5695.et al . Stress, serotonin, and hippocampal neurogenesis in relation to depression and antidepressant effects[J]. Neurosci Biobehav Rev , 2014, 38: 173-192.J Clin Psychiatry , 2000, 61(Suppl 10): 16-24.et al . Dopamine, depression and antidepressants[J]. Fundam Clin Pharmacol , 2004, 18(6): 601-607.Psychol Res Behav Manag , 2010, 3: 91-108.et al . Safety and efficacy of SSRIs in improving poststroke recovery: A systematic review and meta-analysis[J]. J Am Heart Assoc , 2022, 11(13): e025868.Eur Arch Psychiatry Clin Neurosci , 2024, 274(5): 1037-1049.et al . Jiaotaiwan activates serum SCFAs and upregulates cAMP-PKA-CREB-BDNF signaling pathway for antidepressant effects: A multicenter, randomized, controlled study[J]. Chin Herb Med , 2025, 17(4): 790-797.Diagnostic and Statistical Manual of Mental Disorders [M]. Fifth Ed. Washington DC: American Psychiatric Association, 2013: 155-188.et al . Incidence of melancholic depression by age of onset and gender in the Lundby population, 1947-1997[J]. Eur Arch Psychiatry Clin Neurosci , 2023, 273(5): 1163-1173.et al . Metabolically healthy status and BMI in relation to depression: A systematic review of observational studies[J]. Diabetes Metab Syndr , 2019, 13(2): 1099-1103.et al . High blood pressure and depression among the working population of Ghana: A generalized linear model of the risk factors[J]. Depress Anxiety , 2024, 2024: 5261760.
中草药
|药理与临床
2026
, 57
(5) :
1787
-1797
抑郁症心肾不交证中医证候与神经递质的相关性及交泰丸疗效预测模型研究
全屏
杨彤1 , 黄梦楠2 , 何媛媛1 , 雷祺娜1 , 徐强3 , 于春泉1
作者信息
1 天津中医药大学, 天津 100071;
通讯作者:
徐强
作者简介:
杨彤: 杨彤,博士研究生,研究方向为心血管疾病及心身疾病中医临床研究。E-mail:yangtuott@163.com
Study on correlations between traditional Chinese medicine syndromes and neurotransmitters following Jiaotai Pill in treatment of depression with heart-kidney non-interaction syndrome and efficacy predictive model
YANG Tong, HUANG Mengnan, HE Yuanyuan, LEI Qina, XU Qiang, YU Chunquan
Affiliations
doi: 10.7501/j.issn.0253-2670.2026.05.017
文章导航
目的 探讨交泰丸单用及联用选择性5-羟色胺再摄取抑制剂（selective serotonin reuptake inhibitors，SSRIs）治疗抑郁症心肾不交证时，中医证候与外周血神经递质水平变化的相关性，并探索性构建疗效预测模型。方法 基于随机对照试验的事后分析集（n ＝91），分为交泰丸组（n ＝31）、交泰丸联合SSRIs组（n ＝30）和SSRIs组（n ＝30）。治疗8周后，以汉密尔顿抑郁量表减分率≥50%定义应答。比较3组治疗前后神经递质与中医证候变化。采用Spearman相关分析评估中医证候变化值与神经递质5-羟色胺（5-hydroxytryptamine，5-HT）、去甲肾上腺素（norepinephrine，NE）和多巴胺（dopamine，DA）变化值的关联。采用Firth惩罚似然Logistic回归（校正年龄、性别等混杂因素）分析各组基线特征与应答的独立关联，筛选潜在预测因子。基于有统计学意义的预测因子分别构建预测模型，并采用Bootstrap法（1 000次重复）进行内部验证以校正过拟合，报告乐观校正后的曲线下面积（area under curve，AUC）评估模型判别效能。结果 3组间应答率无统计学差异（P ＞0.05）。治疗前后比较显示，3组患者5-HT、NE水平及大部分中医证候评分均较基线显著改善（P ＜0.05）。相关性分析显示，交泰丸组5-HT变化值与失眠多梦变化值（r ＝0.521，P ＝0.003）、咽干口燥变化值（r ＝0.438，P ＝0.014）呈正相关。多因素分析显示，交泰丸组基线“健忘”（OR＝0.60，P ＝0.022）是疗效的负向预测因素；交泰丸联合SSRIs组基线“心悸”是疗效的正向预测因素（OR＝1.62，P ＝0.029），“遗精或月经不调”是负向预测因素（OR＝0.22，P ＝0.007），但后者在治疗后其症状改善不显著。预测模型分析显示，交泰丸组基于“健忘”的模型校正后AUC为0.669（原始AUC＝0.838）。交泰丸联合SSRIs组中同时包含“心悸”与“遗精或月经不调”的复合模型预测效能最佳，其校正后AUC为0.809（原始AUC＝0.937），提示具有初步的区分潜力，但也提示存在过拟合现象。结论 通过探索交泰丸治疗抑郁症心肾不交证患者的中医证候与神经递质变化关联及疗效预测模型，为临床以“心火亢盛”和“肾精亏虚”为主的抑郁症心肾不交证亚型的治疗方案选择提供了初步依据，为交泰丸的精准应用提供了探索性线索，但预测效能需在前瞻性大样本研究中进一步验证。
抑郁症
/
心肾不交证
/
交泰丸
/
神经递质
/
5-羟色胺
/
疗效预测模型
/
中医证候
Objective To preliminarily explore the correlation between changes in traditional Chinese medicine (TCM) syndromes and peripheral neurotransmitter levels in patients with depression of heart-kidney non-interaction syndrome treated with Jiaotai Pill (交泰丸, JTW) alone or in combination with selective serotonin reuptake inhibitors (SSRIs), and to exploratorily develop efficacy prediction models. Methods This post-hoc analysis utilized data from a randomized controlled trial (n = 91). Patients were divided into the JTW group (n = 31), JTW combined with SSRIs group (n = 30), and SSRIs group (n = 30). Response after eight weeks of treatment was defined as a ≥ 50% reduction rate in the Hamilton depression scale (HAMD) score. Changes in neurotransmitter levels and TCM syndrome scores before and after treatment were compared among the three groups. Spearman correlation analysis was used to assess the associations between changes in individual TCM syndrome scores and changes in neurotransmitter levels of 5-hydroxytryptamine (5-HT), norepinephrine (NE), and dopamine (DA). Firth's penalized-likelihood logistic regression, adjusted for confounders such as age and sex, was employed to analyze the independent associations between baseline characteristics and treatment response within each group, identifying potential predictors. Predictive models were constructed based on statistically significant predictors. Bootstrap internal validation (1 000 repetitions) was performed to correct for overfitting, and the optimism-corrected area under the curve (AUC) was reported to evaluate the discriminatory performance of the models. Results No statistically significant difference in response rates was observed among the three groups (P > 0.05). Comparisons before and after treatment showed that 5-HT and NE levels, as well as most TCM syndrome scores, improved significantly from baseline in all three groups (P < 0.05). Correlation analysis revealed that in the JTW group, Δ5-HT was positively correlated with Δinsomnia/dreamfulness (r = 0.521, P = 0.003) and Δdry throat and mouth (r = 0.438, P = 0.014). Multivariate analysis indicated that in the JTW group, baseline “forgetfulness” was a negative predictor of efficacy (OR = 0.60, P = 0.022). In the combination group, baseline “palpitations” was a positive predictor (OR = 1.62, P = 0.029), while “spermatorrhea or irregular menstruation” was a negative predictor (OR = 0.22, P = 0.007). Notably, the symptom of “spermatorrhea or irregular menstruation” itself did not show significant improvement after treatment. Predictive model analysis showed that in the JTW group, the model based on “forgetfulness” had a corrected AUC of 0.669 (original AUC = 0.838). In the combination group, the composite model including both “palpitations” and “spermatorrhea or irregular menstruation” demonstrated the best predictive performance, with a corrected AUC of 0.809 (original AUC = 0.937), suggesting preliminary discriminatory ability but also indicating potential overfitting. Conclusion By exploring the associations between TCM syndromes and neurotransmitter changes in depressed patients with heart-kidney non-interaction syndrome treated with JTW and by developing efficacy prediction models, this study provides preliminary evidence to guide treatment selection for clinical subtypes predominantly characterized by “exuberance of heart fire” or “kidney essence deficiency”. These findings offer exploratory clues for the precise application of JTW, though its predictive performance requires further validation in prospective and large-scale studies.
depression
/
heart-kidney non-interaction syndrome
/
Jiaotai Pill
/
neurotransmitter
/
5-hydroxytryptamine
/
efficacy predictive model
/
traditional Chinese medicine syndrome
杨彤, 黄梦楠, 何媛媛, 雷祺娜, 徐强, 于春泉.
抑郁症心肾不交证中医证候与神经递质的相关性及交泰丸疗效预测模型研究.
中草药,
2026
, 57
(5)
: 1787
-1797
.
DOI: 10.7501/j.issn.0253-2670.2026.05.017
YANG Tong, HUANG Mengnan, HE Yuanyuan, LEI Qina, XU Qiang, YU Chunquan.
Study on correlations between traditional Chinese medicine syndromes and neurotransmitters following Jiaotai Pill in treatment of depression with heart-kidney non-interaction syndrome and efficacy predictive model[J].
Chinese Traditional and Herbal Drugs ,
2026
, 57
(5)
: 1787
-1797
.
DOI: 10.7501/j.issn.0253-2670.2026.05.017
参考文献
引证文献
Liu X L, Xia X, Hu F J, et al . The mediation role of sleep quality in the relationship between cognitive decline and depression[J]. BMC Geriatr , 2022, 22(1): 178.et al . Internet use among patients with schizophrenia and depression[J]. Int J Environ Res Public Health , 2022, 19(9): 5695.et al . Stress, serotonin, and hippocampal neurogenesis in relation to depression and antidepressant effects[J]. Neurosci Biobehav Rev , 2014, 38: 173-192.J Clin Psychiatry , 2000, 61(Suppl 10): 16-24.et al . Dopamine, depression and antidepressants[J]. Fundam Clin Pharmacol , 2004, 18(6): 601-607.Psychol Res Behav Manag , 2010, 3: 91-108.et al . Safety and efficacy of SSRIs in improving poststroke recovery: A systematic review and meta-analysis[J]. J Am Heart Assoc , 2022, 11(13): e025868.Eur Arch Psychiatry Clin Neurosci , 2024, 274(5): 1037-1049.et al . Jiaotaiwan activates serum SCFAs and upregulates cAMP-PKA-CREB-BDNF signaling pathway for antidepressant effects: A multicenter, randomized, controlled study[J]. Chin Herb Med , 2025, 17(4): 790-797.Diagnostic and Statistical Manual of Mental Disorders [M]. Fifth Ed. Washington DC: American Psychiatric Association, 2013: 155-188.et al . Incidence of melancholic depression by age of onset and gender in the Lundby population, 1947-1997[J]. Eur Arch Psychiatry Clin Neurosci , 2023, 273(5): 1163-1173.et al . Metabolically healthy status and BMI in relation to depression: A systematic review of observational studies[J]. Diabetes Metab Syndr , 2019, 13(2): 1099-1103.et al . High blood pressure and depression among the working population of Ghana: A generalized linear model of the risk factors[J]. Depress Anxiety , 2024, 2024: 5261760.
2026年第57卷第5期
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doi: 10.7501/j.issn.0253-2670.2026.05.017
接收时间：2025-11-21
首发时间：2026-09-09
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2种不同金属材料的力学参数
科 属数 种数 占总种数比例 属 种数 占总种数比例 鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78 小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39 多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39 红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87 小菇属 Mycena 11 5.26 光柄菇属 Pluteus 5 2.39 红菇属 Russula 17 8.13 栓菌属 Trametes 5 2.39
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