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Collaborative Treatment Information

Collaborative Treatment Clinical Practice Guidelines

Collaborative Treatment Information

Collaborative Treatment Clinical Practice Guidelines

Collaborative Treatment Clinical Practice Guidelines

F00-F99

Ⅴ. Mental and behavioural disorders

주산기(산후) 우울증 환자의 우울증 개선에 항우울제 단독치료에 비해 한약과 일반침 복합치료를 고려해야 한다.

• 항우울제 복용 후 부작용이 발생하거나, 항우울제 복용에도 치료 효과가 나타나지 않거나, 장기복용한 항우울제를 중단하거나 모유수유 중으로 항우울제 복용을 원치 않는 경우 한약과 침 복합치료를 고려할 수 있다.
• 한약치료를 8주 이상 지속했음에도 증상이 개선되지 않을 경우 침 치료 추가를 고려할 수 있다.
• 한약처방 시 적절한 변증진단에 따라 처방하고 가능한 한 약재의 수와 복용기간을 줄인다. 또한 약물 복용 후 2~3시간 내에는 수유를 피한다. 수유를 통해 영유아에게 설사를 유발할 수 있는 대황 등 한약을 사용하지 않는다. 또한 유즙을 감소시킬 수 있는 한약은 피한다. 그리고 보건복지부 고시 제 2011-118호에 의거, 감수, 부자, 주사, 천남성, 천오, 초오, 파두, 반묘, 반하, 섬수, 경분, 밀타승, 백부자, 연단, 웅황, 호미카, 낭독, 수은, 보두, 속수자 등 중독을 일으킬 수 있는 약재들은 영아들의 대사율이 성인보다 낮으므로 피해야 한다.
• 환자가 침 치료를 선호할 때 일반침 치료 추가를 고려할 수 있다.
• 처방: 가미소간해울탕(백합 15g, 생지황 15g, 도인 10g, 홍화 10g, 합환피 15g, 향부자 15g, 천궁 15g, 복령 15g, 울금 15g, 백작약 15g, 당귀 10g, 시호 10g)
• 각 증상에 따라 다음의 한약재를 추가하여 사용할 수 있다. [분노, 오심번열(五心煩熱)/조구등, 목단피, 치자], [구고(口苦), 구갈(口渴), 변비/산조인(초), 백자인, 욱리인],[복창(腹脹), 변당(便溏), 핍력(乏力)/당삼(초), 목향]

B/Low

  • Wang, D. J., & Chen Z. W. (2017). Clinical study on Jiawei Shugan Jieyu Decoction combined with Xingnao Kaiqiao acupuncture in the treatment of postpartum depression. Sichuan Traditional Chinese Medicine, 35(12), 184-187. Link

여성 갱년기 우울증 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 한약과의 복합치료를 고려해야 한다.

• 환자의 우울증이 갱년기 증후군에 포함되는 심리적 변화(우울과 불안, 신경과민, 급격한 기분 변화)라고 판단된다면 갱년기 증후군에 준하여 치료하고, 그렇지 않고 주요우울장애의 진단기준을 만족한다면 주요우울장애에 준하여 치료한다.
• 항우울제 복용 후에도 증상이 충분히 개선되지 않거나 항우울제를 감량/중단할 때 고려할 수 있다. 항우울제 복용 후 부작용이 발생하거나, 항우울제 복용에도 치료 효과가 나타나지 않거나, 장기복용한 항우울제를 감량할 때 고려할 수 있다.
• 중등도 이상의 우울증에 고려할 수 있다.
• 사용된 처방 : [심신불교(心腎上交)+간울(肝鬱)/ 시호소간탕, 자신소간탕, 청심자신탕, 보신해울청심탕, 시호가용골모려탕, 조경해울방],[간울/단치소요환, 서간과립, 안신해울탕],[심비양허/귀비탕]

B/Moderate

  • Wang, C. G., Mei, J., Zhang, Y., & Zhang, H. (2015). Chinese medicine combined with paroxetine in the treatment of 46 cases of perimenopausal depression, Henan Traditional Chinese Medicine, 35(3), 578-579. Link

  • Yu, H. X. (2015). Clinical Observation of Guipi Decoction Combined with Deanixin in Treating Menopausal Depression. New Chinese Medicine, 47(12), 140-141.

  • Guo, L. H., Yao H. Q., & Kang, Z. (2016). Clinical efficacy of Baihe Dihuang decoction in the treatment of menopausal depression and its effect on neuroendocrine system. Chinese Medicine Herald, 22(8), 70-72. Link

  • Li, K. J., Guo, J., & Chen, Y. (2017). Therapeutic effect of Bushen Jieyu Qingxin Decoction in the treatment of menopausal depression and its effect on DA, NE, 5-HIAA. Journal of Modern Integrative Medicine, 26(26), 2864-2866. Link

  • Li, Y. C. (2017). Clinical effect of Chaihu Shugan decoction combined with flupentixol and melitracen tablets in the treatment of perimenopausal depression. Heilongjiang Medicine, 30(06), 1280-1283. Link

  • Li, J. (2017). Efficacy of nourishing kidney and soothing liver traditional Chinese medicine in the treatment of menopausal depression and its effect on serotonin and tryptophan hydroxylase 2. Journal of Modern Integrative Medicine, 26(17), 1895-1897. Link

  • Li, S. (2017). Clinical observation of Qingxin Zishen decoction combined with venlafaxine in the treatment of perimenopausal depression [master’s thesis]. Nanjing University of Chinese Medicine. Link

  • Tang, H. L. (2017). Clinical observation of Tiaogeng Jieyu Recipe in the treatment of mild to moderate depression in female menopause [master’s thesis]. North China University of Technology. Link

  • Xu, X. H. & Yang, X. Y. (2017). Analysis of the effect of integrated traditional Chinese and western medicine in the treatment of perimenopausal severe depression. Chinese Journal of Family Planning, 25(6), 384-387. Link

  • Dong, M. S. (2018). Efficacy observation of Shugan granule combined with Deanixin in the treatment of female menopausal depression. Exploration of rational drug use in China, 15(4), 20-22. Link

  • Shi, X. H. (2018). Clinical study on the treatment of female menopausal depression with Bushen Jieyu Decoction [master’s thesis]. Hebei Medical University. Link

  • Zhang, D. X. (2018). Evaluation of the effect of Anshen Jieyu Decoction combined with Deanixin in the treatment of mild to moderate depression in female menopause. Digest of the latest medical information in the world, 18(45), 254-255. Link

  • Lin, Y. S., Wang, L. Y., & Zhang, Z. Y. (2019). Observation of clinical efficacy of Chaihujia Longgu Muli Decoction combined with paroxetine in the treatment of perimenopausal depression. Chinese Journal of Traditional Chinese Medicine, 34(7), 3330-3333. Link

  • Wang, G. X., Chang, M. H., Li, Q., & Chen, Y. X. (2019). Observation on the curative effect of Shugan Granules in the treatment of perimenopausal depression with liver stagnation and qi stagnation. Chinese Journal of Experimental Formulas, 25(6), 114-119. Link

  • Luo, J., Wu, Y. L., Song, L. B., & Chen, X. P. (2021). Effect of Danzhi Xiaoyao Pills combined with Flupentixol and Melitracen Tablets in the treatment of perimenopausal depression with sleep disorders. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 31(5), 55-57. Link

  • Yin, X. W. (2021). Efficacy analysis of conventional western medicine combined with selfmade traditional Chinese medicine in the treatment of menopausal depression. Practical clinical practice of integrated traditional Chinese and western medicine. 21(2), 33-34. Link

관해기 우울증 환자의 우울증 개선을 위해 항우울제 단독치료에 비해 명상과 의 복합치료를 고려할 수 있다.

• 필요시 한방신경정신과 전문의 및 관련 전문가에게 의뢰할 수 있다.
• 통상치료란 통상적으로 받는 의학적 및 정신적 치료를 의미한다.

C/Low

  • Kuyken, W., Byford, S., Taylor, R. S., Watkins, E., Holden, E., White, K., et al. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 6, 966-978. Link

  • Segal, Z. V., Bieling, P., Young, T., MacQueen, G., Cooke, R., Martin, L., et al. (2010). Antidepressant Psychiatry, 12, 1256-1264. monotherapy vs sequential pharmacotherapy and mindfulnessbased cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Archives of General Link

성인 치료저항성 주요우울장애 환자의 우울증 개선을 위해 항우울제 단독치료에 비해 명상과의 복합치료를 고려할 수 있다.

• 필요시 한방신경정신과 전문의 및 관련 전문가에게 의뢰할 수 있다.
• 온라인 명상 활용 시 온라인 접속 미디어 환경 및 환자의 선호도를 고려하여 시행한다.

C/Low

  • Michalak, J., Schultze, M., Heidenreich, T., & Schramm, E. (2015). A randomized controlled trial on the efficacy of mindfulness-based cognitive therapy and a group version of cognitive behavioral analysis system of psychotherapy for chronically depressed patients. J Consult Clin Psychol, 83(5), 951-963. Link

  • Cladder-Micus M. B., Speckens, A. E. M., Vrijsen, J. N., T Donders, A. R., Becker, E. S., & Spijker, J. (2018). Mindfulness-based cognitive therapy for patients with chronic, treatment resistant depression: a pragmatic randomized controlled trial. Depression and anxiety, 35(10), 914-924. Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 명상과의 복합치료를 고려할 수 있다.

• 필요시 한방신경정신과 전문의 및 관련 전문가에게 의뢰할 수 있다.
• 온라인 명상 활용 시 온라인 접속 미디어 환경 및 환자의 선호도를 고려하여 시행한다.

C/Low

  • Raevuori, A., Vahlberg, T., Korhonen, T., Hilgert, O., Aittakumpu-Hyden, R., & Forman-Hoffman, V. (2021). A therapist-guided smartphone app for major depression in young adults: A randomized clinical trial. Journal of Affective Disorders, 286, 228-238. Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 명상과의 복합치료를 고려할 수 있다.

• 필요시 한방신경정신과 전문의 및 관련 전문가에게 의뢰할 수 있다.
• 온라인 명상 활용 시 온라인 접속 미디어 환경 및 환자의 선호도를 고려하여 시행한다.

C/Low

  • Li SYH, Bressington D. The effects of mindfulness-based stress reduction on depression, anxiety, and stress in older adults: A systematic review and meta-analysis. Int J Ment Health Nurs. 2019 Jun;28(3):635-656. doi: 10.1111/inm.12568. Epub 2019 Jan 17. PMID: 30656813 Link

  • Liu X, Yi P, Ma L, Liu W, Deng W, Yang X, Liang M, Luo J, Li N, Li X. Mindfulness-based interventions for social anxiety disorder: A systematic review and meta-analysis. Psychiatry Res. 2021 Jun;300:113935. doi: 10.1016/j.psychres.2021.113935. Epub 2021 Apr 20. PMID:33895444 Link

  • Goldsmith E, Koffel E, Ackland P, Hill J, Landsteiner A, Miller W, Stroebel B, Ullman K, Wilt TJ, Duan-Porter W. Implementation of Psychotherapies and Mindfulness-based Stress Reduction for Chronic Pain and Chronic Mental Health Conditions: A Systematic Review [Internet]. Washington (DC): Department of Veterans Affairs (US); 2021 Nov. PMID:35239290 Link

  • Ritvo, P., Knyahnytska, Y., Pirbaglou, M., Wang, W., Tomlinson, G., Zhao, H., et al. (2021). Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth With Major Depressive Disorders: Randomized Controlled Trial. J Med Internet Res, 23(3), e24380.https://doi.org/10.2196/24380 Link

  • Chen, Z. Y., Yan, L. G., Nong X. Y., Chen, F. G., Gan, F. K., Tang, P. Z., Qin, J. M., Huang, Y. M., Huang, L. (2021). Impact of citalopram combined with mindfulness-based stress reduction on symptoms, cognitive functions and self-confidence in patients with depression. Tropical journal of pharmaceutical research, 20(10), s. 2135–2142. doi:10.4314/tjpr.v20i10.17 Link

  • Lin, C., Lin, W., Sun, H., & Jiang L. (2021). Application of mindfulness cognitive training in patients with depression.Health Protection and Promotion. 21(16)46-48. doi:1671-0223(2021)16-046-04 Link

  • Wang, J., Zhang, Z. (2021). The effect on the cognitive function and mental state of mindfulness cognition combined with antidepressants on patients with depression. Medical Science Journal of Central South China. 49(05), 551-554. doi:10.15972/j.cnki.43-1509/r.2021.05.013 Link

  • Xu Nai-hong, Yang Jin-mei, Zhao Dong-rong Hu, N.H., Yang, J. M., & Zhao, D. R. (2021). Study on the intervention effect of mindfulness therapy on depression in patients with depression. Psychologies. 16(19), 36-37,51. doi:10.19738/j.cnki.psy.2021.19.017 Link

  • Tang, H., Kong, Y., Guo, L.,Wang, Q., & Wang, K. (2022). Effects of mindfulness-based stress reduction therapy on patients with moderate to severe depression. Weifang Mental Health Center, Weifang 262400, China. 17(07), 48-50. doi:10.19738/j.cnki.psy.2022.07.015 Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비하여 전침과의 복합치료를 고려할 수 있다.

전침 복합치료는 우울증 증상을 개선하고 부작용을 감소시키므로 환자가 항우울제를 복용하거나 중등도 이상 우울증으로 항우울제 치료를 위해 정신건강의학과에 진료의뢰할 경우 전침과의 복합치료를 고려할 수 있다.

C/Low

  • Zhang GJ, Shi ZY, Liu S, Gong SH, Liu JQ, Liu JS. (2007). Clinical observation on treatment of depression by electro-acupuncture combined with paroxetine. Chinese Journal of IntegrativeMedicine, 13(3), 228-230. Link

  • Duan DM, Tu Y, Chen LP. (2008). Assessment of effectiveness of electroacupuncture and fluoxetine for treatment of depression with physical symptoms. Chinese Acupuncture and Moxibustion, 28(3), 167-170. Link

  • Duan DM, Tu Y, Chen LP, Wu ZJ. (2009). Efficacy evaluation for depression with somatic symptoms treated by electroacupuncture combined with fluoxetine. Journal of Traditional Chinese Medicine, 29(3), 167-173. Link

  • Xu L, Wang LL. (2011). Clinical observation on depression treated by electroacupuncture combined with western medicine. Zhongguo Zhen Jiu, 31(9), 779-782. Link

  • Lin WR, Huang Y, Chen JQ, Wang SX. (2012). Global improvement in agitated depression treated with the alliance therapy of acupuncture and seroxat and the observation of the quality of life. Chinese Acupuncture and Moxibustion, 32(12), 1063-1069. Link

  • Liu XX, Xu QW, Li SL, Jiang LP. (2016). A comparative study of modified Vitalstim electroacupuncture apparatus in the treatment of patients with depression. Journal of Psychiatry, 29(5), 350-352. Link

  • Liu XX, Xu QW, Li SL, Jiang LP. (2017). Therapeutic effects and adverse reaction of modified Vitalstim electro acupuncture instrument in the treatment of depression. Chinese Journal of Practical Nervous Diseases, 20(24), 75-78. Link

  • Tian Y. (2017). Clinical observation of combined electroacupuncture and paroxetine in the treatment of depression. Journal of Baotou Medicine, 41(2), 99-100. Link

  • Ma L. (2018). Clinical Observation on Shallow Needling in Treatment of Heart-spleen Deficiency Type Depression Combined with Sertraline Hydrochloride Tablets. Master thesis Fujian University of Traditional Chinese Medicine. Link

  • Zhao B, Li Z, Wang Y, Ma X, Wang X, Wang X, Liu J. et al. (2019). Manual or electroacupuncture as an add-on therapy to SSRIs for depression: A randomized controlled trial. J Psychiatr Res, 114, 24-33. Link

  • Li W, Sun M, Yin X, Lao L, Kuang Z, Xu S. (2020). The effect of acupuncture on depression and its correlation with metabolic alterations: A randomized controlled trial. Medicine (Baltimore), 99(43), e22752.

  • Wang, Q., Sun, B. J., Liu M. W., & Shi, H. Y. (2022). Clinical Effectiveness and Change in Cytokine of Electroacupunture Combined with Fluoxetine as Therapy for Depression of Stagnation of Liver and Deficiency of Spleen. Traditional Chinese Medicinal Research, 35(01), 30-34. doi:CNKI:SUN:ZYYJ.0.2022-01-009 Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비하여 일반침과의 복합치료를 고려해야 한다.

이미 항우울제 치료를 받고 있거나 중등도 이상 우울증으로 항우울제 치료를 위해 정신건강의학과에 진료의뢰 시 일반침과의 복합치료를 고려해야 한다.

B/Low

  • MacPherson H, Richmond S, Bland M, Brealey S, Gabe R, Hopton A. et al. (2013). Acupunctureand counselling for depression in primary care: a randomised controlled trial, PLoSMed, 10(9), e1001518. Link

  • Bosch P, Van Den Noort M, Yeo S, Lim S, Coenen A, Van Luijtelaar G. (2015). The effect ofacupuncture on mood and working memory in patients with depression and schizophrenia.Journal of Integrative Medicine, 13(6), 380-390. Link

  • Wang J, Jiang JF, Wang LL. (2006). Clinical observation on governor vessel daoqi methodfor treatment of dyssomnia in the patient of depression. Chinese Acupuncture and Moxibution,26(5), 328-330. Link

  • Xu L, Wang LL. (2011). Clinical observation on depression treated by electroacupuncturecombined with western medicine. Chinese Acupuncture and Moxibution, 31(9), 779-782. Link

  • Lin WR, Huang Y, Chen JQ, Wang SX. (2012). Global improvement in agitated depressiontreated with the alliance therapy of acupuncture and seroxat and the observation of the qualityof life. Chinese Acupuncture and Moxibustion, 32(12), 1063-1069. Link

  • Huang Y, Wang XJ, Wang LL, Lu SF, Zhu BM, Xu LF. (2013). Anti-depressive effect of acupunctureon selective serotonin reuptake inhibitors. Chinese Journal of Integrated Taditionaland Western Medicine, 33(10), 1341-1344. Link

  • Wang TJ, Wang LL, Tao WJ, Chen L. (2014). Acupuncture combined with an antidepressant for patients with depression in hospital: a pragmatic randomised controlled trial. Acupuncturein Medicine, 32, 308-312. Link

  • Liu Y, Feng H, Mo Y, Gao J, Mao H, Song M. et al. (2015). Effect of soothing-liver and nourishing-heart acupuncture on early selective serotonin reuptake inhibitor treatment onset fordepressive disorder and related indicators of neuroimmunology: a randomized controlledclinical trial. J Tradit Chin Med, 35(5), 507-513. Link

  • Liu Y, Feng H, Mao H, Mo Y, Yin Y, Liu W. et al. (2015). Impact on serum 5-HT and TH1/TH2 in patients of depressive disorder at acute stage treated with acupuncture and westernmedication. Zhongguo Zhen Jiu, 35(6), 539-543. Link

  • Wang QS, Ji XD, Yuang GZ, Zhu WX. (2015). The observation of the clinical efficacy of acupuncturetreatment to depression with insomnia and impact analysis of the 5-HT content.Journal of Clinical Acupuncture and Moxibustion, 11(3), 8-10. Link

  • Li PQ. (2016). Clinical Study of Acupuncture“Five Emotion Points”Combined with Deanxitin Treating Depression. Master thesis Guangzhou University of Chinese Medicine. Link

  • Ren JN. (2016). Therapeutic Observation of Acupuncture plus Medication for Depression.Shanghai Journal of Acupuncture and Moxibustion, 35(1), 21-22. Link

  • Zheng YH, Hou L. (2016). Clinical observation of Xingnao Kaiqiao acupuncture combinedwith fluoxetine in the treatment of depression. Modern Diagnosis and Treatment, 27(2),220-222. Link

  • Li XN, Gao S, Wu L, Mei JL, Li N. (2017). Clinical Observation of Acupuncture plus Paroxetinefor Depression Due to Liver-qi Stagnation. Shanghai Journal of Acupuncture andMoxibustion, 36(2), 138-141. Link

  • Lu T, Yan P, Jin XF. (2017). Clinical observation of acupuncturing“Jieyu prescription”withfluoxetine on depression. Journal of Shanxi College of Traditional Chinese Medicine, 18(2),52-53. Link

  • Wang Z, Wang X, Liu J, Chen J, Liu X, Nie G. et al. (2017). Acupuncture treatment modulatesthe corticostriatal reward circuitry in major depressive disorder. J Psychiatr Res, 84, 18-26. Link

  • Zhang J, Li J, Huang XZ, He W, Zhang M. (2017). Research on Curative Effect and Influence Factors of Ampoule Based on Community in Treatment of Depression in Old Age. China & Foreign Medical Treatment, 36(4), 1-2+5. Link

  • Zhu WX, Wang J, Wang QS, Ji XD, Yuan GZ. (2017). Antidepressant effect of acupunctureand its influence on peripheral inflammatory cytokines. Medical Journal of the Chinese People’sArmed Police Force, 28(8), 816-819. Link

  • Cai JY, Ding YA, Hou Le, Tong Zs, Xu Y. (2018). Clinical Study on Acupuncture in Methodof Regulating Mentality and Smoothing Liver Combined with SSRI Medications for Depression.New Chinese Medicine, 50(12), 191-193. Link

  • Hu M, Zhao GH, Luo JJ. (2018). Clinical efficacy of citalopram hydrobromide combinedwith acupuncture in the treatment of depression. Modern Medicine and Health ResearchElectronic Journal, 2(18), 20-21. Link

  • Liu J, Wang A, Nie G, Wang X, Huang J. (2018). Acupuncture for female depression: a randomizedcontrolled trial. Zhongguo Zhen Jiu, 38(4), 375-378. Link

  • Ma L. (2018). Clinical Observation on Shallow Needling in Treatment of Heart-spleen DeficiencyType Depression Combined with Sertraline Hydrochloride Tablets. Master thesisFujian University of Traditional Chinese Medicine. Link

  • Tao ZM. (2018). 35 cases of moderate and mild depression of phlegm-qi stagnation typetreated by breathing tonifying and reducing method combined with paroxetine hydrochloridetablets. Traditional Chinese Medicinal Research. 31(8), 15-18.

  • Wang PR, Yang CY, Lian Z, Zhou YC, Chen XP, Yu LH. (2019). Therapeutic effect of thecombined treatment with acupuncture and venlafaxine hydrochloride on depression basedon diffusion tensor imaging technology. Zhongguo Zhen Jiu, 39(6), 571-575. Link

  • Xie B, Huang ZY. (2019). Clinical effect of Tiaoqi Anshen acupuncture combined with Escitalopramin the treatment of depression. China Modern Medicine, 26(36), 107-109. Link

  • Yue YY, Qi JP, Pan ZS. (2019). Effects of duloxetine combined with acupuncture on neurotransmitterand immune function in patients with depression, Experimental and LaboratoryMedicine, 37(2), 313-315. Link

  • Zhao B, Li Z, Wang Y, Ma X, Wang X, Wang X et al. (2019). Manual or electroacupunctureas an add-on therapy to SSRIs for depression: A randomized controlled trial. J Psychiatr Res.Jul;114:24-33. Link

  • Liu M, Li ZX, Deng XG, Huangfu QY, Wang X. (2020). Observation on the Curative Effectof Skull Suture Acupuncture Combined with Paroxetine in the Treatment of Patients with Depression. World Journal of Integrated Traditional and Western Medicine, 15(11), 2121,4+2129. Link

  • Tang Y, Zhang SJ, Zhao R, Cui LS, Liu X, Wang YN. (2020). Effects of Shu Gan Tiao ShenNeedling Method Combined with Medication on Cognitive Function, Social Function andSerum S100βProtein in Patients with Recurrent Depression. Shanghai Journal of Acupunctureand Moxibustion, 39(10), 1259-64. Link

  • Gong LL, Li DD, Li XY. (2021). Observation on the Therapeutic Effect of Acupuncture forNourishing Kidney and Strengthening Brain Combined with Escitalopram Oxalate in Treatmentof Major Depressive Disorder. Journal of Liaoning University of Traditional ChineseMedicine, 1-12. Link

  • Liu K, Li Q. (2021). Study on the effect of acupuncture on insomnia caused by mild to moderatedepression. Chinese Journal of Modern Drug Application. 15(6):232-4.

  • Lu JW. (2021). Clinical Study on Acupuncture Guided by Brain-Gut Axis Theory in theTreatment of Depression. Guangming Journal of Chinese Medicine, 36(1), 108-112. Link

  • Wang Z, Jia X, Lin Z. (2021). Combined Effects of Paroxetine and Acupuncture on ClinicalEfficacy and Cognitive Function of Senile Depression Patients. Latin American Journal of Pharmacy, 40(4), 802-807. Link

  • Tan, X. Q., Xia, H., & Wu, Y. (2021). Clinical Study on Acupuncture Combined with ParoxetineHydrochloride Tablets for Mild and Moderate Depression Complicated with Insomnia.Journal of New Chinese Medicine, 53(16),139-142. doi:10.13457/j.cnki.jncm.2021.16.036 Link

  • Wang Y, Huang YW, Ablikim D, Lu Q, Zhang AJ, Dong YQ, Zeng FC, Xu JH, Wang W, HuZH. (2022). Efficacy of acupuncture at ghost points combined with fluoxetine in treating depression:A randomized study. World J Clin Cases; 10(3): 929-938. Link

  • Wei, L., Zheng, Z. Y., Liu, D., Chen, H. L., Jin, H., & Yang, J. F. (2021). RCTs of FuyangYiyin Acupuncture in Treating Depression. Journal of Clinical Acupuncture and Moxibustion,37(08),30-34. doi:10.19917/j.cnki.1005-0779.02115737. Link

  • Zhu, F. Y., Niu, M. D., Ma, Y., Du, X. R., Sun, L. Z., & Zhan, YT. (2022). Efficacy Observationof Acupuncture with Warm Unblocking Method Combined with Mirtazapine forTreatment-resistant Depression. Shanghai Journal of Acupuncture and Moxibustion,41(04),348-352. https://doi:10.13460/j.issn.1005-0957.2022.04.0348 Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 감맥대조탕과의 복합치료를 고려할 수 있다.

감맥대조탕 단독치료 권고문(R1-8), 한약과 항우울제 복합치료 권고문(R9)에 기술한 임상적 고려사항을 참조한다.

C/Very Low

  • He, Y. F. & Tan, B. (2006). Clinical observation of Ganmai Dazao decoction combined with clomipramine in the treatment of depression. Shizhen Chinese Medicine and Chinese Medicine,(10), 2026-2027. Link

  • Zhu, W. X., Ji, X. D, & Yuan, G. Z. (2017). A randomized controlled study of serotonin reuptake inhibitor combined with Ganmai Dazao decoction in the treatment of depression. Journal of Clinical Psychiatry, (03), 171-174. Link

  • Zhang, D. (2018). Efficacy and safety of sertraline combined with modified Ganmai Dazao decoction in the treatment of depression. Journal of Clinical Rational Medicine, 11(14), 3-4. https://doi.org/10.15887/j.cnki.13-1389/r.2018.14.002 Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 구미진심과의 복합치료를 고려해야 한다.

• 심비양허(心脾兩虛) 변증 시 고려할 수 있다.
• 우울증과 함께 불안이 동반된 경우 고려할 수 있다.
• 처방구성(평보진심단): 천문동, 숙지황, 원지 각 60g, 오미자, 복령, 현호색, 육계 각 50g, 인삼 20g, 산조인 10g
• 변증시치에 따라 다음의 한약재를 추가하여 사용할 수 있다.
- 음허(陰虛): 천문동과 숙지황을 증량
- 비기허(脾氣虛): 복령과 인삼을 증량
- 심허(心虛): 산조인과 원지를 증량

B/Low

  • Hu, F. D. (2015). A controlled study on the efficacy and safety of Jiuwei Zhenxin granules combined with bupropion in the treatment of first-episode depression. Journal of Psychiatry, 28(03), 205-207. Link

  • Kuang, W., Tian, L., Yue, L., & Li, J. (2016). Effects of escitalopram with a Chinese traditional compound Jiuweizhenxin-keli on mismatch negativity and P50 in patients with major depressive disorders. Neuropsychiatric disease and treatment, 12, 1935-1941. Link

  • Wang, P. D., Chen, L. J., Liu, G,, Jin, Z. M., Xu, M., & Wang, L. P. (2018). Clinical study of Jiuwei Zhenxin granules combined with duloxetine in the treatment of depression. Modern Medicine and Clinical, (11), 2848-2851. Link

  • Hu, F, D., Su, J., & L,i Y. G. (2020). The study of clinical efficacy and safety between Nine town heart particles and combination therapy with Fluoxetine Hydrochloride Tablets in the treatment of first-episode depression. Jilin Medicine, (01), 22-24. Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 시호가용골모려탕과의 복합치료를 고려할 수 있다.

시호가용골모려탕 단독치료 권고문(R1-7), 한약과 항우울제 복합치료 권고문(R9)에 기술한 임상적 고려사항을 참조한다.

C/Very Low

  • Xiao, Q. G., Li, S. S., Wang, L. F., & Guo, N. C. (2018). The efficacy of Chaihu Jia Longgu Muli Decoction combined with duloxetine hydrochloride in the treatment of anxiety and depression. Journal of Clinical Rational Medicine, (17), 35-36. https://doi.org/10.15887 /j.cnki.13-1389/r.2018.17.021 Link

  • Wang, S., Chen, J., Yang, N. & Qiao, H. F. (2020). Clinical study of Chaihu Jia Longgu Muli Decoction combined with western medicine in the treatment of 30 cases of severe depression with insomnia. Jiangsu Traditional Chinese Medicine, (10), 27-29. https://doi.org/10.19844/j .cnki.1672-397X.2020.10.009 Link

  • Wu, L. L,, Pan, K. & Wu, A. L. (2020). Clinical study of Chaihu Longgu Muli Decoction combined with paroxetine in the treatment of depression. Journal of Integrated Chinese and Western Medicine Cardiovascular and Cerebrovascular Diseases, (12), 1994-1996. Link

  • Zu, Y. C. (2020). Clinical observation of Chaihujia Longgu Muli Decoction in the treatment of depression due to liver stagnation and qi stagnation [master’s thesis]. Nanjing University of Traditional Chinese Medicine. Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 월국환과의 복합치료를 고려해야 한다

월국환 단독치료 권고문(R1-5), 한약과 항우울제 복합치료 권고문(R9)에 기술한 임상적 고려사항을 참조한다.

B/Low

  • Yao, H. J. (2008). Yueju Pill combined with Prozac in the treatment of 48 cases of depression. Clinical Medicine, 28(12), 114. Link

  • Chen, M. J. & Yao, R. (2015). Clinical observation of Yueju pill combined with duloxetine in the treatment of somatic anxiety and depression. Neurological Injury and Functional Reconstruction, (02), 175-176. Link

  • Sun, S. D. (2015). Professor Tang Changjin’s Academic Experience and Clinical Observation on Differentiation and Treatment of Depression[master’s thesis]. Anhui university of Chinese medicine. Link

  • Lan, J. P., Jiang, C. M., & Zheng, S. (2020). Clinical study of Yueju pill combined with fluoxetine hydrochloride capsule in the treatment of depression. New Chinese Medicine, 52(03), 29-31. https://doi.org/10.13457/j.cnki.jncm .2020.03.009. Link

  • Wu, R., Zhu, D., Xia, Y., Wang, H., Tao, W., Xue, W.,…, & Chen, G. (2015). A role of Yueju in fast-onset antidepressant action on major depressive disorder and serum BDNF expression: a randomly double-blind, fluoxetine-adjunct, placebo-controlled, pilot clinical study. Neuropsychiatric disease and treatment, 11, 2013–2021. https://doi.org/10.2147/NDT.S86585 Link

  • Zhu, D. D. (2016). Clinical study of Yueju Pill in improving depressive symptoms rapidly[-master’s thesis] Nanjing university of Chinese medicine. Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 시호소간산과의 복합치료를 고려해야 한다.

시호소간산 단독치료 권고문(R1-4), 한약과 항우울제 복합치료 권고문(R9)에 기술한 임상적 고려사항을 참조한다.

B/Low

  • Cheng, S. Y., Li, L., & Li, J. M. (2007). Clinical obsevation of combined use of traditional Chinese and western medicine for depression. Liaoning Journal of Traditional Chinese Medicine, (07), 957-958. https://doi.org/10.13192/j.ljtcm.2007.07.97. chengshy.059 Link

  • Deng, S. Z. (2012). Observation on the curative effect of Chaihu Shugan powder combined with citalopram in the treatment of depression. Traditional Chinese Medicine, 19(12), 81-82. Link

  • Gu, X. X. (2016). Clinical observation on treating depression with Chaihu Shugan San plus mirtazapine tablets. Clinical Journal of Chinese Medicine, 8(2), 82-83. Link

  • Liu, Z. (2017). Efficacy of Chaihu Shugan Powder combined with western medicine in the treatment of patients with depression and its effect on inflammatory factors and 5-HT. Shaanxi Traditional Chinese Medicine, 38(7), 873-874. Link

  • Xie, Z. (2017). Clinical effect of mirtazapine tablets combined with Chaihu Shugan powder in the treatment of depression. Journal of Chronic Diseases, (08), 931-933. https://doi.org/10.16440/j.cnki.1674-8166.2017.08.025 Link

  • Liu, Z. X. (2018). Clinical study on treating depression with the Chaihu Shugan powder. Traditional Chinese Medicine Clinical Research, 10(12), 19-20. Link

  • Xiong, Y, Guo, R. J., Song, D. Q., Sun, Y., Wang, P. G., & Li, Y. (2019). Effects of modified Chaihu Shugan Powder on mood and quality of life in elderly patients with depression. World Journal of Integrative Medicine, (09), 1291-1294. https://doi.org/10.13935/j.cnki.sjzx.190926 Link

  • Yang, Q. S. (2019). Efficacy analysis of duloxetine combined with Chaihu Shugan powder in the treatment of 55 cases of depression. Journal of Chengde Medical College, (04), 311-313. https://doi.org/10.15921/j.cnki.cyxb.2019.04. 013 Link

  • Sun. L, X. (2020). Clinical Study on Chaihu Shugan Powder Combined with Escitalopram Oxalate for Depression of Liver Qi Stagnation Type. New Chinese medicine, 52(2), 37-40. https://doi.org/10.13457/j.cnki.jncm.2020.02.010 Link

  • Tan, C. H., Chen, S. R., Lin, J. X., & Zhao. Y. H. (2020). Clinical efficacy of modified Chaihu Shugan Decoction in the treatment of depression and Qi stagnation syndrome. Inner Mongolia Traditional Chinese Medicine, (05), 11-13. https://doi.org/10.16040/j.cnki.cn15-1101.2020. 05.006 Link

  • Xiong, Y. (2020). Clinical observation of modified Chaihu Shugan powder combined with escitalopram oxalate in elderly patients with depression[master’s thesis]. Beijing University Of Chinese Medicine. Link

  • Li, Z. (2022). Clinical effect analysis of the Chaihu Shugan decoction on depression with Qi-stagnation syndrome. Clinical Journal of Chinese Medicine. 22(09). 52-54. Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 단치소요산과의 복합치료를 고려해야 한다

단치소요산 단독치료 권고문(R1-3), 한약과 항우울제 복합치료 권고문(R9)에 기술한 임상적 고려사항을 참조한다.

B/Moderate

  • Huo J, Fu, H. P., & Li, A.L. (2008). The clinical research of depressive disorder treated in Dan zhi Saoyao decoction for ease combined fluoxetine. Journal of Henan University of Traditional Chinese Medicine, 23(136), 38-93. https://doi.org/10.16368/j.issn.1674-8999.2008.03.044 Link

  • Jiang, J. X., Zhou, Y., Yang, Y., & Liang, L. (2015). Efficacy of Xiaoyao San Jiawei combined with citalopram in the treatment of depression and its influence on HPA, HPT and HPG axis. Modern Journal of Integrative Medicine, (33), 3715-3717. Link

  • Lu, X. Y. & Zhao, L. (2015). The efficacy of Jiawei Xiaoyao pill combined with escitalopram oxalate in the treatment of depression. World Latest Medical Information Digest, (82), 84,89 Link

  • Zhang, X. P., Zhuang, J. J., & Wu, M. (2015). Randomized parallel controlled study of Jiawei Xiaoyao capsule combined with sertraline in the treatment of mild to moderate depression. Journal of Practical Chinese Medicine, (08), 69-71. https://doi.org/10.13729/j.issn.1671-7813.2015.08.35 Link

  • Ren, Q. P. & Lin, H. (2017). A randomized parallel controlled study of Danzhi Xiaoyao Powder combined with paroxetine in the treatment of moderate to mild depression. Journal of Practical Chinese Medicine, (01), 52-54. https://doi.org/10.13729/j.issn.1671-7813.2017.01.23 Link

  • Wang, C. (2016). Clinical efficacy of Xiaoyaosan combined with paroxetine in the treatment of senile depression and its effect on HPA axis function. Chinese Journal of Practical Neurological Disorders, 19(18), 127-128. Link

  • Chen, Z. P. & Hou, C. Y. (2017). Effect analysis of Jiawei Xiaoyao powder combined with fluoxetine hydrochloride in the treatment of depression. Chinese Medicine Clinical Research (10), 59-61. Link

  • Yan, L. X. (2017). Danzhi Xiaoyao Powder combined with paroxetine in the treatment of depression. Bright TCM, 32(16), 2391-2393. Link

  • Tong, Z. S., Liu, Y., & Huang, J. D. (2018). Clinical study of Jiawei Xiaoyao powder combined with fluoxetine hydrochloride in the treatment of depression. Laboratory Medicine and Clinical (09), 1249-1251. Link

  • Gao, C. (2019). Clinical effect of Danzhi Xiaoyao decoction combined with buspirone in the treatment of depression. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 29(7), 27-28. https://doi.org/10.16458/j.cnki.1007-0893.2019.07.011 Link

  • Cao, G. P. & Zhang, M. (2020). Effects of Jiawei Xiaoyao Pill on inflammatory factors and quality of life in patients with depression. Shenzhen Journal of Integrative Medicine, (20), 49-51. https://doi.org/10.16458/j.cnki.1007-0893.2020. 20.023 Link

  • Liu, J. X., Lin, J. P, Liu, Z. H, & Pan, Z. Y. (2020). Clinical observation of Jiawei Xiaoyao Powder combined with fluoxetine hydrochloride in the treatment of depression. Chinese Folk Therapy, (06), 58-60. https://doi.org/10.19621/j.cnki.11-3555/r.2020.0628 Link

  • Wang, L. T. (2020). Influence of Danzhi Xiaoyao Powder on the clinical efficacy of depression.Clinical practice of integrated traditional Chinese and Western medicine, 20(11), 45-47. https://doi.org/10.13638/j.issn.1671-4040.2020.11.021 Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 소요산과의 복합치료를 고려해야 한다.

소요산 단독치료 권고문(R1-2), 한약과 항우울제 복합치료 권고문(R9)에 기술한 임상적 고려사항을 참조한다.

B/Moderate

  • Wei, P., Li, Y., & Li, Y. (1999). 30 Cases of Depression Treated with Modified Xiaoyao Powder. Chinese Medicine Research, (05), 54-55. Link

  • Xia, X. Y., Tan, X. Y., Wang, D. J., & Mend, Q. M. (2011). The efficacy observation of Xiaoyaosan combined with Escitalopram in the treatment of depression. China Medical Herald, 8(24), 71-72. Link

  • Gao, X. (2012). Xiaoyao powder combined with escitalopram oxalate tablets in the treatment of depression. China Modern Doctor, 50(1), 66-77, 70. Link

  • Zhang, J. Z. (2012). Clinical efficiency of paroxetine combined with Xiaoyaosan in the treatment of 68 patients with depression. Chinese Medicine Guide, 10(12), 415-416. https://doi.org/10.15912/j.cnki.gocm.2012.12.530 Link

  • Liu, G. C. (2013). Observation on the effect of Xiaoyao-san combined with paroxetine in the treatment of 60 cases of depression. Inner Mongolia Traditional Chinese Medicine, (3), 56-57. https://doi.org/10.16040/j.cnki.cn15-1101.2013.03.171 Link

  • Lian, Z., Wu, Q., & Zhao, S. N. (2015). Observation on the curative effect of Modified Xiaoyaosan combined with paroxetine tablets in the treatment of depression. China Practical Medicine, (35), 138-139. https://doi.org/10.14163/j.cnki.11-5547/r.2015.35.099 Link

  • Liu, D. (2017). Clinical study on the therapeutic effect of paroxetine combined with Xiaoyao Pill in patients with first-episode depression[master’s thesis]. Shaanxi university of Chinese medicine. Link

  • Guo, J. H. (2018). Analysis of clinical effect of Jiawei Xiaoyao Powder on depression patients. World Journal of Sleep Medicine, 5(05), 569-571. Link

  • Guo. A, R. (2018). Clinical analysis of 60 cases of depression treated with Xiaoyao pill and sertraline. Modern Health Care, (24), 97-98. Link

  • Tong, Z. S., Liu, Y., & Huang, J. D. (2018). Clinical study of Jiawei Xiaoyao powder combined with fluoxetine hydrochloride in the treatment of depression. Laboratory Medicine and Clinical, (09), 1249-1251. Link

  • Wu, Y. F., Yang, M. Z., & Yu, L. (2019). Microbial regulation mechanism of Jiawei Xiaoyao granules in the treatment of depression with liver stagnation and spleen deficiency syndrome. Shizhen Traditional Chinese Medicine, (03), 633-635. Link

  • Wang, Y. J., & Zuo, W. B. (2022). Effects of Jiawei Xiaoyao powder combined with Fluoxetine in treatment of patients with depression. Medical Journal of Chinese People’s Health, 34(09), 57-59+66. Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 귀비탕과의 복합치료를 고려할 수 있다.

귀비탕 단독치료 권고문(R1-1), 한약과 항우울제 복합치료 권고문(R9)에 기술한 임상적 고려사항을 참조한다.

C/Low

  • Chen, W., Liu, L., Yang, X. S., Wang, N. N., & Liu, Z. T. (2013). Clinical observation of depression treated with modified Guipi decoction and escitalopram. World Journal of Integrated Traditional and Western Medicine, (08), 829-831. https://doi.org/10.13935/j.cnki.sjzx.2013.08.033 Link

성인 주요우울장애 환자의 우울증 증상 개선을 위해 항우울제 단독치료에 비해 한약과의 복합치료를 고려해야 한다.

• 항우울제 복용 후 부작용이 발생하거나, 항우울제 복용에도 치료 효과가 나타나지 않거나, 장기복용한 항우울제를 감량할 때 고려할 수 있다.
• 중등도 이상의 우울증에 고려할 수 있다.
• 개별 한약은 하위권고문을 참조하여 변증에 따라 선택한다.

B/Moderate

  • Chen, W., Liu, L., Yang, X. S., Wang, N. N., & Liu, Z. T. (2013). Clinical observation of depression treated with modified Guipi decoction and escitalopram. World Journal of Integrated Traditional and Western Medicine, (08), 829-831.https://doi.org/10.13935/j.cnki.sjzx.2013.08.033 Link

  • Wei, P., Li, Y., & Li, Y. (1999). 30 Cases of Depression Treated with Modified Xiaoyao Powder. Chinese Medicine Research, (05), 54-55. Link

  • Xia, X. Y., Tan, X. Y., Wang, D. J., & Mend, Q. M. (2011). The efficacy observation of Xiaoyaosan combined with Escitalopram in the treatment of depression. China Medical Herald, 8(24), 71-72. Link

  • Gao, X. (2012). Xiaoyao powder combined with escitalopram oxalate tablets in the treatment of depression. China Modern Doctor, 50(1), 66-77, 70. Link

  • Zhang, J. Z. (2012). Clinical efficiency of paroxetine combined with Xiaoyaosan in the treatment of 68 patients with depression. Chinese Medicine Guide, 10(12), 415-416.https://doi.org/10.15912/j.cnki.gocm.2012.12.530 Link

  • Liu, G. C. (2013). Observation on the effect of Xiaoyao-san combined with paroxetine in the treatment of 60 cases of depression. Inner Mongolia Traditional Chinese Medicine, (3), 56-57. https://doi.org/10.16040/j.cnki.cn15-1101.2013.03.171 Link

  • Lian, Z., Wu, Q., & Zhao, S. N. (2015). Observation on the curative effect of Modified Xiaoyaosan combined with paroxetine tablets in the treatment of depression. China Practical Medicine, (35), 138-139. https://doi.org/10.14163/j.cnki.11-5547/r.2015.35.099 Link

  • Liu, D. (2017). Clinical study on the therapeutic effect of paroxetine combined with Xiaoyao Pill in patients with first-episode depression[master’s thesis]. Shaanxi university of Chinese medicine. Link

  • Guo, J. H. (2018). Analysis of clinical effect of Jiawei Xiaoyao Powder on depression patients. World Journal of Sleep Medicine, 5(05), 569-571. Link

  • Guo. A, R. (2018). Clinical analysis of 60 cases of depression treated with Xiaoyao pill and sertraline. Modern Health Care, (24), 97-98. Link

  • Tong, Z. S., Liu, Y., & Huang, J. D. (2018). Clinical study of Jiawei Xiaoyao powder combined with fluoxetine hydrochloride in the treatment of depression. Laboratory Medicine and Clinical, (09), 1249-1251. Link

  • Wu, Y. F., Yang, M. Z., & Yu, L. (2019). Microbial regulation mechanism of Jiawei Xiaoyao granules in the treatment of depression with liver stagnation and spleen deficiency syndrome. Shizhen Traditional Chinese Medicine, (03), 633-635. Link

  • Yuan, Jin., Pei, Q., Qu, M., & Zheng, Qin. (2022) Clinical effect of Jiawei Xiaoyao Powder in the treatment of depression with liver stagnation and spleen deficiency.中国医药导报, 19(28): 7-10,22.17 Link

  • Huo J, Fu, H. P., & Li, A.L. (2008). The clinical research of depressive disorder treated in Dan zhi Saoyao decoction for ease combined fluoxetine. Journal of Henan University of Traditional Chinese Medicine, 23(136), 38-93.https://doi.org/10.16368/j.issn.1674-8999.2008.03.044 Link

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