Zhiqiaochuanxiong decoction for major depressive disorder complicated by functional dyspepsia: a case report with fast-acting efficacy

ObjectiveTo introduce a clinical case from Professor Huang Xi from Xiangya Hospital in traditional Chinese medical (TCM) treatment for a major depressive disorder (MDD) complicated by functional dyspepsia (FD).MethodsA 26-year old unemployed male migrant worker (Han nationality) presented himself at the TCM outpatient department of our hospital on May 13th 2013, with the chief complaint of persistent low mood and negative emotions lasting 2.5 years. He was diagnosed as having MDD complicated by FD. The TCM differentiation made was “Gan-qi-Yujie” (Liver-Qi stagnation). Zhiqiaochuanxiong (ZQCX) decoction, composed of Zhiqiao (Fructus Aurantii Submaturus) 40 g and Chuanxiong (Rhizoma Chuanxiong) 40 g, was given to be taken twice daily. The patient's condition was evaluated with a 128-channel electroencephalogram (EEG) and high-resolution manometry (HRM). During follow-up the patient was monitored with the Patient Health Questionnaire and Leeds Dyspepsia Questionnaire.ResultsAfter treatment, the symptoms of depression and the FD comorbidity disappeared. Furthermore, the main EEG and HRM were significantly improved after 1-7 weeks of ZQCX decoction administration.ConclusionZQCX decoction showed rapid prokinetic and anti-depressive effects in a MDD patient complicated by FD. Most commonly used antidepressants target only the brain, whereas ZQCX decoction targets the brain-gut axis according to TCM theory.