Objective  To investigate the therapeutic effect of Shuli Shaoyang Prescription on refractory depression and its effects on brain-derived neurotrophic factor(BDNF) and neurotransmitter levels.

  Methods  Eighty patients with refractory depression admitted to the psychological outpatient department of our hospital were selected as research objects, and were randomly divided into observation group and control group, with 40 cases in each group. The control group was given paroxetine hydrochloride tablets for oral administration, while the observation group added with Shuli Shaoyang Prescription based on the control group. After continuous treatment for 8 weeks, the efficacy and adverse reactions of the two groups were observed and compared. The scores of TCM syndrome, 17-Item Hamilton Rating Scale for Depression(HAMD-17), Hamilton Anxiety Scale (HAMA), Symptom Checklist 90 (SCL-90), and the changes in the levels of BDNF and neurotransmitter were compared between the two groups before and after treatment.

  Results  After treatment, the scores of TCM syndrome, HAMD-17, HAMA and SCL-90 of patients in both groups were significantly reduced, and the observation group was significantly lower than those of the control group (P < 0.05). The clinical total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). After treatment, the levels of 5-hydroxytryptamine (5-HT), norepinephrine (NE), neuropeptide Y (NPY) and mature BDNF (mBDNF) and tyrosine kinase receptor B of BDNF (TrkB) in the two groups were significantly increased after treatment, and the above indicators in the observation group were significantly higher than those of the control group (P < 0.05), while the substance P (SP) and precursor of BDNF (proBDNF) levels were significantly decreased, and they were significantly lower in the observation group than those in the control group (P < 0.05). The adverse reactions in the observation group was 15.00%, which was lower than 20.00% in the control group, but there was no statistically significant difference between the two groups (P>0.05).

  Conclusion  Shuli Shaoyang Prescription can significantly enhance curative effect in treatment of refractory depression, improve the patients' emotions such as depression, anxiety. Therefore, emotions may be regulated by regulating the levels of BDNF and neurotransmitters.