针刺督脉压痛点治疗抑郁症合并胃肠道症状的临床观察

发布时间：2018-03-24 20:57

本文选题：抑郁症　切入点：督脉压痛点　出处：《南京中医药大学》2017年硕士论文

【摘要】：目的:抑郁症因其广泛存在的躯体障碍备受关注,胃肠道症状为最常见的躯体障碍,本研究通过搜集文献,探讨了督脉、抑郁症与胃肠的相互关系,通过对抑郁症合并胃肠道症状患者的督脉压痛点进行观察并针刺治疗,旨在发现抑郁症合并不同胃肠道症的压痛点差异及治疗过程中胃肠症状及压痛点的变化规律,通过量表得分评价治疗效果,从而进一步了解胃肠与抑郁症的关系。方法:将符合本研究纳入标准的患者随机分为针刺药物组和单纯药物组。针刺药物组患者运用脊推法寻找出压痛点并记录其症状,将患者的压痛点与症状,压痛点与压痛点,症状与症状之间进行关联分析:治疗上运用针刺压痛点及口服西酞普兰,药物组患者仅口服西酞普兰。两组患者分别于治疗前和治疗过程中对两组进行汉密尔顿抑郁量表(HAMD)、胃肠疾病中医证候评分表测定,比较治疗过程中症状与压痛点的变化,应用组间及组内比较对治疗前后及两组之间的治疗效果进行评定。结果:患者压痛点分布多位于T5、T7、T8、T9、T11。关联分析统计发现上消化道症状多与T7、T5、T8、T9、T11相关,而下消化道症状多于T7、T5、Ti1、T8、T9相关。通过对HAMD量表及胃肠疾病中医证候量表统计分析,针刺药物组与单纯药物组对于抑郁症患者情绪及胃肠道症状改善都有良好效果(P0.05),两组之间对总体情绪改善无明显差别(P0.05),在胃肠症状上针刺药物组疗效优于单纯药物组(P0.05)。治疗过程中T5、T7压痛点减少率最低,对恶心呕吐、食欲减退及便秘的针刺效应依次递减。结论:1、抑郁症合并胃肠道症状患者的督脉压痛点成规律性分布,不同消化道分布规律有差异,其不同症状与压痛点,压痛点与压痛点,症状与症状之间存在关联性。2、症状的减轻优先于压痛点的减少,治疗过程中压痛点随症状的减轻而减少,不同症状患者的压痛点减少也不同。3、在短期治疗中(2周内),针刺治疗对抑郁症胃肠症状改善优于药物治疗,对于总体的改善二者并无明显差别,针刺即刻效应明显,提示针刺治疗早期介入的临床必要性,针刺督脉压痛点的治疗对不同胃肠症状改善有差异。
[Abstract]:Objective: depression because of physical barriers to its widespread concern, gastrointestinal symptoms were the most common somatic disorders, this study by collecting literature, discusses the relationship between Du, depression and gastrointestinal, the depression patients with gastrointestinal symptoms on tenderness points were observed and the acupuncture treatment, in order to find changes with depression different gastrointestinal disease during the treatment of tenderness point difference and gastrointestinal symptoms and tenderness, the treatment effect was evaluated by scoring scale, so as to further understand the relationship between gastrointestinal and depression. Methods: in accordance with the inclusion criteria were randomly divided into acupuncture group and medication group. The drug group were treated with acupuncture and drug ridge push method to find out the tenderness and record their symptoms, the patient's pain points and symptoms, and tenderness tenderness, correlation analysis between the symptoms and symptoms: treatment The use of acupuncture point tenderness and oral citalopram, drug group were only oral citalopram. In two groups were measured before and during treatment of the two groups of Hamilton Depression Scale (HAMD), disease syndromes gastrointestinal score determination, treatment, changes of symptoms and tenderness in the process of application between group and group comparison of the two groups before and after treatment between the treatment effect was evaluated. Results: the pain point located in the distribution of T5, T7, T8, T9, T11. correlation statistical analysis of upper gastrointestinal symptoms and T7, T5, T8, T9, T11, and gastrointestinal symptoms more than T7, T5, Ti1. T8, T9. Based on HAMD scale and gastrointestinal diseases in TCM syndrome scale statistical analysis, the acupuncture medicine group and the medication group has a good effect on emotion and gastrointestinal tract symptoms improved in patients with depression (P0.05), between the two groups had no significant difference on the overall mood improvement (P0.05 ), in the gastrointestinal symptoms on the efficacy of acupuncture medicine group is better than the simple drug group (P0.05). During the treatment of T5, T7 reduced the lowest rate of tenderness, nausea and vomiting, loss of appetite and constipation acupuncture effect decreasing. Conclusion: 1, depression and gastrointestinal symptoms in patients with Du pain points into the regular pressure distribution. The different distribution of the digestive tract are different, the different symptoms and tenderness, tenderness and tenderness, there is a correlation between.2 symptoms and symptoms, reduction of symptoms prior to the tenderness point reduction, tenderness point during treatment with reduction of symptoms and reduce symptoms, patients with different tenderness point reduction of different.3. In the short-term treatment (2 weeks), acupuncture treatment for depression gastrointestinal symptoms is better than drug therapy, the overall improvement of two there is no significant difference, the immediate effect of acupuncture significantly, suggesting that the clinical necessity of acupuncture treatment on early intervention of acupuncture and The treatment of pulse pressure pain points is different for the improvement of different gastrointestinal symptoms.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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