柴麦升降散治疗肝郁脾虚型广泛性焦虑障碍的临床研究

发布时间：2018-04-10 08:27

本文选题：广泛性焦虑障碍　切入点：肝郁脾虚　出处：《南京中医药大学》2017年硕士论文

【摘要】：目的:探讨柴麦升降散治疗肝郁脾虚型广泛性焦虑障碍(GAD)的临床效果。与对照组(帕罗西汀组)对照,通过比对两组治疗前后的汉密尔顿焦虑量表(HAMA)以及中医证候评分的变化,探讨其临床疗效、作用机制及安全性。方法:根据相关的纳入标准、排除标准,选出60例符合GAD诊断的患者,随机分为治疗组(柴麦升降散组)和对照组(帕罗西汀组),每组各30例。治疗组口服柴麦升降散汤剂,每次250～300ml,分早晚两次温服;对照组口服盐酸帕罗西汀片(乐友,浙江华海药业),剂型为20mg一片,早饭后半小时服用,由半片(前4天)逐渐加量至一片(第五天起),总疗程为4周,治疗前对两组患者的性别、年龄、焦虑量表评分(HAD和HAMA)、中医证候评分进行比较,确定两组无差异。观察两组的HAMA及中医证候评分,分别在治疗前、2周、4周时测定一次。试验全程监测血、尿、粪、肝肾功能、ECG等安全性指标以及相关的副反应,试验结束时前后组间进行对比,评价临床疗效及安全性。结果:柴麦升降散与帕罗西汀均能改善GAD患者HAMA评分、中医症候积分。治疗2周时柴麦升降散组的HAMA及中医证候评分改善均比西药组有优势(P0.05),治疗4周时柴麦升降散组的中医症候评分改善比西药组有优势(P0.05),两组HAMA评分改善类似(P0.05)。结论:柴麦升降散能有效改善GAD患者的焦虑量表评分及临床症状,说明其治疗GAD是有效的。与西药相比,柴麦升降散起效快,改善中医症状的效果显著,并且副作用较西药少,肯定了柴麦升降散治疗GAD的疗效。
[Abstract]:Objective: to investigate the clinical effect of Chaimai Shengshang Powder (QIMAPS) in the treatment of generalized anxiety disorder (GAD) with liver depression and spleen deficiency.Compared with the control group (paroxetine group), by comparing the changes of Hamilton anxiety scale (Hama) and TCM syndrome score before and after treatment, the clinical efficacy, mechanism and safety of the two groups were discussed.Methods: according to the relevant inclusion criteria and exclusion criteria, 60 patients with GAD were selected and randomly divided into treatment group (Chaimai Shengsan group) and control group (paroxetine group, 30 cases in each group).The treatment group was treated with Chaimai Shengsan decoction, 250ml / time, divided into morning and evening, and the control group took paroxetine hydrochloride tablets (Leyou, Zhejiang Huahai Pharmaceutical Co., Ltd.) in the form of 20mg, which was taken half an hour after breakfast.From the first 4 days to one tablet (from the fifth day), the total course of treatment was 4 weeks. The gender, age, anxiety scale scores of had and Hama were compared before treatment, and the TCM syndrome scores were not different between the two groups.The HAMA and TCM syndrome score were measured at 2 weeks and 4 weeks before treatment.The blood, urine, feces, liver and kidney function and ECG were monitored in the whole course, and the side effects were compared before and after the trial, and the clinical efficacy and safety were evaluated.Results: both Chaimai Shengsan and paroxetine could improve the HAMA score and TCM symptom score of GAD patients.After 2 weeks of treatment, the HAMA and TCM syndromes of Chaimai Shengsheng Powder group were better than that of western medicine group (P 0.05). After 4 weeks of treatment, the improvement of traditional Chinese medicine symptom score of Chaimai Shengsheng Powder group was better than that of western medicine group (P 0.05). The improvement of HAMA score in both groups was similar to that in western medicine group (P 0.05).Conclusion: Chaimai Shengsheng Powder can effectively improve the anxiety scale score and clinical symptoms of patients with GAD, indicating that it is effective in the treatment of GAD.Compared with western medicine, Chaimai Shengsheng Powder had a faster effect, improved the symptoms of traditional Chinese medicine significantly, and had less side effects than western medicine. The curative effect of Chaimai Shengsheng Powder on GAD was confirmed.
【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】：R277.7

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