二仙汤合柴胡加龙骨牡蛎汤治疗围绝经期女性抑郁症的研究

发布时间：2018-09-12 08:48

【摘要】：目的:观察二仙汤合柴胡加龙骨牡蛎汤治疗围绝经期女性抑郁症的临床疗效,并且与西药氟西汀的治疗互相比较,探讨二仙汤合柴胡加龙骨牡蛎汤治疗方案对于围绝经期女性抑郁症患者的治疗效果、优势以及安全性。方法:台湾地区新北市振兴医疗群院所2015年6月至2016年9月到门诊治疗的病患中,选择符合纳入标准的围绝经期女性抑郁症患者66例,其中治疗组有34例,对照组有32例。治疗组以中药二仙汤合柴胡加龙骨牡蛎汤治疗,而对照组以西药氟西汀治疗,疗程为8周。观察并比较两组患者治疗前与治疗第2、4、6、8周后的汉米尔顿抑郁量表(HAMD)与中医证候评分量表的评分、综合疗效、症状疗效及安全性指标等。结果:1.8周的疗程结束后疗效指标HAMD的比较,治疗组总有效率为82.4%,其中痊愈有5例(14.7%)、显着进步有14例(41.2%)、进步有9例(26.5%)、无效有6例(17.6%)。对照组总有效率为84.4%,其中痊愈有5例(15.6%)、显着进步有14例(43.8%)、进步有8例(25.0%)、无效有5例(15.6%)。治疗组与对照组HAMD疗效的比较,两组间无统计学差异(p0.05)。说明围绝经期女性抑郁症中药治疗与西药治疗,都具有改善抑郁状态的疗效。2.8周的疗程结束后中医证候评分疗效的比较,治疗组总有效率为82.4%,其中显效有9例(26.5%)、有效有19例(55.9%)、无效有6例(17.6%)。对照组总有效率为81.2%,其中显效有8例(25.0%)、有效有18例(56.2%)、无效有6例(18.8%)。治疗组与对照组中医证候评分疗效的比较,两组疗效没有统计学差异(p0.05)。说明围绝经期女性抑郁症的治疗,中药治疗与西药治疗都具有改善临床症状的作用及疗效。3.治疗8周疗程结束后各组内临床症状的比较,中药治疗组在神情抑郁、潮热汗出、感觉异常、烦躁不安、默默不言、头晕、神疲乏力、心悸、胸胁满闷、脘腹胀满、失眠多梦、食欲减少、肢体酸痛、大便不调等中医症状,均可以逐渐获得改善(p0.05)。西药对照组可以改善神情抑郁、烦躁不安、默默不言、头晕、神疲乏力、心悸、胸胁满闷、脘腹胀满、失眠多梦、食欲减少、肢体酸痛、大便不调等中医症状(p0.05),但是对于潮热汗出与感觉异常则没有明显的疗效(p0.05)。4.治疗8周疗程结束后两组间各临床症状的比较,治疗组在潮热汗出、感觉异常、胸胁满闷与食欲减少方面,改善程度比对照组显着,有统计上的差异(p0.05)。而其它症状改善的比较,两组之间没有统计学差异(p0.05)。说明中药治疗组对于潮热汗出、感觉异常、胸胁满闷与食欲减少症状的改善明显优于西药对照组的治疗。5.两组副作用的比较,治疗组方面有6例次,其中恶心有3例、轻微腹泻有3例。对照组方面出现有21例次副作用,其中口干有4例、失眠有3例、恶心有3例、焦虑有2例、乏力有2例,头晕有3例、头痛有1例、便秘有3例。说明中药治疗围绝经期女性抑郁症的副作用较少,临床容易为患者所接受。结论:本研究结果显示采用中药二仙汤合柴胡加龙骨牡蛎汤治疗台湾地区围绝经期女性抑郁症病患有一定的疗效。中药治疗对于改善潮热汗出、感觉异常疗效显着,明显优于西药治疗,而且对于烦躁不安、胸胁满闷症状改善较快速。此外,二仙汤合柴胡加龙骨牡蛎汤治疗时间愈长,愈能改善食欲减少及胸胁满闷症状,而逐渐显示出本合方疏肝理气的优势。本研究以二仙汤合柴胡加龙骨牡蛎汤加减的科学浓缩中药剂治疗,具有安全性佳、副作用少及使用方便等特点,因此本治疗方法值得临床推广。
[Abstract]:Objective: To observe the clinical efficacy of Erxian decoction combined with Chaihu plus Longgu Oyster Decoction in the treatment of perimenopausal women with depression, and compare it with fluoxetine to explore the efficacy, advantages and safety of Erxian decoction combined with Chaihu plus Longgu Oyster Decoction in the treatment of perimenopausal women with depression. From June 2015 to September 2016, 66 perimenopausal women with depression were selected from the outpatient department of Beishi Zhenxing Medical Group Hospital, including 34 cases in the treatment group and 32 cases in the control group. Results: After 1.8 weeks of treatment, the total effective rate of HAMD in the treatment group was 82.4%, of which 5 cases were cured (14.7%). There were 14 cases (41.2%) of progress, 9 cases (26.5%) of progress and 6 cases (17.6%) of ineffectiveness. The total effective rate was 84.4% in the control group, of which 5 cases (15.6%) were cured, 14 cases (43.8%) were markedly improved, 8 cases (25.0%) were improved, and 5 cases (15.6%) were ineffective. The total effective rate was 82.4%(26.5%), 19(55.9%) and 6 (17.6%) respectively. The total effective rate was 81.2% in the control group, 8 (25.0%) and 18 (5.5%) in the treatment group. 6.2% and 6 cases (18.8%) were ineffective. There was no significant difference in the curative effect between the treatment group and the control group (p0.05). Chinese medicine treatment group in the mood depression, hot flashes sweating, feeling abnormal, restlessness, silence, dizziness, fatigue, palpitations, chest and flank tightness, abdominal distention, insomnia, dreams, loss of appetite, limb soreness, irregular stool and other Chinese medicine symptoms, can gradually be improved (p0.05). Western medicine control group can improve mood depression, restlessness, silence. Not to mention, dizziness, fatigue, palpitations, chest and flank full of tightness, abdominal distention, insomnia, more dreams, loss of appetite, limb pain, incoordination of stool and other symptoms of traditional Chinese medicine (p0.05), but for hot flashes sweating and sensory abnormalities were not obvious effect (p0.05). 4. After 8 weeks of treatment between the two groups after the comparison of clinical symptoms, treatment group in hot flashes sweating, feeling There was no significant difference in the improvement of other symptoms between the two groups (p0.05). It showed that the improvement of the symptoms of hot flashes, sweating, abnormal sensation, chest and throat fullness and loss of appetite in the treatment group was better than that in the control group. Treatment. 5. Comparing the side effects between the two groups, there were 6 cases in the treatment group, including 3 cases of nausea and 3 cases of mild diarrhea. In the control group, there were 21 side effects, including 4 cases of dry mouth, 3 cases of insomnia, 3 cases of nausea, 2 cases of anxiety, 2 cases of fatigue, 3 cases of dizziness, 1 case of headache and 3 cases of constipation. Conclusion: Erxian Decoction combined with Chaihu and Longgu Oyster Decoction is effective in the treatment of perimenopausal female depressive disorders in Taiwan. The treatment of traditional Chinese medicine has a significant effect on improving hot flashes and sweating, and is superior to Western medicine. In addition, Erxian Decoction combined with Chaihu plus Longgu Oyster Decoction can improve the symptoms of loss of appetite and fullness of chest and hypochondriac, and gradually shows the advantages of this prescription in soothing the liver and regulating qi. Because of its good safety, fewer side effects and convenient use, the treatment is worthy of clinical promotion.
【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R277.7

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