逍遥散治疗脑外伤后综合征临床研究

发布时间：2018-02-11 06:15

本文关键词： 逍遥散脑外伤后综合征躯体健康精神健康　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本课题通过在脑外伤后综合征(post traumatic brain syndrome,PTBS)患者中分别应用逍遥散联合常规西药治疗、单纯常规西药治疗两种方案,观察比较两种治疗方法对PTBS患者临床症状、躯体健康及精神健康的改善情况来研究逍遥散治疗PTBS的临床疗效。方法:在本次临床试验中共有60例PTBS患者既符合纳入标准又符合排除标准,将这60例患者随机地分为试验组和对照组,对照组30人,采取常规西药治疗,试验组30人,采取常规西药联合逍遥散。在患者治疗前后分别用Rivermead脑外伤后综合征症状问卷量表、健康状况调查问卷 SF-36(The Short Form-36Health Survey,SF-36)量表评估患者的临床症状及生活质量,围绕生活质量的躯体健康和精神健康两方面将该量表分为8个分量表进行统计分析。整个治疗周期为6周,通过比较两组患者的治疗前后Rivermead脑外伤后综合征症状问卷量表评分和SF-36评分来评价逍遥散在脑外伤综合征治疗中的作用。将所搜集的临床数据运用SPSS 20.0进行统计分析,显著性水平取α =0.05。结果:1.治疗6周后,根据Rivermead脑外伤后综合征症状问卷量表评分结果,两组患者症状评分等级经秩和检验(Mann-Whitney U检验)得P=0.0070.05,说明两组患者治疗后症状评分等级有统计学差异。有效率评价方面,试验组患者显效9例,有效18例,无效3例,总有效率90%;对照组患者显效2例,有效19例,无效9例,总有效率70%,两组总有效率差异经秩和检验(Mann-Whitney U检验)得P=0.0070.05,说明两组的总有效率差异有统计学意义。2.治疗6周后,根据健康状况调查问卷SF-36量表评分结果,试验组和对照组在躯体健康方面(PCS)经独立样本T检验得P=0.6620.05,差异无统计学意义;躯体健康所包含的分量表条目经秩和检验(Mann-Whitney U检验)得生理机能P=0.986㧐0.05,生理职能 P=0.4130.05,躯体疼痛 P=0.8940.05,总体健康 P=0.4260.05,以上四方面差异皆无统计学意义;相反,在精神健康(MCS)经独立样本T检验P=0.0010.05,差异有统计学意义;精神健康所包含的分量表条目生命活力经独立样本T验P=0.0440.05,精神健康所包含的其它分量表条目经秩和检验(Mann-Whitney U检验)得如下结果,社交功能P=0.0440.05,情感职能P=0.010.05,心理健康P=0.0340.05,以上四方面差异皆有统计学意义。结论:1.逍遥散在一定程度上可以缓解PTBS患者临床症状,和单纯西药治疗相比,联合应用逍遥散有增强临床治疗效果的作用。2.逍遥散有改善PTBS患者总体健康状况的作用,尤其表现在对精神心理健康方面的改善作用。3.PTBS患者精神心理健康方面的改善对临床症状的改善有一定的作用,临床中应重视对PTBS患者精神健康的治疗。
[Abstract]:Objective: to observe and compare the clinical symptoms of patients with post traumatic brain syndrome (PTBS) by using Xiaoyao Powder combined with routine western medicine and simple routine western medicine respectively. To study the clinical efficacy of Xiaoyao Powder in the treatment of PTBS methods: in this clinical trial, 60 patients with PTBS met both inclusion and exclusion criteria. The 60 patients were randomly divided into the experimental group and the control group. 30 patients in the control group were treated with conventional western medicine, and 30 patients in the experimental group were treated with routine western medicine combined with Xiaoyao Powder. The patients were treated with Rivermead's symptom questionnaire before and after treatment. The SF-36(The Short Form-36Health Survey (SF-36) scale was used to evaluate the clinical symptoms and quality of life (QOL) of the patients. The scale was divided into 8 subscales in terms of physical and mental health of QOL. The whole treatment period was 6 weeks. The effects of Xiaoyao Powder on the treatment of brain trauma syndrome were evaluated by comparing the scores of Rivermead and SF-36 before and after treatment. The collected clinical data were analyzed by SPSS 20.0. Results: 1. After 6 weeks of treatment, according to the scale of Rivermead posttraumatic syndrome questionnaire, The symptom score of the two groups was obtained by rank sum test (Mann-Whitney U test), indicating that there was statistical difference between the two groups after treatment. In the evaluation of effective rate, there were 9 cases of remarkable effect, 18 cases of effective effect and 3 cases of ineffectiveness in the trial group. The total effective rate was 90%; in the control group, there were 2 cases of remarkable effect, 19 cases of effective effect, 9 cases of ineffective, total effective rate of 70%, the difference of total effective rate of two groups was obtained by rank sum test (Mann-Whitney U test), indicating that the total effective rate of the two groups was significantly different after 6 weeks of treatment. According to the scores of SF-36 scale in the health status questionnaire, there was no significant difference between the test group and the control group in terms of physical health by independent sample T test (P < 0. 6620.05). The component table items contained in physical health were tested by rank sum test (Mann-Whitney U test). There was no significant difference in the above four aspects among the four aspects: physiological function (P < 0. 4130.05), somatic pain (P = 0. 8940.05), general health (P = 0. 4260.05), mental health (P = 0. 0010.05) and mental health (P = 0. 0010.05). The component table items contained in mental health were tested by independent sample T (P = 0.0440.05), and other subscale items included in mental health were tested by rank sum test (Mann-Whitney U test). Social function, affective function and mental health were all significantly different. Conclusion: Xiaoyao San can alleviate the clinical symptoms of patients with PTBS to a certain extent, compared with western medicine alone. The combined application of Xiaoyao Powder has the effect of enhancing the clinical therapeutic effect. 2. Xiaoyao Powder has the effect of improving the overall health status of patients with PTBS. Especially in the improvement of mental and mental health. 3. The improvement of mental and mental health has certain effect on the improvement of clinical symptoms. The treatment of mental health of patients with PTBS should be paid attention to in clinic.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.15

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