半夏泻心汤化裁方对功能性消化不良患者内脏敏感性及心理影响的研究

发布时间：2017-12-31 21:12

本文关键词：半夏泻心汤化裁方对功能性消化不良患者内脏敏感性及心理影响的研究　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景及目的:功能性消化不良(Functional Dyspepsia,FD)是临床常见消化系统疾病,中医多将此病归属于"胃痞"、"胃脘痛"等范畴。目前的西医疗效缺乏特异性和可选择性,而中医药通过辨证论治基础上制定个性化诊疗方案,已经取得了很好的临床疗效,但目前中药的作用机制尚不明确,难以得到广泛认可。本研究旨在观察半夏泻心汤化裁方对于FD寒热错杂证患者内脏敏感性及心理状态的影响,探讨其可能存在的作用机制,使其疗效有据可循,进一步推广半夏泻心汤化裁方在治疗FD中的应用。研究方法:本研究采用随机对照试验方法进行研究,选取首都医科大学附属北京中医医院消化中心门诊2016年3月至2016年12月收治的功能性消化不良寒热错杂证患者70例作为研究对象,治疗组44例,对照组21例,失访5例。治疗组服用中药半夏泻心汤化裁方颗粒剂(清半夏10g、黄芩10g、黄连5g、煅瓦楞子30g、姜厚朴10g、党参15g、干姜10g、生甘草5g、炒神曲15g),1包配方颗粒/日,加水300ml混匀,平均分成两等份,早晚分服,约150ml/次,餐前服用。对照组予安慰剂治疗。服药7天为1疗程,共4疗程,观察周期28天。分别在治疗前、治疗14天、治疗28天对患者进行中医证候积分、西医症状积分的评定,在治疗前、后对患者水负荷试验、焦虑抑郁自评量表等观察指标进行观察与评价。比较两组及两组之间治疗前、后在各观察指标的差异。所有数据用SPSS 21.0软件进行统计。研究结果:剔除因失访而致脱落的病例5例,共完成临床观察病例数65例,其中治疗组44例,对照组21例。临床观察评价比较:1.内脏敏感性评价:治疗28天后,治疗组阈值饮水量显著高于治疗前(P0.05),对照组各项指标治疗前后无明显改善(P0.05),治疗组和对照组在水负荷各项指标上,差异无统计学意义(P0.05)。2.心理因素评价:治疗28天后,治疗组在焦虑、抑郁自评量表评分方面有显著改善(P0.05);对照组在焦虑抑郁自评量表评分上与治疗前比较差异同样均具有统计学差异(P0.05),但两组间差异无统计学意义(P0.05)。3.中医证候积分评价:治疗28天后,除了小便短黄外,治疗组其余中医证候较治疗前具有显著改善(P0.05)。对照组除了小便短黄及大便稀溏外,其余中医证候治疗前后比较均有所改善(P0.05),治疗组与对照组之间除了身重困倦、胸闷、小便短黄和大便稀溏等证候外,其余证候积分治疗前、后差异均具有统计学意义(P0.05)。4.西医症状积分评价:治疗28天,治疗组在西医各项症状较治疗具有显著改善(P0.05)。对照组除上腹烧灼感外,其余各项症状亦有改善(P0.05)。治疗组和对照组在西医各项症状积分上差异具有统计学意义(P0.05),治疗组西医症状整体评定各变量积分均显著低于对照组,即治疗组在西医症状整体评定各变量上均显著优于对照组。结论:半夏泻心汤化裁方能够改善FD寒热错杂证患者内脏敏感性及不良情绪。
[Abstract]:Background and objective: functional dyspepsia (FDD) is a common disease of digestive system. "stomachache" and other categories. The current Western medicine efficacy is lack of specificity and selectivity, and Chinese medicine through the dialectical treatment of the basis of personalized diagnosis and treatment program, has achieved a good clinical effect. However, the mechanism of traditional Chinese medicine is not clear, it is difficult to be widely recognized. The purpose of this study was to observe the effect of Banxia Xiexin decoction on visceral sensitivity and psychological state of patients with FD cold and heat disorder syndrome. To explore the possible mechanism of its action, so that its efficacy can be followed, and further promote the application of Banxiaxiexin decoction in the treatment of FD. Research methods: this study was conducted by a randomized controlled trial. From March 2016 to December 2016, 70 cases of functional dyspepsia with cold and heat disorder syndrome were selected. There were 44 cases in the treatment group, 21 cases in the control group and 5 cases in the control group. The treatment group was treated with Banxia Xiexin decoction (10g, Scutellaria 10g, Huanglian 5g, calcined corrugated 30g). Ginger magnolia 10g, Codonopsis lanceolata 15g, dried ginger 10g, raw liquorice 5g, fried Shenqu 15g / day, mixed with 300ml water, divided into two equal parts in the morning and evening. The control group was treated with placebo. The control group was treated with placebo for 7 days for a course of 4 courses. The observation period was 28 days. After 28 days of treatment, the patients were evaluated with TCM syndrome integral and western medicine symptom score. Before and after the treatment, the patients were tested with water load. Self-rating anxiety and depression scale and other observation indicators were observed and evaluated. The two groups and between the two groups before treatment. All the data were counted by SPSS 21.0 software. Results: 5 cases were excluded and 65 cases were observed. There were 44 cases in the treatment group and 21 cases in the control group. The clinical observation evaluation was compared with that in the control group. The evaluation of visceral sensitivity: after 28 days of treatment, the threshold drinking water in the treatment group was significantly higher than that in the pre-treatment group (P 0.05). In the control group, there was no significant improvement before and after treatment, the treatment group and the control group in each index of water load. Psychological factor evaluation: after 28 days of treatment, the scores of anxiety and depression in the treatment group were significantly improved (P 0.05). The scores of self-rating anxiety and depression in the control group were also significantly different from those before treatment (P 0.05). However, the difference between the two groups was not statistically significant (P 0.05). Evaluation of TCM syndrome score: after 28 days of treatment, except for short yellow urine. The other TCM syndromes in the treatment group were significantly improved than before treatment P0.05.The control group except short yellow urine and loose stool, the other TCM syndromes were improved before and after treatment (P0.05). Treatment group and control group between the body heavy sleepiness, chest tightness, short yellow urine and loose stool, and other symptoms before treatment. The later differences were statistically significant (P0.05N. 4). Evaluation of western medicine symptom score: treatment for 28 days. The symptoms of western medicine in the treatment group were significantly improved than that of the treatment P0.05.The control group except upper abdominal burning sensation. The other symptoms were also improved P0.050.The difference between the treatment group and the control group in the western medicine symptom score was statistically significant (P0.05). The integral scores of all variables in the treatment group were significantly lower than those in the control group. Conclusion: Banxia Xiexin decoction can improve visceral sensitivity and bad emotion of FD patients with cold and heat disorder syndrome.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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