疏肝解郁化积法治疗恶性肿瘤相关性抑郁综合征临床研究

发布时间：2018-01-16 21:13

本文关键词：疏肝解郁化积法治疗恶性肿瘤相关性抑郁综合征临床研究　出处：《山东中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的以“疏肝解郁化积”为法,组方“疏肝解郁化积方”干预治疗恶性肿瘤相关性抑郁综合征,观察其临床疗效及对患者生活质量的影响,提高癌症患者生存质量。对中西医综合干预治疗恶性肿瘤相关性抑郁综合征提供更多方法。方法于2015年01月至2016年01月期间就诊于山东中医药大学东附属医院肿瘤科门诊的恶性肿瘤患者中,选取符合本研究纳入标准的60例患者,采用随机对照试验的方法,分为西药组:给予口服百优解20mg/日;中药组:给予“疏肝解郁化积方”,中药水煎服,日一剂;两组均持续6周治疗,于治疗前后采集临床数据。观察所有入组患者治疗效果差异。用SPSS19统计软件进行数据统计分析,统计数据以均数±标准差(x±s)表示。组间比较采用秩和检验,组内比较采用配对t检验,P0.05表示有统计学意义。结果1、西药组经治疗后总体有效率为56.67%,中药组总体有效率为63.33%。两组之间无统计学差异(P0.05)。2、治疗前后HAMD积分比较,经t检验,中药组与西药组治疗前后HAMD积分具有统计学意义(P0.05)。经t检验,两组之间对比,无统计学意义(P0.05)。表明两组在改善患者HAMD积分上,二者无显著差异。3、治疗前后SERS积分比较,经t检验,中药组治疗前后及两组之间SERS积分具有统计学意义(P0.05)。西药组治疗前后差异无统计学意义(P0.05)。表明中药组较西药组在治疗中具有较低的治疗副作用。4、治疗前QLQ-C30整体生活质量、症状量表、功能领域各维度得分与参考值比较显示提示恶性肿瘤相关性抑郁在各维度使患者生活质量不同程度的下降。中药组治疗前与治疗后比较,失眠、食欲减退、便秘、疼痛、恶心呕吐、疲乏及情绪功能领域数据有显著性差异(P0.05)。其他领域无显著性差异(P0.05)。见表6。西药组治疗前与治疗后比较,失眠、腹泻、恶心呕吐及情绪功能领域数据有显著性差异(P0.05)。其他领域无显著性差异(P0.05)。见表7。表明中药组治疗在改善患者症状,提高患者生活质量方面,优于西药组。并具有较低的副作用。结论中药组与西药组在治疗恶性肿瘤相关性抑郁综合征的总体临床疗效及改善HAMD积分上无明显差异;中药组在改善患者QLQ-C30积分上优于西药组,中药组较西药组在治疗中具有较低的治疗副作用。以“疏肝解郁化积”法组方能在一定程度上提高患者生活质量,降低治疗带来的副反应。为中医治疗肿瘤相关性抑郁综合征提供了新方法。值得进一步研究与推广。
[Abstract]:Objective to observe the clinical effect and quality of life of patients with malignant tumor-associated depression syndrome treated by "Shugan Jieyu Huazhi prescription". To improve the quality of life of cancer patients. To provide more methods for the treatment of malignant tumor-associated depression syndrome by comprehensive intervention of traditional Chinese and western medicine. Methods from January 2015 to January 2016, we visited Shandong traditional Chinese Medicine. Malignant tumor patients in the Department of Oncology, East affiliated Hospital of the University. Sixty patients who met the criteria of this study were selected and divided into western medicine group by randomized controlled trial. Traditional Chinese medicine group: "Shugan Jieyu Huazhi prescription", traditional Chinese medicine decoction of water, a daily dose; The two groups were treated for 6 weeks. The clinical data were collected before and after the treatment. The difference of treatment effect between all the patients was observed. The data were analyzed by SPSS19 software. The statistical data were expressed as mean 卤standard deviation x 卤s. Rank sum test was used for inter-group comparison and pairing t test (P0.05) was used for intra-group comparison. Results 1. The total effective rate was 56.67 in the western medicine group and 63.33 in the traditional Chinese medicine group. There was no statistical difference between the two groups (P0.05. 2). The HAMD score was compared before and after treatment. After t test, the HAMD score of Chinese medicine group and western medicine group was statistically significant before and after treatment (P 0.05). After t test, there was a comparison between the two groups. There was no significant difference between the two groups in improving the HAMD score of the patients. There was no significant difference between the two groups. The SERS scores were compared before and after treatment by t test. The SERS score of the Chinese medicine group before and after treatment and between the two groups was statistically significant (P 0.05), but there was no significant difference before and after treatment in the western medicine group (P 0.05). The results showed that the traditional Chinese medicine group had lower side effects than the western medicine group. Before treatment, QLQ-C30 overall quality of life, symptom scale. The scores of each dimension and reference value in the functional field showed that the quality of life of patients with malignant tumor-related depression decreased in different degrees in each dimension. Before and after treatment, insomnia and loss of appetite were found in the traditional Chinese medicine group. Constipation, pain, nausea and vomiting. There was significant difference in the data of fatigue and emotional function (P 0.05). There was no significant difference in other fields (P 0.05). See Table 6.Compared before and after treatment, insomnia and diarrhea in the western medicine group. There was significant difference in the data of nausea and vomiting and emotional function (P 0.05). There was no significant difference in other fields (P 0.05). See Table 7. Improve the quality of life of patients. Conclusion there is no significant difference between the Chinese medicine group and the western medicine group in the overall clinical efficacy and the improvement of HAMD score in the treatment of malignant tumor-associated depression syndrome. The Chinese medicine group was superior to the western medicine group in improving the QLQ-C30 score of the patients. The traditional Chinese medicine group has lower side effects than the western medicine group. To a certain extent, it can improve the quality of life of the patients. It provides a new method for the treatment of tumor-associated depression syndrome by traditional Chinese medicine. It is worthy of further study and promotion.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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