加味乌梅丸汤剂治疗围绝经期抑郁的临床观察

发布时间：2018-03-21 07:20

本文选题：乌梅丸　切入点：围绝经期抑郁　出处：《中国中医科学院》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的通过观察围绝经期抑郁患者服用加味乌梅丸汤剂后抑郁症状、围绝经期综合症状、中医症状及性激素水平的变化情况,与服用黛力新组对照,评价加味乌梅丸汤剂治疗围绝经期抑郁的疗效与优势。研究方法将54例围绝经期抑郁患者随机分为两组,其中治疗组30例,对照组24例。治疗组给予加味乌梅丸代煎汤剂,对照组给予黛力新,两组疗程均为1个月(30天)。观察两组患者的汉密尔顿抑郁量表(24项)(Hamilton Depression Scale,HAMD)、改良Kupperman Index(KI)评分、中医症状评分及女性激素包括雌二醇(Estradiol,E2)、促黄体生成素(Luteinizing Hormone,LH)、卵泡刺激素(Follicle-stimulating Sormone,FSH)的变化情况。研究结果1.通过计算HAMD评分减分率来评价两组药物对患者抑郁症状的改善程度,治疗1个月后治疗组与对照组HAMD评分均显著下降,与治疗前比较有显著性差异(P0.01)。治疗组加味乌梅丸汤剂治疗围绝经期抑郁的总有效率为96.67%,黛力新对照组的总有效率为75%,两组内治疗前、后比较亦具有显著性差异(P0.01)。说明两组药物均可以治疗围绝经期抑郁,而治疗组加味乌梅丸汤剂疗效优于对照组。2.分别对两组患者KI评分治疗前、后进行组间比较及本组内比较,结果均具有显著性差异(P0.01),治疗后两组KI评分均下降,治疗组评分下降程度较对照组明显。说明两组药物均可以改善围绝经期抑郁患者综合症状,而治疗组疗效优于对照组。3.分别对两组患者中医症状评分治疗前、后进行组间比较及本组内比较,结果均具有显著性差异(P0.01),两组治疗后中医症状评分均下降,治疗组评分下降程度较对照组明显。说明两组药物均可以降低中医症状评分,改善中医症状,而治疗组优于对照组。4.治疗组治疗后E2水平升高,FSH水平降低,与治疗前比较有统计学差异(P0.05),LH水平降低不明显(P0.05)。对照组治疗后E2水平升高,FSH、LH水平降低均不明显(P0.05)。说明治疗组药物可以改善性激素水平,升高E2,降低FSH,而对照组药物对性激素水平的调节作用不明显。5.治疗过程中两组均未发生不良反应。研究结论加味乌梅丸汤剂是治疗围绝经期抑郁的有效方剂,不仅可以减轻抑郁症状,而且可以改善围绝经期综合症状,调节性激素水平,提高患者的生活质量。
[Abstract]:Objective to observe the changes of depressive symptoms, syndromes, TCM symptoms and sex hormone levels in patients with peri-menopausal depression after taking Jiawei Wumei Pill decoction. Methods 54 patients with peri-menopausal depression were randomly divided into two groups: treatment group (n = 30) and control group (n = 24). The patients in the control group were given Delyxin for a course of 1 month and 30 days. 24 items of Hamilton Depression scale (Hamd) and modified Kupperman Index (KI) score were measured. The changes of TCM symptom scores and female hormones including estradiol Estradiolol E2H, luteinizing Hormoneine LHH, Follicle-stimulating hormone Follicle-stimulating hormone FSHs were evaluated by calculating the HAMD score reduction rate to evaluate the degree of improvement of depressive symptoms in the two groups. After one month of treatment, the HAMD scores of both the treatment group and the control group were significantly decreased. There was a significant difference between before treatment and before treatment. The total effective rate of modified Wumei Pill decoction in the treatment group was 96.67. The total effective rate in the Delixin control group was 75. Before the treatment, the total effective rate of the treatment group was 96.67. There was also a significant difference between the two groups in the treatment of peri-menopausal depression, and the therapeutic effect of modified Wumei Pill decoction in the treatment group was better than that in the control group .2.The Ki scores of the two groups were compared before and after the treatment. The results showed that there were significant differences between the two groups (P 0.01). After treatment, the KI scores of the two groups were all decreased, and the scores of the treatment group were significantly lower than those of the control group, which indicated that both drugs could improve the comprehensive symptoms of the patients with menopausal depression. The curative effect of the treatment group was better than that of the control group .3.The scores of TCM symptoms in the two groups were compared before and after the treatment. The results showed that there were significant differences between the two groups (P 0.01), and the scores of TCM symptoms in the two groups decreased after treatment. The decrease of scores in the treatment group was more obvious than that in the control group, which indicated that both the two groups could reduce the TCM symptom score and improve the TCM symptom, while the treatment group was superior to the control group .4.After treatment, the E2 level in the treatment group increased and the FSH level decreased. There was significant difference between the two groups before and after treatment. There was no significant decrease in the level of P0.05L in the control group, but no significant decrease in the level of FSH LH after treatment in the control group. The results showed that the treatment group could improve the level of sex hormone. Increase of E _ 2 and decrease of FSH, but the effect of control group on sex hormone level was not obvious. There were no adverse reactions in both groups. Conclusion Jiawei Wumei Pill decoction is an effective prescription for the treatment of peri-menopausal depression. It can not only alleviate the depression, but also improve the comprehensive symptoms of perimenopause, regulate the level of sex hormone, and improve the quality of life of the patients.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.116

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