针刺结合保神汤治疗肝气郁结型抑郁症的临床观察

发布时间：2018-04-10 15:08

本文选题：肝气郁结 + 抑郁症　；参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:本课题采用随机对照设计的方法对针刺结合中药内服来治疗肝气郁结型抑郁症进行系统的研究与分析;全面对比针刺结合中药内服与单纯口服抗抑郁药物米氮平在疗效及副作用的差异。材料与方法:研究对象主要来源就诊于辽宁中医药大学附属医院脑病K2门诊的肝气郁结型的抑郁症患者,将60例患者用计算机随机化分组的方法分为治疗组即针药组和对照组即西药组。其中针药组采用针刺太冲、三阴交、百会、四神聪、膻中、印堂、神门、内关结合中药内服保神汤的方法,针刺每日1次,每周5次(周末休息),中药内服每日2次,连续治疗8周;西药组口服米氮平,30mg/日一次,连续服药8周。根据汉密尔顿抑郁量表和Asberg抗抑郁药物副作用量表对患者进行疗效和副作用评价。结果:1.HAMD评分:治疗8周后,针药组与西药组均能降低HAMD评分,组内进行比较,差异具有统计学意义(P0.05),表明两组治疗肝气郁结型抑郁症均有疗效;组间比较HAMD评分,差异无统计学意义(P0.05),表明两组的疗效相当。2.SERS评分:治疗8周后,两组比较SERS评分,差异具有统计学意义(P0.05),说明针刺结合中药内服治疗肝气郁结型抑郁症比口服西药米氮平治疗肝气郁结型抑郁症在减轻副作用方面更明显。3.有效率:针药组的总有效率为76.6%,西药组的总有效率为70.00%。两组临床疗效比较无统计学意义(P0.05),表明两组疗效相当。结论:1.针刺结合保神汤治疗肝气郁结型抑郁症疗效显著,对HAMD减分率影响明显。2.针刺结合保神汤治疗肝气郁结型抑郁症在HAMD减分率、总有效率方面与口服抗抑郁药物米氮平疗效相当。3.针刺结合保神汤治疗肝气郁结型抑郁症在减少SERS评分、减轻药物不良反应方面优于口服抗抑郁药物米氮平。
[Abstract]:Objective: to study and analyze the treatment of depression due to stagnation of liver-qi by acupuncture combined with traditional Chinese medicine.The efficacy and side effects of acupuncture combined with traditional Chinese medicine were compared with those of oral antidepressant metozapine alone.Materials and methods: the main subjects of the study came from the depressive patients with liver qi depression in the clinic of encephalopathy K2 affiliated to Liaoning University of traditional Chinese Medicine.60 patients were randomly divided into treatment group (acupuncture group) and control group (western medicine group).The acupuncture and medicine group was treated with acupuncture of Taichong, Sanyinjiao, Baihui, Sishencong, Tanzhong, Yintang, Shenmen and Neiguan combined with traditional Chinese medicine for internal administration of Baoshen decoction. Acupuncture was given once a day, 5 times a week (weekend break, traditional Chinese medicine, 2 times a day).In the western medicine group, 30 mg of metozapine was administered once a day for 8 weeks.According to Hamilton Depression scale and Asberg antidepressant side effect scale, the curative effect and side effect were evaluated.Results 1. Hamd score: after 8 weeks of treatment, both acupuncture and medicine group and western medicine group could reduce HAMD score, and the difference was statistically significant (P 0.05), which indicated that both groups had curative effect in treating depression of stagnation of liver-qi, and compared HAMD score between the two groups.There was no significant difference between the two groups (P 0.05), indicating that the efficacy of the two groups was equal. 2. SERS score: after 8 weeks of treatment, the SERS scores were compared between the two groups.The difference was statistically significant (P 0.05), indicating that acupuncture combined with traditional Chinese medicine in the treatment of depression of stagnation of liver-qi is more obvious than oral metozapine in the treatment of depression of stagnation of liver-qi.Effective rate: the total effective rate of acupuncture and medicine group was 76. 6, and the total effective rate of western medicine group was 70. 00kum.There was no significant difference in clinical efficacy between the two groups (P 0.05), indicating that the two groups had the same curative effect.Conclusion 1.Acupuncture combined with Baoshen decoction was effective in the treatment of depression with stagnation of liver-qi, and had a significant effect on HAMD score reduction rate.Acupuncture combined with Baoshen decoction in the treatment of depression of liver-qi stagnation in the HAMD score reduction rate, the total effective rate and oral antidepressant mirtazapine equivalent to the efficacy of .3.Acupuncture combined with Baoshen decoction in the treatment of depression of liver-qi depression was superior to oral antidepressant miazapine in reducing SERS score and alleviating adverse drug reactions.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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