自拟“郁解汤”治疗恶性肿瘤相关性抑郁的临床研究

发布时间：2018-04-21 09:05

本文选题：郁解汤 + 恶性肿瘤相关性抑郁　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:观察自拟“郁解汤”治疗恶性肿瘤相关性抑郁的临床疗效。方法:选择62例恶性肿瘤伴抑郁的患者,随机分成试验组(31例)和对照组(31例),试验组给予自拟“郁解汤”为主方的中医药辨证治疗,对照组给予常规的中医药辨证治疗(不含“郁解汤”中的药物)。每日一剂,2周为一疗程,共观察4个疗程。两组患者在治疗前、治疗2周、4周、6周、8周后均采用汉密尔顿抑郁量化表、自制“郁证”中医临床症状量化表进行量化评分。然后汇总资料进行统计学分析。结果:1.两组病例经治疗后抑郁评分均有所下降,试验组在治疗各阶段抑郁评分均较对照组明显下降(P0.05);试验组治疗后各阶段评分均较治疗前有明显下降(P0.05)。2.试验组药物总有效率为87%,对照组为77%,两组药物对恶性肿瘤相关性抑郁均有效,治疗2周后两组疗效相当(P0.05),其余治疗阶段试验组疗效较对照组更明显(P0.05)。3.试验组、对照组药物均能改善各因子评分,且试验组治疗结束后五个因子评分均较治疗前有明显改善(P0.05);试验组在改善焦虑/躯体化、认知障碍因子评分均较对照组有明显疗效(P0.05);试验组药物仅在治疗2周后显示出对体重因子评分改善的优势(P0.05),其余治疗阶段两组药物疗效相当(P0.05);两组药物对睡眠因子的改善无明显差异(P0.05);试验组药物仅在治疗6周后显示出对迟缓因子评分改善的优势(P0.05),其余治疗阶段两组药物疗效相当(P0.05)。4.试验组、对照组药物均能明显改善中医临床症状量化评分,试验组药物仅在治疗4周后显示出较对照组明显的优势(P0.05),其余治疗阶段两组药物疗效相当(P0.05);试验组经治疗后各阶段中医临床量化评分均较治疗前明显下降(P0.05)。5.试验组、对照组用药均能明显改善“郁证”,两者在治疗2周后疗效相当(P0.05),在其余治疗阶段试验组疗效较对照组显著(P0.05)。结论:自拟“郁解汤”为主方的中医药辨证治疗较常规的中医药辨证治疗能明显提高恶性肿瘤相关性抑郁的缓解率,能显著改善焦虑/躯体化、认知障碍因子评分,其作用机制有待进一步深入研究,以便造福更多恶性肿瘤患者,为恶性肿瘤相关性抑郁提供新的治疗方式。
[Abstract]:Objective: to observe the clinical effect of Yujie decoction on malignant tumor associated depression. Methods: 62 patients with malignant tumor with depression were randomly divided into two groups: the experimental group (n = 31) and the control group (n = 31). The control group was treated with traditional Chinese medicine syndrome differentiation (excluding Yujie decoction). A daily dose of 2 weeks as a course of treatment, a total of 4 courses of observation. Two groups of patients before treatment, 2 weeks after 4 weeks and 6 weeks to 8 weeks after the use of Hamilton depression quantitative table, self-made "depression syndrome" TCM clinical symptoms quantitative scale to quantify the score. Then summarize the data for statistical analysis. The result is 1: 1. After treatment, the depression scores of the two groups were all decreased, the depression scores of the experimental group were significantly lower than those of the control group, and the scores of each stage of the treatment group were significantly lower than those of the control group. The total effective rate of drugs in the trial group was 87 and that in the control group was 77. The two groups were all effective in the treatment of malignant tumor-related depression. After 2 weeks of treatment, the efficacy of the two groups was equivalent to that of P0.05, while that of the other treatment stage was more obvious than that of the control group. In the test group and control group, the scores of each factor were improved, and the scores of five factors after the treatment were significantly improved compared with those before treatment, and the anxiety / somatization was improved in the test group. The scores of cognitive impairment factors were significantly better than those of the control group (P 0.05), the drug of the test group only showed the advantage of improving the score of body mass factor after 2 weeks of treatment, and the other two groups had the same curative effect as that of the control group, and the two groups had the same effect on sleep cause. There was no significant difference between the two groups in the improvement of P0.05A, the drug in the test group showed the advantage of improving the score of retardation factor only after 6 weeks of treatment, and the curative effect of the other two groups was equivalent to that of P0.05. 4. Both the experimental group and the control group could significantly improve the quantitative score of TCM clinical symptoms. After 4 weeks of treatment, the drugs in the test group only showed obvious advantages over the control group, and in the other treatment stage, the curative effect of the two groups was similar to that of the control group, and the clinical quantitative score of TCM in each stage of the trial group was significantly lower than that of the control group before and after the treatment. In the experimental group and control group, the "depression syndrome" was obviously improved by medication. The curative effect of both groups was similar after 2 weeks of treatment, and the effect of the test group was significantly higher than that of the control group in the other stages of treatment. Conclusion: the traditional Chinese medicine dialectical treatment with "Yu Jie Tang" as the main prescription can obviously improve the remission rate of malignant tumor-related depression, improve anxiety / somatization, and improve the score of cognitive disorders. Its mechanism needs further study in order to benefit more patients with malignant tumors and provide a new treatment for malignant tumor-associated depression.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7;R273

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