调肝和中法治疗功能性消化不良餐后不适综合征的临床观察

发布时间：2018-06-02 13:48

本文选题：功能性消化不良 + 餐后不适综合征　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:通过运用导师自拟调肝和中汤治疗餐后不适综合征(PDS),观察其临床疗效和患者生活质量改善水平,为临床治疗PDS提供参考,并为推广调肝和中法的应用提供有力依据。方法:选择符合本研究纳入标准的60例PDS患者,随机分为两组。治疗组30例,采用自拟调肝和中汤治疗;对照组30例,采用莫沙必利片治疗。两组治疗4周,共一个疗程。治疗结束后,观察和记录中医证候总积分、各单项症状积分、HAMA/HAMD评分等在治疗前后的变化,收集数据并进行统计分析,得出结论。结果:1.中医证候疗效比较:治疗组总有效率93.33%,对照组总有效率70.00%。两组治疗后总有效率相比较,差异有统计学意义(P0.05),提示治疗组总体疗效优于对照组。2.中医证候总积分比较:治疗后,两组中医证候总积分均明显下降(P0.01),经组间比较提示治疗组的疗效优于对照组(P0.01)。3.主要症状疗效比较:治疗组治疗餐后饱胀、早饱的总有效率分别为90.48%、87.50%,对照组依次为52.63%、47.06%,两组比较差异有统计学意义(P0.05),提示治疗组餐后饱胀、早饱疗效优于对照组。4.各单项症状积分比较:治疗组各项症状积分经治疗后都有明显改善(P0.01);对照组除烧心反酸症状无明显改善外,其余各项症状较治疗前都有所好转(P0.01、P0.05)。各项症状对比来看,治疗组餐后饱胀、早饱、上腹痛、恶心嗳气、烧心反酸及便溏不爽的疗效明显优于对照组(P0.01、P0.05);而在饮食减少、两胁胀满、胸闷善太息等方面两组疗效无明显差异(P0.05)。5.HAMD/HAMD评分比较:两组各自评分与治疗前比较都明显降低(P0.01),治疗组评分改善更明显(P0.01)。结论:调肝和中法治疗PDS能够改善患者餐后饱胀、早饱等主要症状,对于恶心嗳气、便溏不爽等症状也有较好的疗效,同时能降低焦虑、抑郁评分,调节不良情绪,且无不良反应发生。调肝和中法治疗PDS能够获得良好的临床疗效。
[Abstract]:Objective: to observe the clinical efficacy and quality of life of patients with PDS by using tutors' self-made Tiaogan decoction to treat the patients with postprandial discomfort syndrome (PHS), and to provide reference for clinical treatment of PDS, and to provide a strong basis for popularizing the application of liver regulation and Chinese medicine. Methods: 60 patients with PDS were randomly divided into two groups. 30 cases in the treatment group were treated with self-made Tiaogan he Zhong decoction and 30 cases in the control group were treated with mosapride tablets. The two groups were treated for 4 weeks with a course of treatment. After treatment, observe and record the total integral of TCM syndrome, every single symptom integral and Hama / Hamd score before and after treatment, collect data and make statistical analysis, and draw a conclusion. The result is 1: 1. Comparison of TCM syndromes efficacy: the total effective rate of treatment group 93.33, control group total effective rate 70.005. After treatment, the total effective rate of the two groups was significantly higher than that of the control group (P 0.05), indicating that the overall curative effect of the treatment group was better than that of the control group. 2. Comparison of the total integral of TCM syndromes: after treatment, the total integral of TCM syndromes in the two groups decreased significantly (P 0.01). The comparison between the two groups indicated that the curative effect of the treatment group was better than that of the control group (P 0.01). 3. Comparison of the main symptoms: the total effective rate of the treatment group was 90.48 and the total effective rate of early satiety was 90.48 and that of the control group was 52.63 and 47.06 respectively. The difference between the two groups was statistically significant (P0.05), suggesting that the treatment group was better than the control group in terms of post-meal fullness and early satiety. Comparison of individual symptom scores: after treatment, the symptom scores in the treatment group were significantly improved (P 0.01), while in the control group, the symptoms of reflux acid in the heart were not obviously improved, and the other symptoms were improved compared with those before the treatment. Compared with the symptoms, the curative effect of the treatment group on fullness after meal, early satiety, upper abdominal pain, nausea and belching, resuscitation of heart, acid reflux and loose stools was obviously better than that of the control group (P0.01 / P0.05N), while in the diet reduction, the two sides were full, There was no significant difference in the curative effect between the two groups in terms of chest tightness, good relief, etc. There was no significant difference in the curative effect between the two groups. 5. The score of Hamd / Hamd in the two groups was significantly lower than that before treatment, and the score of the treatment group was improved more obviously than that of the control group (P 0.01). Conclusion: regulating liver and treating PDS with Chinese medicine can improve the main symptoms such as fullness and early satiety after meal, and can also have good effect on nausea, belching, loose stools and other symptoms. Meanwhile, it can reduce the scores of anxiety and depression, and regulate the bad mood. No adverse reactions occurred. Regulating liver and treating PDS with Chinese medicine can obtain good clinical effect.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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