柔肝醒脾汤加减治疗功能性消化不良伴焦虑抑郁状态的临床疗效观察

发布时间：2018-06-18 20:31

本文选题：功能性消化不良 + 柔肝醒脾汤　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：本课题运用自拟柔肝醒脾汤(炒白芍30g；柴胡、党参、炒白术、茯苓、茯神、陈皮、焦山楂、神曲、炒枳壳、郁金各10g；砂仁后下5g；合欢花后下20g；炙甘草6g)联合西药雷贝拉唑钠肠溶胶囊、枸橼酸莫沙必利片、氟哌噻吨美利曲辛片治疗功能性消化不良(FD).伴焦虑抑郁状态,观察临床疗效及增效降低临床复发率的作用,为临床探索该病提供新思路新方法。方法：选取2014年1月至2015年6月期间于泰州市中医院门诊就诊和住院治疗的肝郁脾虚型FD伴焦虑抑郁状态的患者95例,用简单随机分组的方法,中药+西药的治疗组为50例,单纯西药治疗对照组45例。对照组予雷贝拉唑钠肠溶胶囊20mg,每日1次,早饭前口服；枸橼酸莫沙必利片5mg,每日3次,每次饭前口服；氟哌噻吨美利曲辛片1片,每日两片、早中各一片。治疗组在对照组的基础上,加用柔肝醒脾汤为基础方加味,中药汤剂均由本院中药房提供,统一机煎,每日2次,每次1袋,200ml/袋。总疗程为4周,疗程结束后随访3个月,观察两组患者治疗前后中医症状、HAMA、HAMD评分变化及复发率情况。结果：1、中医症候疗效：治疗组总有效率94%,对照组总有效率77.8%,提示治疗组总疗效率高于对照组(P0.05)。两组患者治疗后中医症状总积分有显著统计学意义(P0.05)。而中医症状单项积分中,治疗组在改善胃脘胀满、饮食减少、胃脘疼痛、嗳气反酸、神疲乏力、便溏不爽方面明显优于对照组(P0.01),在改善烦躁易怒、失眠多梦方面优于对照组(P0.05)。2、HAMA和HAMD评分比较：治疗后两组比较治疗组HAMD评分和HAMA评分均显著低于对照组,提示治疗组优于对照组。3、复发率比较：治疗组复发率为10.6%,对照组复发率为37.1%,结果提示对照组复发率明显高于对照组,差异有显著统计学意义(P0.005)。结论：柔肝醒脾汤加减联合治疗FD伴焦虑抑郁,治疗组总有效率明显高于单纯西药对照组,有效改善或消除了患者中医临床症状,明显降低HAMA和HAMD的评分,有效改善患者的精神状态,提高了其生活质量,且复发率明显低于对照单纯西药组,充分说明了本方案疗效确切,且安全可靠,具有良好的临床应用前景。
[Abstract]:Objective: to study the application of Rugan Xingpi decoction (stir-fried white peony 30g; Radix Bupleurum, Codonopsis pilosula, stir-fried Atractylodes macrocephala, Poria cocos, Fu Shen, Chen Pei, Jiaohaw, Dianqu, fried Fructus aurantii, Tujin 10g each; Radix Glycyrrhizae (6 g) combined with Rabeprazole sodium enteric-coated capsule, mosapride citrate tablet and droperazothioate melitaxine tablet in the treatment of functional dyspepsia (FDN). In order to provide a new method for clinical exploration of the disease, the clinical efficacy and synergism were observed in order to reduce the clinical recurrence rate in patients with anxiety and depression. Methods: from January 2014 to June 2015, 95 cases of FD with anxiety and depression of liver depression and spleen deficiency were selected from outpatient and inpatients of Taizhou Hospital of traditional Chinese Medicine, and 50 cases were treated with traditional Chinese medicine and western medicine. There were 45 cases in the control group treated with western medicine alone. The control group was given rabeprazole enteric capsule 20mg once a day before breakfast; mosapride citrate tablet 5mg 3 times a day before meals; droperazol titration metroxine one tablet two times a day and one tablet in the morning and one in the middle of the day. On the basis of the control group, the treatment group was treated with Rugan Xingpi decoction as the basic prescription, and the traditional Chinese medicine decoction was provided by the pharmacy of our hospital. The total course of treatment was 4 weeks, followed up for 3 months after the end of the course of treatment, to observe the changes of Hamah Hamd score and the recurrence rate of the two groups before and after treatment. Results: the total effective rate of the treatment group was 945.The total effective rate of the control group was 77.8%, which indicated that the total effective rate of the treatment group was higher than that of the control group (P 0.05). After treatment, the total score of TCM symptoms in the two groups was significantly higher than that in the control group (P 0.05). In the single score of TCM symptoms, the treatment group was significantly better than the control group in improving stomachache, diet reduction, epigastric pain, belching and acid regurgitation, fatigue, loose stools, and improving irritability and irritability. The scores of Hamd and Hama in the treatment group were significantly lower than those in the control group after treatment, and the scores of Hamd and Hamd in the treatment group were significantly lower than those in the control group, and the scores of Hamd and Hama in the treatment group were significantly lower than those in the control group. The results showed that the recurrence rate of the treatment group was significantly higher than that of the control group (P 0.005), the recurrence rate of the treatment group was 10.6, and that of the control group was 37.1.The results showed that the recurrence rate of the treatment group was significantly higher than that of the control group. Conclusion: the total effective rate of the treatment group is significantly higher than that of the control group, which can effectively improve or eliminate the clinical symptoms of TCM and decrease the scores of Hama and Hamd. The patients' mental state and quality of life were improved effectively, and the recurrence rate was obviously lower than that in the control group, which fully showed that the therapeutic effect of this scheme was accurate, safe and reliable, and had a good prospect of clinical application.
【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】：2016
【分类号】：R259;R277.7

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