针刺结合中药治疗肝气郁结型郁证临床研究

发布时间：2018-06-26 08:58

本文选题：抑郁症 + 郁证　；参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:观察针刺结合“逍遥汤加减”治疗肝气郁结型郁证的临床疗效。材料与方法:将符合入选标准的70例肝气郁结型郁证患者随机分为治疗组与对照组各35例。对照组35例(中药治疗),治法为疏肝解郁,理气调中。方药:以“逍遥汤加减”(当归、鸡血藤、川芎、白芍、郁金、茯苓各20g,牡蛎、石决明、珍珠母、龙骨各30g,陈皮、木香、柴胡、白术、香附各15,甘草10g)治疗,l剂/d,水煎400m L,早中晚口服。治疗组35例(针药治疗)针灸治疗取神庭、百会、膻中,率谷、太阳、内关、太冲、三阴交、安眠均双侧;喉中有梗加天突。针刺得气后,留针20min,l次/d;中药治疗同对照组。每组连续治疗10d为l疗程。连续治疗2疗程,判定两组临床疗效,比较两组治疗前后HAMD评分变化、中医症候疗效评分变化及治疗过程中的不良反应。治疗期间禁食刺激性食物,注意避免情绪波动。结果:1.HAMD评分判定总体疗效:治疗组总有效率97.14%,愈显率为82.86%,对照组总有效率为88.57%,愈显率为59.59%;中医症候疗效评分判定总体疗效:治疗组总有效率97.14%,愈显率为71.43%,对照组总有效率为91.43%,愈显率为48.57%。两种疗效判定方法下的数据均用秩和检验计算比较疗效,治疗组疗效均优于对照组(P0.05)。2.两组治疗前后自身比较HAMD评分变化、中医症候疗效变化,统计结果均P0.01,说明治疗组与对照组在郁证治疗上疗效肯定。3.治疗后组间比较HAMD评分、中医症候疗效评分变化,统计结果分别是P0.01和P0.05,即治疗组在改善郁证症状上也优于对照组。结论:1.针刺结合“逍遥汤加减”的治疗方法能明显改善肝气郁结型郁证患者的症状。2.针药结合治疗郁证在临床疗效、改善症状方面均优于单纯中药疗法。3.针药并举治疗肝气郁结型郁证,疗效满意,无严重不良反应,值得推广。
[Abstract]:Objective: to observe the clinical effect of acupuncture combined with Xiaoyao decoction on stagnation of liver-qi syndrome. Materials and methods: 70 patients with stagnation of liver qi were randomly divided into treatment group and control group. In the control group, 35 cases were treated with traditional Chinese medicine. Prescription: "Xiaoyao decoction" (Angelica sinensis, chicken blood vine, Ligusticum chuanxiong, Radix Paeoniae Alba, Tulip, Poria cocos, oyster, stone cassia, mother of pearl, keel each 30g, Chen Pei, Muxiang, Chaihu, Atractylodes macrocephala, Rhizoma Cyperus, 15 each, 10 g Glycyrrhiza (10 g) for 1 day, 400 mL decoction, early, middle and late oral. Treatment group 35 cases (acupuncture and medicine treatment) acupuncture and moxibustion treatment of Shenting, Baihui, Tanzhong, rate Valley, Sun, Neiguan, Taichong, Sanyinjiao, sleep are bilateral; After acupuncture to get qi, the needle was kept for 20 mins / d, and the control group was treated with traditional Chinese medicine. Each group was treated continuously for 10 days as a course of treatment. The clinical efficacy of the two groups was evaluated after two consecutive courses of treatment. The changes of Hamd score, TCM symptom score and adverse reactions were compared before and after treatment. During the treatment fasting stimulating food, pay attention to avoid emotional fluctuations. Results: the total effective rate was 97.14 in the treatment group, 82.86 in the treatment group, 88.57 in the control group and 59.59 in the control group; the total effective rate was 97.14 in the treatment group and 71.43 in the control group. The total effective rate was 91.43 and the effective rate was 48.57. The data of the two methods were calculated and compared by rank sum test. The curative effect of the treatment group was better than that of the control group (P0.05). 2. Before and after treatment, the changes of Hamd score and TCM syndromes were compared between the two groups (P 0.01), which indicated that the therapeutic effect of treatment group and control group on depression syndrome was positive. 3. After treatment, Hamd scores and TCM symptom scores were compared, the statistical results were P0.01 and P0.05 respectively, that is, the treatment group was also superior to the control group in improving the symptoms of depression. Conclusion 1. Acupuncture combined with Xiaoyao decoction can obviously improve the symptoms of patients with stagnation of liver-qi syndrome. Acupuncture combined with medicine in the treatment of depression in clinical efficacy, improve symptoms are better than simple Chinese medicine therapy. 3. 3. The treatment of stagnation of liver-qi syndrome with acupuncture and medicine has satisfactory curative effect and no serious adverse reaction, so it is worth popularizing.
【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】：R277.7

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