河车路长盒灸法治疗脆性糖尿病脾肾阳虚型抑郁症临床研究

发布时间：2018-07-05 02:25

本文选题：河车路 + 长盒灸法　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：采用四川省中医院著名中医大家李仲愚先生的河车路理论,结合长盒灸法,以河车路(大椎至长强之间)长盒灸法为治疗方案治疗脆性糖尿病后抑郁症脾肾阳虚型,比较其与口服百忧解(盐酸氟西汀胶囊)临床治疗的疗效差异,筛选治疗脆性糖尿病后抑郁症的优势方案,为推广温阳灸法、河车路理论的临床运用提供客观试验依据。方法：把符合纳入标准的65例脆性糖尿病脾肾阳虚型抑郁症受试者随机分为试验组与对照组,经排除本次临床研究过程中脱落、剔除的病例后,治疗组最终完成31例,对照组最终完成30例。试验组采取河车路长盒灸法,每日1次,10次为1疗程,共计2个疗程。对照组采用口服百忧解,每日40mg,连续服用20天。观察两组治疗前、后汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)、中医证候量表的指标变化,比较两组之间的差异。结果：(1)基线比较：治疗前两组脆性糖尿病后抑郁症脾肾阳虚型受试者在年龄、性别、脆性糖尿病病程、抑郁症病程、中医证候量表评分、HAMD-17项评分、SDS评分比较,组间均衡(P0.05),具有可比性。(2)组间比较：治疗后两组脆性糖尿病后抑郁症脾肾阳虚型患者HAMD-17项评分、SDS评分组间对比,差异无统计学意义(P0.05)；治疗后两组中医证候量表评分组间对比,差异有统计学意义(P0.05)。(3)组内比较：治疗前、后两组脆性糖尿病后抑郁症脾肾阳虚型患者HAMD-17项评分、SDS评分、中医证候量表评分组内对比,差异均具有统计学意义(P0.05)。(4)总体疗效比较：治疗后根据疗效判定准则判定,治疗组共31人,痊愈0人,显效19人,有效8人,无效4人,总有效率86.70%；对照组30人,痊愈0人,显效14人,有效8人,无效8人,总效率73.21%,两组患者总有效率进行比较,差异无统计学意义(P0.05)。结论：(1)河车路长盒灸法在改善脆性糖尿病后抑郁症脾肾阳虚型患者中医临床症状上疗效较对照组更优,但HAMD-17项评分、SDS评分变化与对照组比较无明显差异。(2)河车路长盒灸法操作简便,安全有效,无毒副反应,值得临床推广运用。
[Abstract]:Objective: to adopt Mr. Li Zhongyu's theory of river car road of Sichuan traditional Chinese Medicine Hospital and combine long box moxibustion with long box moxibustion to treat the deficiency of spleen and kidney yang in depressive patients with brittle diabetes mellitus by using long box moxibustion between Dazhui and Changqiang. To compare the curative effect between Prozac hydrochloride and oral fluoxetine hydrochloride, to screen the superior scheme for treating depression after brittle diabetes, to provide the objective experimental basis for popularizing the moxibustion method of warming yang and the clinical application of the theory of river car road. Methods: 65 subjects of depressive patients with fragile diabetes mellitus with spleen and kidney yang deficiency were randomly divided into two groups: the experimental group and the control group. 31 cases in the treatment group were excluded from the clinical study and eliminated. In the control group, 30 cases were finally completed. The experimental group was treated with long box moxibustion, 10 times a day as a course of treatment, a total of 2 courses. The control group was treated with Prozac 40 mg daily for 20 days. The indexes of Hamilton Depression scale (Hamd), Self-rating Depression scale (SDS) and TCM Syndrome scale (TCM) were observed before and after treatment, and the differences between the two groups were compared. Results: (1) baseline comparison: before treatment, two groups of subjects of depression with deficiency of spleen and kidney yang were compared in age, sex, course of brittle diabetes, course of depression, score of TCM syndromes scale and SDS score. (2) comparison between the two groups: after treatment, there was no significant difference in HAMD-17 score and SDS score between the two groups of depression patients with spleen and kidney yang deficiency after treatment (P0.05); after treatment, the scores of TCM syndrome scale were compared between the two groups. The difference was statistically significant (P0.05). (3): before and after treatment, the scores of HAMD-17 items in depression patients with deficiency of spleen and kidney yang, and the scores of TCM syndromes were compared before and after treatment. The difference was statistically significant (P0.05). (4). According to the criteria of curative effect, there were 31 patients in the treatment group, 0 were cured, 19 were effective, 8 were effective, 4 were ineffective, the total effective rate was 86.70, while in the control group, 30 patients were cured. The total efficiency of the two groups was 73.21. There was no significant difference in the total effective rate between the two groups (P0.05). Conclusion: (1) the effect of long box moxibustion on improving the clinical symptoms of patients with spleen and kidney yang deficiency after brittle diabetes mellitus is better than that of the control group. But there was no significant difference in SDS score between HAMD-17 score and control group. (2) the long box moxibustion method on Heche Road was simple, safe and effective, and had no toxicity and side effects, so it was worth popularizing in clinic.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

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