蠲郁颗粒治疗肝郁痰阻型郁证的临床观察

发布时间：2018-11-11 10:01

【摘要】：目的:采用随机对照的方法,验证蠲郁颗粒治疗肝郁痰阻型郁症临床疗效,通过探讨蠲郁颗粒治疗肝郁痰阻型郁症的有效性,从理论和临床两个方面系统分析蠲郁颗粒治疗肝郁痰阻型郁症的理论基点。方法:选取长春中医药大学附属医院中西医结合睡眠中心门诊就诊,符合课题研究纳入标准的肝郁痰阻型郁症患者作为观察对象,将72例患者随机分为治疗组(蠲郁颗粒组)36例与对照组(盐酸氟西汀组)36例;在研究过程中治疗组与对照组各有1例未按本方案服用药物,剔除病例,未列入统计结果。最终将符合肝郁痰阻型郁症患者70例列入统计。两组分别给予蠲郁颗粒和盐酸氟西汀口服治疗,蠲郁颗粒按中药口服方法,每袋10g,每次1袋,每日早晚2次口服;盐酸氟西汀1片(20mg),晨起口服,每日1次,14天为1疗程,共4疗程。疗程结束后,进行疗效观察,采用SPSS19.0统计软件对治疗前后蠲郁颗粒组和盐酸氟西汀组两组患者进行治疗前后的数据统计。结果:治疗前通过对病例的性别、年龄、病程进行比较,两组具有可比性(P均0.05),治疗4个疗程后,两组治疗后临床疗效分析、中医证候疗效、HAMDL抑郁量表评分及SDS自评量表评分比较,经统计处理,P0.05,说明治疗组疗效优于对照组。治疗组同对照组治疗前后中医证候积分比较有显著统计学意义(P0.01)。治疗后治疗组与对照组在中医症候积分比较,P0.05,有差异。说明两组均能改善肝郁痰阻型郁症患者的症状,但应用中药蠲郁颗粒组治疗更优,并未见到不良反应。本项研究证实了蠲郁颗粒在改善肝郁痰阻型郁症方面疗效显著。结论:中药蠲郁颗粒能明显改善HAMD总评分,并能够改善患者情绪低落、活动能力减退、思维与认知功能迟缓等症状,同时中药治疗组能明显对患者情绪低落、反应迟钝、口中黏腻、咽堵、腹胀等症状具有明显改善作用。
[Abstract]:Objective: to verify the clinical efficacy of Juanyu granule in the treatment of liver stagnation and phlegm blocking depression, and to explore the effectiveness of Juanyu granule in treating liver depression and phlegm blocking depression. The theoretical basis of Juanyu granule in the treatment of stagnation of liver stagnation phlegm and phlegm was analyzed theoretically and clinically. Methods: the patients with liver depression and phlegm obstruction were selected from the clinic of sleep center of integrated traditional Chinese and western medicine in Changchun University of traditional Chinese Medicine (Changchun University of traditional Chinese Medicine). 72 patients were randomly divided into treatment group (Juanyu granule group) 36 cases and control group (fluoxetine hydrochloride group) 36 cases; In the course of the study, one case in the treatment group and one case in the control group did not take the drug according to this scheme, but the cases were excluded and not included in the statistical results. Finally, 70 patients with stagnation of liver and phlegm were included in the statistics. The two groups were treated with Juanyu granules and fluoxetine Hydrochloride orally respectively. Juanyu granules were taken orally according to the traditional Chinese medicine method, 1 bag per bag, 2 times a day in the morning and evening. Fluoxetine hydrochloride (20mg) tablet was taken orally once a day, 14 days as a course of treatment for 4 courses. After the course of treatment, the curative effect was observed, and the data of Juanyu granule group and fluoxetine hydrochloride group before and after treatment were analyzed by SPSS19.0 software. Results: by comparing the sex, age and course of disease of the cases before treatment, the two groups were comparable (P 0.05). After 4 courses of treatment, the clinical effect of the two groups was analyzed, and the curative effect of TCM syndrome was analyzed. The scores of HAMDL depression scale and SDS self-rating scale were compared, the results showed that the therapeutic effect of the treatment group was better than that of the control group (P 0.05). The scores of TCM syndromes in treatment group and control group were significantly different before and after treatment (P 0.01). After treatment, there was a difference between the treatment group and the control group in TCM symptom score (P0.05). The results showed that both groups could improve the symptoms of patients with stagnation of liver and phlegm, but the treatment of Juanyu granule was better than that of traditional Chinese medicine. This study confirms that Juanyu granule is effective in improving stagnation of liver and phlegm. Conclusion: Juanyu granule can obviously improve the total score of HAMD, and can improve the symptoms of depression, decreased activity, delayed thinking and cognitive function, etc. At the same time, the traditional Chinese medicine treatment group is obviously depressed and slow to respond to the patients. Sticky mouth, pharynx obstruction, abdominal distension and other symptoms have a significant improvement.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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