大承气汤肠疗治疗躁狂症（阳明腑实证）的临床观察

发布时间：2018-12-07 19:47

【摘要】：躁狂症是以情绪过分活动、高涨为主的一种情感性精神障碍疾病。中医中并无躁狂症之病名,但根据其症状可以归到“狂证”范畴。本文从现代医学和中医学两方面论述阳明腑实之躁狂症的病因病机、治法及研究进展。并通过临床观察来总结大承气汤肠疗治疗阳明腑实之躁狂症的疗效,为今后中医治疗躁狂症提供了一种安全有效的治疗方法,同时也为以后研究躁狂症的病因病机及治疗方向奠定了一定的理论基础。目的:观察大承气汤肠疗治疗阳明腑实之躁狂症的临床效果,揭示大承气汤肠疗治疗阳明腑实之躁狂症的临床意义和优点,为进一步研究中医治疗狂躁症寻求一条新的途径。方法:本研究课题把60例符合中医和西医诊断标准的阳明腑实之躁狂症患者随机分为治疗组30例和对照组30例。其中治疗组给予大承气汤肠疗,对照组给予碳酸锂口服治疗,治疗时间为14天。两组患者经治疗后分别观察精神症状并给予BRMS评分,比较两组的差异从而总结治疗前后疗效。结果:(1)疾病疗效的比较:治疗组总有效率为86.67%,对照组总有效率为63.33%,差异具有统计学意义(P0.05)。(2)治疗后BRMS比较:治疗后治疗组的BRMS分值与对照组的BMRS分值相对比,差异具有统计学意义(P0.05)。结论:大承气汤肠疗治疗躁狂症患者优于碳酸锂。一方面大承气汤具有通腑泻热、荡涤胃肠、活血行滞、推陈致新的功效,另一方面由于直肠粘膜上有很丰富的血液循环,吸收能力强,当通过肠疗给药时药物不仅能被充分吸收,而且不经过肝脏和胃,直接进入血液循环,减少对肝脏的损害,同时也减少了胃酸对药物的影响。大承气汤肠疗治疗躁狂症的临床疗效肯定,值得医学者对其更深一步探讨研究。
[Abstract]:Mania is a kind of affective disorder with emotional overactivity and upsurge. There is no name for mania in Chinese medicine, but according to its symptoms can be classified as "mad syndrome" category. This paper discusses the etiology, pathogenesis, treatment methods and research progress of mania in Yangmingfushi from two aspects of modern medicine and traditional Chinese medicine. And through clinical observation to summarize the therapeutic effect of Dachengqi decoction on mania of Yangmingfu, which provides a safe and effective method for the treatment of mania in Chinese medicine in the future. It also lays a theoretical foundation for the study of the etiology, pathogenesis and treatment direction of mania. Objective: to observe the clinical effect of Dachengqi decoction (Dacheng Qi decoction) on treating mania of Yangming Fu and solid. To reveal the clinical significance and advantages of Dachengqi decoction for treating mania of Yangmingfu-shenshi, and to seek a new way for further study on the treatment of mania by traditional Chinese medicine (TCM). Methods: 60 patients with mania of Yangmingfu were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Dachengqi decoction and the control group was treated with lithium carbonate orally for 14 days. After treatment, the patients in the two groups were observed their mental symptoms and BRMS scores, and the differences between the two groups were compared to sum up the curative effect before and after treatment. Results: (1) comparison of the curative effect of disease: the total effective rate of the treatment group was 86.67 and the total effective rate of the control group was 63.33. The difference was statistically significant (P0.05). (2) after the treatment of BRMS comparison: the treatment group BRMS scores compared with the control group BMRS score, the difference was statistically significant (P0.05). Conclusion: Dachengqi decoction is superior to lithium carbonate in the treatment of mania. On the one hand, Dachengqi decoction has the effect of relieving heat, purging stomach and intestine, activating blood circulation, pushing Chen Zhixin, on the other hand, because of the abundant blood circulation on the rectal mucosa, it has a strong absorptive capacity. When administered by intestinal therapy, the drug can not only be fully absorbed, but also directly enter the blood circulation without going through the liver and stomach, thus reducing the damage to the liver and the influence of gastric acid on the drug. The clinical effect of Dachengqi decoction on mania is confirmed, which is worthy of further study.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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