【作者】 曾铭毅；

【导师】 林昌松；

【作者基本信息】 广州中医药大学 ， 中医临床基础， 2011， 博士

【摘要】 目的对于慢性疲劳综合征(CFS)这一尚无明确发病原因及有效治疗方案的疾病来讲,中医药治疗无疑是一值得继续深入探讨研究的途径,在减轻患者病情、提高生活质量的同时也为传统医学找到了新的发展方向,更进一步体现了传统医学的整体观和辨证论治的精髓,体现了中医在一些疾病治疗上的优越性。本研究将用中药复方治疗CFS,对其临床疗效及机理进行探讨。方法按照西医CFS诊断标准,以及中医证型辨证标准,在台湾中医门诊及病房收集病例,纳入年龄在18-50岁之间的患者60例,随机分为两组,每组各30例,治疗组(小建中汤),对照组(甘麦大枣汤),每日一剂,三周为一疗程。采用疲劳症候量化评分,并结合量表检查结果对两种方法治疗慢性疲劳进行临床观察。结果经过治疗后,治疗组与对照组的中医证候疗效总有效率分别为90.0%和76.67%,两组间中医证候总疗效等级分布差异有统计学意义(P<0.05)。两组中医证候疗效比较,差异有显著性意义,治疗组疗效优于对照组。治疗组与对照组的疲劳严重度量表分值分别由治疗前138.55+15.12和139.94±16.22下降到治疗后的79.11±14.53和96.62±17.76,两组治疗后组间差异和组内前后比较差异均有统计学意义(P<0.05)。治疗组与对照组的CFS临床症状积分分别由治疗前20.14±7.61和21.03±8.57下降到治疗后的5.18±2.03和8.76±2.44,两组治疗后组间差异和组内前后比较差异均有统计学意义(P<0.05)。治疗后生存质量分析,两组生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、活力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)和健康变化(HT)情况比较,差异有显著性意义。试验组生存质量高于对照组。两组治疗后神疲懒言、失眠多梦、心悸等变化情况比较,差异无统计学意义(P>0.05)。两组治疗后体倦乏力变化情况比较,差异有统计学意义(P<0.05)。治疗后脘闷症状及体征等消失率比较,差异有显著性意义(P<0.05)。治疗后便溏、面色萎黄、头晕眼花症状及体征等消失率比较,差异均无显著性意义(P>0.05)。安全性检测表明,治疗前血、尿、大便常规、肝肾功能、心电图正常者,治疗后未见异常改变,表明该药临床应用安全。结论运用小建中汤治疗慢性疲劳综合征,疗效明显优于甘麦大枣汤。更多还原

【Abstract】 ObjectiveThis randomized controlled clinical trial intends to discuss the clinical application of Chronic Fatigue Syndrome(CFS). For chronic fatigue syndrome (CFS) this is unclear etiology and effective treatment of disease speaking, TCM therapy is undoubtedly a worthy of further research approach, in alleviating symptoms in patients, improving the quality of life for the traditional medicine also found a new development direction, further embodies the overall concept of traditional medicine and TDS, embodies the essence of traditional Chinese medicine in the treatment of disease in some advantages. This study will use herbal treatment, the clinical efficacy of CFS, and its mechanism are discussed.MethodsResearch objects are patients who were diagnosed as Chronic Fatigue Syndrome and it’s safe in clinical application. According to western medicine diagnosis standards and CFS TCM syndrome differentiation standard, in Taiwan of TCM clinic and ward collect cases aged 18-, into the patients aged between 50 to 60 cases were randomly divided into two groups and each group each 30 cases, the treatment group (XiaoJian reduced), the control group in tonga (Ian m jujube soup), daily a dose, three weeks for one period of treatment. Adopt fatigue symptoms, and combining the quantitative rating of two kinds of examination results, questionnaire method for treatment of chronic fatigue clinical observation.ResultsAfter treatment, the treatment group and control group after the total effective rate of TCM syndrome curative effect respectively,76.67% 90.0% and between the two groups total curative effect of TCM syndrome was statistically significant level distribution difference (P<0.05). Two groups of traditional Chinese medical syndrome curative effect comparison, greup significance, the curative effect of treatment group was better than control.The fatigue of the treatment group and control group by treatment respectively severcty scale scores before 15.12 and 139.94+138.55+16.22 descend to therapy 96.62 14.53 and 79.11+17.76, plus or minus two groups after treating between-group differences and groups are before-and-after differences within the statistical significance (P<0.05).The treatment group and control group by clinical symptoms of CFS respectively 20.14 before treatment points 7.61 and 21.03+8.57 hospital after treatment dropped to 5.18+2.03 and stated, two groups of plus or minus 2.44 after treatment between-group differences and groups are before-and-after differences within the statistical significance (P<0.05).After treatment, two groups living quality analysis physiological function (PF), physiological functions (RP), and physical pain (BP), overall health (GH), energy (VT), social function (SF), emotional functions (RE), mental health (MH) and health changes (HT) compare greup significance. 4.75%more than control quality of life.The two groups after treating lazy to talk, god exhausting insomnia changes, palpitations, etc, difference compared not statistically significant (P> 0.05).The two groups after treating body changes, tired weak comparative difference was statistically significant (P<0.05).After treatment, the wan stuffy symptoms and signs disappeared rate quite significant difference (P<0.05).After treatment, loose stools, complexion is yellow, lightheaded symptoms and signs disappeared rate quite, there are no significant differences in significance (P>0.05).Safety test indicated, before treatment stool blood and urine and kidney function, electrocardiogram routine and normal, not seen after treatment, abnormal changes that the drug clinical application security.ConclusionUse of Xiaojian decoction to chronic fatigue syndrome, efficacy is obvious better than Ian m jujube soup.更多还原