【作者】 纪长青；

【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】 目的本课题通过设立中药复方治疗组和西药对照组,采用简式健康表BSRS和汉密尔顿抑郁量表(HAMD)观察治疗前后抑郁症患者评分变化,从而判定临床疗效,为治疗抑郁症提供一种安全可靠的治疗方法。方法按照西医抑郁症诊断标准,以及中医证型辨证标准,在台湾中医诊所门诊收集病例,纳入年龄在18-65岁之间的患者60例,随机分为两组,每组各30例,治疗组(自拟补肾疏肝方：熟地、淫羊霍、醋香附、杜仲各25g,合欢花、柴胡、郁金、补骨脂各20g,石菖蒲、山萸肉、炒栀子、青皮、佛手、枇杷叶、陈皮各15g),对照组(氟西汀)。治疗组每次一剂、对照组每次用药9g,早晚各一次。六周为一疗程。采用中医症候量化评分,并结合HAMD量表对两种方法治疗抑郁症进行临床观察。结果经过治疗后,治疗组临床痊愈率为50.0%,显效率为33.3%,对照组临床痊愈率为23.3%,显效率为33.3%。治疗组与对照组的中医证候疗效总有效率分别为96.7%和83.3%,两组总有效率比较,治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。两组中医证候疗效等级比较(P<0.05),差异有显著性意义,治疗组疗效优于对照组。治疗后两组中医证候分值比较,治疗组优于对照组(P<0.05)。两组治疗后HAMD分值比较,差异有显著性意义,治疗组疗效优于对照组(P<0.05)。两组治疗后BSRS分值比较,差异有显著性意义,治疗组疗效优于对照组(P<0.05)。两组治疗后精神抑郁、情绪不宁情况改善程度比较,差异有显著性意义(P<0.05)。说明治疗组的疗效比对照组好。两组治疗后心烦易怒、善太息、嗳气、腹胀情况改善程度比较,差异无显著性意义(P>0.05)。说明两组的治疗方法对以上证候的疗效相当。治疗后腰酸背痛症状及体征等消失率比较,差异有显著性意义(P<0.05)。治疗后胸胁胀痛、足萎无力、耳鸣如蝉、小便频数等症状及体征等消失率比较,差异无显著性意义(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。结论自拟补肾疏肝方治疗抑郁症患者中医证候疗效比氟西汀好。自拟补肾疏肝方缓解患者精神抑郁、情绪不宁、腰酸背痛等证候比氟西汀好。更多还原

【Abstract】 ObjectiveThis randomized controlled clinical trial intends to discuss the establishment of Chinese herbal treatment group and control group, using Jane type health table Hamilton depression scale (BSRS and observed before and after treatment HAMD) depression score changes, thus determine clinical curative effect, for the treatment of depression provides a reliable efficacy analysis basis.MethodsResearch objects are patients who were diagnosed as depression and it’s safe in clinical application. According to western medicine depression diagnosis standard, and TCM syndrome differentiation standard, in Taiwan of TCM clinic, into the outpatient collect 60 cases aged between 18 and 65, patients were randomly divided into two groups and each group each 30 cases, the treatment group (herbal) since fitting JieYu party, the control group in treatment group and control group, each 9g, each drug in the morning and again. Six weeks for one period of treatment. TCM symptoms by quantitative grading, and combining the two methods HAMD scale clinical observation treatment of depression.ResultsAfter treatment, the treatment group and control group of TCM syndrome curative effect of total effective 93.33% and 83.33% respectively, 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. After treatment, the two groups score syndromes, the treatment group than in control group compared. Two groups HAMD score after treatment compared greup significance, the curative effect of treatment group was better than control. The two groups after treating score BSRS comparison, greup significance, the curative effect of treatment group was better than control. The two groups after treating depression, mood restless conditions improve degree comparison, significant difference (P<0.05). Explain the curative effect of the treatment group than the control group. The two groups after treating upset irritability, good TaiXi, gas, abdominal distension conditions improve degree comparison, no statistically significant difference between the significance (P>0.05). Explain two groups in treatment of Shanghai wait of curative effect quite. After treatment, the waist sour backache symptoms and signs disappeared rate quite greup significance. After treatment, stalking, flatulence, foot withering chest unable, tinnitus such as cicadas, urinate frequency etc symptoms and signs disappeared rate quite, no statistically significant difference between the significance. 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.ConclusionSince Bushenshuganfa depression to the treatment of TCM syndrome than fluoxetine good curative effect. Since BushenshuganFa ease to patients with depression, mood restless, waist sour backache etc syndrome than fluoxetine good.更多还原