疏肝化湿和胃法及心理治疗对新加坡功能性消化不良气滞湿阻证的疗效观察

【作者】 曹蓓；

【导师】 薛博瑜；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2009， 博士

【摘要】 目的:本研究以新加坡地区功能性消化不良病患为研究对象,观察以疏肝化湿和胃法为主、以自拟柴术消痞方配合EPT心理治疗对功能性消化不良(FD)气滞湿阻证的治疗效果。方法:将50例符合FD诊断标准的患者随机分为两组,治疗组以自拟柴术消痞方配合能量心理疗法(EPT心理疗法);对照组单纯服用柴术消痞方,疗程4周,治疗前后分别给予FD症状量表测评,并统计结果。结果:治疗组以柴术消痞方配合EPT心理治疗后,显效19例,有效3例,无效2例,总有效率91.67%;对照组服用柴术消痞方治疗后,显效6例,有效11例,无效5例,总有效率77.28%。两组间比较治疗组疗效明显优于对照组(P＜0.01),具有非常显著差异,说明柴术消痞方配合EPT心理治疗比单纯服用柴术消痞方疗效更具有优势。治疗组和对照组自身治疗前后总体疗效比较也有非常显著差异(P＜0.01),表明治疗组柴术消痞方配合EPT心理治疗和对照组柴术消痞方都对肝郁湿阻证FD症状有显著治疗意义。中医症状总积分比较,治疗组治疗前20.38±6.68分,治疗后6.75±3.77分,对照组治疗前19.2±6.7分,治疗后10.50±4.52分;单项症状比较,治疗组在脘痞胀满、情志抑郁、大便不爽3项症状改善上明显优于对照组(P＜0.01),在早饱、嗳气呃逆、口干口苦、善太息、食少纳差、脘痛、疲乏等项症状改善上两组间无显著差异(P＞0.05)。结论:以疏肝化湿和胃法拟定的柴术消痞方是治疗功能性消化不良气滞湿阻证的有效方剂,配合EPT心理治疗对于FD患者的康复意义重大,值得临床重视并广泛开展。更多还原

【Abstract】 AIM:The purpose of this study is to explore the therapeutic effect of Chinese herbal medicine insoothing the liver-qi, removing the dampness and regulating the stomach, and psychologicalefficacy for the treatment of Functional dyspepsia (FD) for Singaporeans, whom with theTCM syndrome of liver-qi stagnancy and dampness retention.METHODS:50 subjects, being randomized divided into two groups. The treatment group had beenrespectively taking herbal medicine, Chaizhu Xiaopi Decoction and integrated withpsychological treatment; whilst the control group just simply consuming herbal medicine,Chaizhu Xiaopi Decoction as an intervention for 4 weeks. All the subjects, before and aftertreatment, were examined with FD symptoms scale.RESULTS:In treatment group, there were 19 significantly improved, 3 effective and 2 cases had noimprovement, the total effective rate of the treatment group were 91.67%; whilst in thecontrol group, there were 6 significantly improved, 11 effective and 5 cases had noimprovement, the effective rate in the control group were 77.28% respectively. Compare thetreatment group to the control group, before and after treatment, treatment group had showeda significant different improvement in the symptoms. (P<0.01) This indicated that theefficacy of Chaizhu Xiaopi Decoction accompanied by psychological treatment is muchbetter than only consumed Chaizhu Xiaopi Decoction in control group.In comparison, within the treatment group and control group, it was very significantdifference in the efficacy before and after treatment.(P<0.01)This indicated that both ChaizhuXiaopi Decoction and Chaizhu Xiaopi Decoction applied together with psychologicaltreatment both were effective in treating FD syndrome of liver-qi stagnancy and dampretention.The total scores of treatment group in FD symptoms scale, before and after treatment groupwere 20.38±6.68、6.75±3.77 respectively; whilst that of control group were 21.05±6.79、 10.50±4.52 respectively. The improvement on some of the single FD symptoms, such as bloating and abdominal distension, depression and bowel movement problem in treatment group were very significantly improved as compare to the control group, (P<0.01). Other than these three symptoms, early satiety, belch, bitter and dry in mouth, upper abdominal pain, the need to sigh to release stress, poor appetite and lethargy were not significantly difference between two groups. (P>0.05)CONCLUSION:The efficacy of the traditional Chinese herbal medicine based on the TCM principles of , Chaizhu Xiaopi Decoction, together with psychological intervention, for FD treatment has obviously excelled that of control group which only applying Chaizhu Xiaopi Decoction. The treatment group could not only alleviate FD symptoms but also effectively relieve depressive condition of the patients. This suggested that psychological intervention for FD treatment is important, and more research is needed and physicians should apply it into clinical practice more for better effect.更多还原