本文選題：抑郁癥　切入點：督脈壓痛點　出處：《南京中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:抑郁癥因其廣泛存在的軀體障礙備受關(guān)注,胃腸道癥狀為最常見的軀體障礙,本研究通過搜集文獻,探討了督脈、抑郁癥與胃腸的相互關(guān)系,通過對抑郁癥合并胃腸道癥狀患者的督脈壓痛點進行觀察并針刺治療,旨在發(fā)現(xiàn)抑郁癥合并不同胃腸道癥的壓痛點差異及治療過程中胃腸癥狀及壓痛點的變化規(guī)律,通過量表得分評價治療效果,從而進一步了解胃腸與抑郁癥的關(guān)系。方法:將符合本研究納入標準的患者隨機分為針刺藥物組和單純藥物組。針刺藥物組患者運用脊推法尋找出壓痛點并記錄其癥狀,將患者的壓痛點與癥狀,壓痛點與壓痛點,癥狀與癥狀之間進行關(guān)聯(lián)分析:治療上運用針刺壓痛點及口服西酞普蘭,藥物組患者僅口服西酞普蘭。兩組患者分別于治療前和治療過程中對兩組進行漢密爾頓抑郁量表(HAMD)、胃腸疾病中醫(yī)證候評分表測定,比較治療過程中癥狀與壓痛點的變化,應用組間及組內(nèi)比較對治療前后及兩組之間的治療效果進行評定。結(jié)果:患者壓痛點分布多位于T5、T7、T8、T9、T11。關(guān)聯(lián)分析統(tǒng)計發(fā)現(xiàn)上消化道癥狀多與T7、T5、T8、T9、T11相關(guān),而下消化道癥狀多于T7、T5、Ti1、T8、T9相關(guān)。通過對HAMD量表及胃腸疾病中醫(yī)證候量表統(tǒng)計分析,針刺藥物組與單純藥物組對于抑郁癥患者情緒及胃腸道癥狀改善都有良好效果(P0.05),兩組之間對總體情緒改善無明顯差別(P0.05),在胃腸癥狀上針刺藥物組療效優(yōu)于單純藥物組(P0.05)。治療過程中T5、T7壓痛點減少率最低,對惡心嘔吐、食欲減退及便秘的針刺效應依次遞減。結(jié)論:1、抑郁癥合并胃腸道癥狀患者的督脈壓痛點成規(guī)律性分布,不同消化道分布規(guī)律有差異,其不同癥狀與壓痛點,壓痛點與壓痛點,癥狀與癥狀之間存在關(guān)聯(lián)性。2、癥狀的減輕優(yōu)先于壓痛點的減少,治療過程中壓痛點隨癥狀的減輕而減少,不同癥狀患者的壓痛點減少也不同。3、在短期治療中(2周內(nèi)),針刺治療對抑郁癥胃腸癥狀改善優(yōu)于藥物治療,對于總體的改善二者并無明顯差別,針刺即刻效應明顯,提示針刺治療早期介入的臨床必要性,針刺督脈壓痛點的治療對不同胃腸癥狀改善有差異。
[Abstract]:Objective: depression because of physical barriers to its widespread concern, gastrointestinal symptoms were the most common somatic disorders, this study by collecting literature, discusses the relationship between Du, depression and gastrointestinal, the depression patients with gastrointestinal symptoms on tenderness points were observed and the acupuncture treatment, in order to find changes with depression different gastrointestinal disease during the treatment of tenderness point difference and gastrointestinal symptoms and tenderness, the treatment effect was evaluated by scoring scale, so as to further understand the relationship between gastrointestinal and depression. Methods: in accordance with the inclusion criteria were randomly divided into acupuncture group and medication group. The drug group were treated with acupuncture and drug ridge push method to find out the tenderness and record their symptoms, the patient's pain points and symptoms, and tenderness tenderness, correlation analysis between the symptoms and symptoms: treatment The use of acupuncture point tenderness and oral citalopram, drug group were only oral citalopram. In two groups were measured before and during treatment of the two groups of Hamilton Depression Scale (HAMD), disease syndromes gastrointestinal score determination, treatment, changes of symptoms and tenderness in the process of application between group and group comparison of the two groups before and after treatment between the treatment effect was evaluated. Results: the pain point located in the distribution of T5, T7, T8, T9, T11. correlation statistical analysis of upper gastrointestinal symptoms and T7, T5, T8, T9, T11, and gastrointestinal symptoms more than T7, T5, Ti1. T8, T9. Based on HAMD scale and gastrointestinal diseases in TCM syndrome scale statistical analysis, the acupuncture medicine group and the medication group has a good effect on emotion and gastrointestinal tract symptoms improved in patients with depression (P0.05), between the two groups had no significant difference on the overall mood improvement (P0.05 ), in the gastrointestinal symptoms on the efficacy of acupuncture medicine group is better than the simple drug group (P0.05). During the treatment of T5, T7 reduced the lowest rate of tenderness, nausea and vomiting, loss of appetite and constipation acupuncture effect decreasing. Conclusion: 1, depression and gastrointestinal symptoms in patients with Du pain points into the regular pressure distribution. The different distribution of the digestive tract are different, the different symptoms and tenderness, tenderness and tenderness, there is a correlation between.2 symptoms and symptoms, reduction of symptoms prior to the tenderness point reduction, tenderness point during treatment with reduction of symptoms and reduce symptoms, patients with different tenderness point reduction of different.3. In the short-term treatment (2 weeks), acupuncture treatment for depression gastrointestinal symptoms is better than drug therapy, the overall improvement of two there is no significant difference, the immediate effect of acupuncture significantly, suggesting that the clinical necessity of acupuncture treatment on early intervention of acupuncture and The treatment of pulse pressure pain points is different for the improvement of different gastrointestinal symptoms.

【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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