【摘要】：目的:觀察二仙湯合柴胡加龍骨牡蠣湯治療圍絕經(jīng)期女性抑郁癥的臨床療效,并且與西藥氟西汀的治療互相比較,探討二仙湯合柴胡加龍骨牡蠣湯治療方案對于圍絕經(jīng)期女性抑郁癥患者的治療效果、優(yōu)勢以及安全性。方法:臺灣地區(qū)新北市振興醫(yī)療群院所2015年6月至2016年9月到門診治療的病患中,選擇符合納入標(biāo)準(zhǔn)的圍絕經(jīng)期女性抑郁癥患者66例,其中治療組有34例,對照組有32例。治療組以中藥二仙湯合柴胡加龍骨牡蠣湯治療,而對照組以西藥氟西汀治療,療程為8周。觀察并比較兩組患者治療前與治療第2、4、6、8周后的漢米爾頓抑郁量表(HAMD)與中醫(yī)證候評分量表的評分、綜合療效、癥狀療效及安全性指標(biāo)等。結(jié)果:1.8周的療程結(jié)束后療效指標(biāo)HAMD的比較,治療組總有效率為82.4%,其中痊愈有5例(14.7%)、顯著進(jìn)步有14例(41.2%)、進(jìn)步有9例(26.5%)、無效有6例(17.6%)。對照組總有效率為84.4%,其中痊愈有5例(15.6%)、顯著進(jìn)步有14例(43.8%)、進(jìn)步有8例(25.0%)、無效有5例(15.6%)。治療組與對照組HAMD療效的比較,兩組間無統(tǒng)計學(xué)差異(p0.05)。說明圍絕經(jīng)期女性抑郁癥中藥治療與西藥治療,都具有改善抑郁狀態(tài)的療效。2.8周的療程結(jié)束后中醫(yī)證候評分療效的比較,治療組總有效率為82.4%,其中顯效有9例(26.5%)、有效有19例(55.9%)、無效有6例(17.6%)。對照組總有效率為81.2%,其中顯效有8例(25.0%)、有效有18例(56.2%)、無效有6例(18.8%)。治療組與對照組中醫(yī)證候評分療效的比較,兩組療效沒有統(tǒng)計學(xué)差異(p0.05)。說明圍絕經(jīng)期女性抑郁癥的治療,中藥治療與西藥治療都具有改善臨床癥狀的作用及療效。3.治療8周療程結(jié)束后各組內(nèi)臨床癥狀的比較,中藥治療組在神情抑郁、潮熱汗出、感覺異常、煩躁不安、默默不言、頭暈、神疲乏力、心悸、胸脅滿悶、脘腹脹滿、失眠多夢、食欲減少、肢體酸痛、大便不調(diào)等中醫(yī)癥狀,均可以逐漸獲得改善(p0.05)。西藥對照組可以改善神情抑郁、煩躁不安、默默不言、頭暈、神疲乏力、心悸、胸脅滿悶、脘腹脹滿、失眠多夢、食欲減少、肢體酸痛、大便不調(diào)等中醫(yī)癥狀(p0.05),但是對于潮熱汗出與感覺異常則沒有明顯的療效(p0.05)。4.治療8周療程結(jié)束后兩組間各臨床癥狀的比較,治療組在潮熱汗出、感覺異常、胸脅滿悶與食欲減少方面,改善程度比對照組顯著,有統(tǒng)計上的差異(p0.05)。而其它癥狀改善的比較,兩組之間沒有統(tǒng)計學(xué)差異(p0.05)。說明中藥治療組對于潮熱汗出、感覺異常、胸脅滿悶與食欲減少癥狀的改善明顯優(yōu)于西藥對照組的治療。5.兩組副作用的比較,治療組方面有6例次,其中惡心有3例、輕微腹瀉有3例。對照組方面出現(xiàn)有21例次副作用,其中口干有4例、失眠有3例、惡心有3例、焦慮有2例、乏力有2例,頭暈有3例、頭痛有1例、便秘有3例。說明中藥治療圍絕經(jīng)期女性抑郁癥的副作用較少,臨床容易為患者所接受。結(jié)論:本研究結(jié)果顯示采用中藥二仙湯合柴胡加龍骨牡蠣湯治療臺灣地區(qū)圍絕經(jīng)期女性抑郁癥病患有一定的療效。中藥治療對于改善潮熱汗出、感覺異常療效顯著,明顯優(yōu)于西藥治療,而且對于煩躁不安、胸脅滿悶癥狀改善較快速。此外,二仙湯合柴胡加龍骨牡蠣湯治療時間愈長,愈能改善食欲減少及胸脅滿悶癥狀,而逐漸顯示出本合方疏肝理氣的優(yōu)勢。本研究以二仙湯合柴胡加龍骨牡蠣湯加減的科學(xué)濃縮中藥劑治療,具有安全性佳、副作用少及使用方便等特點(diǎn),因此本治療方法值得臨床推廣。
[Abstract]:Objective: To observe the clinical efficacy of Erxian decoction combined with Chaihu plus Longgu Oyster Decoction in the treatment of perimenopausal women with depression, and compare it with fluoxetine to explore the efficacy, advantages and safety of Erxian decoction combined with Chaihu plus Longgu Oyster Decoction in the treatment of perimenopausal women with depression. From June 2015 to September 2016, 66 perimenopausal women with depression were selected from the outpatient department of Beishi Zhenxing Medical Group Hospital, including 34 cases in the treatment group and 32 cases in the control group. Results: After 1.8 weeks of treatment, the total effective rate of HAMD in the treatment group was 82.4%, of which 5 cases were cured (14.7%). There were 14 cases (41.2%) of progress, 9 cases (26.5%) of progress and 6 cases (17.6%) of ineffectiveness. The total effective rate was 84.4% in the control group, of which 5 cases (15.6%) were cured, 14 cases (43.8%) were markedly improved, 8 cases (25.0%) were improved, and 5 cases (15.6%) were ineffective. The total effective rate was 82.4%(26.5%), 19(55.9%) and 6 (17.6%) respectively. The total effective rate was 81.2% in the control group, 8 (25.0%) and 18 (5.5%) in the treatment group. 6.2% and 6 cases (18.8%) were ineffective. There was no significant difference in the curative effect between the treatment group and the control group (p0.05). Chinese medicine treatment group in the mood depression, hot flashes sweating, feeling abnormal, restlessness, silence, dizziness, fatigue, palpitations, chest and flank tightness, abdominal distention, insomnia, dreams, loss of appetite, limb soreness, irregular stool and other Chinese medicine symptoms, can gradually be improved (p0.05). Western medicine control group can improve mood depression, restlessness, silence. Not to mention, dizziness, fatigue, palpitations, chest and flank full of tightness, abdominal distention, insomnia, more dreams, loss of appetite, limb pain, incoordination of stool and other symptoms of traditional Chinese medicine (p0.05), but for hot flashes sweating and sensory abnormalities were not obvious effect (p0.05). 4. After 8 weeks of treatment between the two groups after the comparison of clinical symptoms, treatment group in hot flashes sweating, feeling There was no significant difference in the improvement of other symptoms between the two groups (p0.05). It showed that the improvement of the symptoms of hot flashes, sweating, abnormal sensation, chest and throat fullness and loss of appetite in the treatment group was better than that in the control group. Treatment. 5. Comparing the side effects between the two groups, there were 6 cases in the treatment group, including 3 cases of nausea and 3 cases of mild diarrhea. In the control group, there were 21 side effects, including 4 cases of dry mouth, 3 cases of insomnia, 3 cases of nausea, 2 cases of anxiety, 2 cases of fatigue, 3 cases of dizziness, 1 case of headache and 3 cases of constipation. Conclusion: Erxian Decoction combined with Chaihu and Longgu Oyster Decoction is effective in the treatment of perimenopausal female depressive disorders in Taiwan. The treatment of traditional Chinese medicine has a significant effect on improving hot flashes and sweating, and is superior to Western medicine. In addition, Erxian Decoction combined with Chaihu plus Longgu Oyster Decoction can improve the symptoms of loss of appetite and fullness of chest and hypochondriac, and gradually shows the advantages of this prescription in soothing the liver and regulating qi. Because of its good safety, fewer side effects and convenient use, the treatment is worthy of clinical promotion.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R277.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李駿馳;余韜;章舒;;女性圍絕經(jīng)期綜合征治療的研究進(jìn)展[J];中國社區(qū)醫(yī)師;2016年23期

2 徐金燕;;柴胡加龍骨牡蠣湯治療失眠癥的臨床效果探討[J];中國民間療法;2016年06期

3 黃清苑;溫利輝;徐金燕;李曉芹;;柴胡加龍骨牡蠣湯治療氣郁質(zhì)失眠癥30例臨床觀察[J];北方藥學(xué);2016年05期

4 陳光耀;吳卓耘;張新寧;陳瑩瑩;劉燕;丁雷;周清緣;宋月晗;;柴胡加龍骨牡蠣湯對創(chuàng)傷后應(yīng)激障礙模型大鼠行為學(xué)的調(diào)節(jié)作用[J];環(huán)球中醫(yī)藥;2016年02期

5 胡元紅;楊永朋;王曉燕;;柴胡加龍骨牡蠣湯治療抑郁癥臨床觀察及理論探討[J];世界最新醫(yī)學(xué)信息文摘;2016年08期

6 馬敬;王寧;;女性抑郁癥患者血清激素與細(xì)胞因子表達(dá)研究[J];醫(yī)學(xué)與哲學(xué)(B);2015年11期

7 葛紅敏;董苒;楊媛;;老年女性抑郁癥患者的臨床特征分析[J];醫(yī)學(xué)理論與實踐;2015年20期

8 廖文斌;楊旭紅;;柴胡加龍骨牡蠣湯聯(lián)合帕羅西汀治療廣泛性焦慮障礙80例[J];四川精神衛(wèi)生;2015年04期

9 劉占國;王慧萍;;柴胡加龍骨牡蠣湯合黛力新治療腦卒中后抑郁30例[J];江西中醫(yī)藥;2015年05期

10 李黎;;二仙湯的現(xiàn)代臨床運(yùn)用[J];四川中醫(yī);2014年12期

，

本文編號：2238503