本文選題：抑郁癥　切入點：肝郁腎虛證　出處：《長春中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的：觀察具有滋養(yǎng)陰精，補益肝腎的滋水清肝顆粒，對抑郁癥肝郁腎虛型患者中醫(yī)證候改善的臨床療效、漢密爾頓抑郁量表（HAMD）評分療效，并對其治療的整體有效性作出客觀的評價分析。 方法：任意選擇符合納入標(biāo)準(zhǔn)的門診抑郁癥患者48例，隨機分為兩組分別為治療組、對照組。對照組選用口服路優(yōu)泰，治療組藥物為滋水清肝顆粒，兩組均以12周為1個療程，并同時配合心理咨詢每周一次，共12次。試驗期間，，停用影響臨床療效的其他中西醫(yī)藥物。觀察比較兩組藥物治療抑郁癥肝郁腎虛型患者的療效。 結(jié)果：根據(jù)漢密爾頓抑郁量表（HAMD）療效分析，治療組臨床控制率為67%，總有效率為96%；對照組臨床控制率為50%，總有效率為92%；在總有效率方面，治療組比較對照組，P0.05結(jié)果無統(tǒng)計學(xué)差異。治療組和對照組在治療前后兩組患者HAMD積分比較上，P0.05有統(tǒng)計學(xué)意義，組間比較P0.05無統(tǒng)計學(xué)意義。說明治療組和對照組治療前后兩組患者HAMD積分無顯著差異。治療組中醫(yī)癥狀臨床控制率為65%，總有效率為92%；對照組臨床控制率為38%，總有效率為83%；總有效率治療組與對照組有統(tǒng)計學(xué)差異P0.05。治療組及對照組組內(nèi)和組間比較，治療前后差異均有統(tǒng)計學(xué)意義P0.05；治療后的組間比較，在神情抑郁，興趣索然，思維遲緩，健忘，少寐，多夢，腰膝酸軟方面，治療組與對照組差異有統(tǒng)計學(xué)意義P0.05，說明在改善以上癥狀上，治療組療效優(yōu)于對照組。 結(jié)論：在同樣配合12次心理咨詢的情況下，治療組、對照組在治療肝郁腎虛型抑郁癥患者在臨床總療效上無顯著性差異，治療組在中醫(yī)證候療效積分上于對照組比較，有顯著差異。因此得出滋水清肝顆粒是治療抑郁癥腎虛肝郁證的有效方劑。
[Abstract]:Objective: to observe the clinical effect of Zishuiqinggan granule with nourishing yin and essence and tonifying liver and kidney on the improvement of TCM syndromes in patients with depression of liver stagnation and kidney deficiency, and to evaluate the efficacy of Hamilton Depression scale (Hamd). And the overall effectiveness of its treatment to make an objective evaluation and analysis. Methods: Forty-eight depressive patients who met the inclusion criteria were randomly divided into two groups: treatment group and control group. The control group was treated by oral administration of Luyou Tai, and the treatment group was treated with Zishui Qinggan granule. Both groups were treated with 12 weeks as a course of treatment, and at the same time with psychological counseling once a week, a total of 12 times. During the trial, other traditional Chinese and western medicine affecting the clinical efficacy were stopped. The therapeutic effects of the two groups on depression patients with liver depression and kidney deficiency were observed and compared. Results: according to the analysis of Hamilton Depression scale (Hamd), the clinical control rate and the total effective rate in the treatment group were 67 and 96 respectively; in the control group, the clinical control rate was 50 and the total effective rate was 92; in the total effective rate, the clinical control rate was 50 and the total effective rate was 92. There was no statistical difference between the treatment group and the control group (P0.05). The HAMD scores of the treatment group and the control group before and after treatment were significantly higher than that of the control group (P0.05). There was no significant difference in HAMD scores between the two groups before and after treatment. The clinical control rate of TCM was 65, the total effective rate was 92 in the treatment group, and the clinical control rate in the control group was 38. The total effective rate in the treatment group was significantly different from that in the control group (P 0.05). The differences before and after treatment were statistically significant (P0.05). After treatment, there were significant differences between the two groups in terms of depression, lack of interest, slow thinking, amnesia, sleepless sleep, more dreams, weak waist and knee, The difference between the treatment group and the control group was statistically significant (P 0.05), which indicated that the treatment group was better than the control group in improving the above symptoms. Conclusion: there is no significant difference in the total clinical efficacy between the treatment group and the control group in the treatment of depression due to liver depression and kidney deficiency under the same condition of 12 times of psychological consultation, while the curative effect integral of TCM syndrome in the treatment group is compared with that in the control group, and there is no significant difference in the total clinical effect between the treatment group and the control group. It is concluded that Zishui Qinggan granule is an effective prescription for the treatment of depression with kidney deficiency and liver depression.
【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R749.4

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