本文關(guān)鍵詞：半夏瀉心湯化裁方對功能性消化不良患者內(nèi)臟敏感性及心理影響的研究　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 半夏瀉心湯化裁方 功能性消化不良 精神心理因素 內(nèi)臟敏感性

【摘要】：研究背景及目的:功能性消化不良(Functional Dyspepsia,FD)是臨床常見消化系統(tǒng)疾病,中醫(yī)多將此病歸屬于"胃痞"、"胃脘痛"等范疇。目前的西醫(yī)療效缺乏特異性和可選擇性,而中醫(yī)藥通過辨證論治基礎(chǔ)上制定個性化診療方案,已經(jīng)取得了很好的臨床療效,但目前中藥的作用機制尚不明確,難以得到廣泛認可。本研究旨在觀察半夏瀉心湯化裁方對于FD寒熱錯雜證患者內(nèi)臟敏感性及心理狀態(tài)的影響,探討其可能存在的作用機制,使其療效有據(jù)可循,進一步推廣半夏瀉心湯化裁方在治療FD中的應(yīng)用。研究方法:本研究采用隨機對照試驗方法進行研究,選取首都醫(yī)科大學(xué)附屬北京中醫(yī)醫(yī)院消化中心門診2016年3月至2016年12月收治的功能性消化不良寒熱錯雜證患者70例作為研究對象,治療組44例,對照組21例,失訪5例。治療組服用中藥半夏瀉心湯化裁方顆粒劑(清半夏10g、黃芩10g、黃連5g、煅瓦楞子30g、姜厚樸10g、黨參15g、干姜10g、生甘草5g、炒神曲15g),1包配方顆粒/日,加水300ml混勻,平均分成兩等份,早晚分服,約150ml/次,餐前服用。對照組予安慰劑治療。服藥7天為1療程,共4療程,觀察周期28天。分別在治療前、治療14天、治療28天對患者進行中醫(yī)證候積分、西醫(yī)癥狀積分的評定,在治療前、后對患者水負荷試驗、焦慮抑郁自評量表等觀察指標(biāo)進行觀察與評價。比較兩組及兩組之間治療前、后在各觀察指標(biāo)的差異。所有數(shù)據(jù)用SPSS 21.0軟件進行統(tǒng)計。研究結(jié)果:剔除因失訪而致脫落的病例5例,共完成臨床觀察病例數(shù)65例,其中治療組44例,對照組21例。臨床觀察評價比較:1.內(nèi)臟敏感性評價:治療28天后,治療組閾值飲水量顯著高于治療前(P0.05),對照組各項指標(biāo)治療前后無明顯改善(P0.05),治療組和對照組在水負荷各項指標(biāo)上,差異無統(tǒng)計學(xué)意義(P0.05)。2.心理因素評價:治療28天后,治療組在焦慮、抑郁自評量表評分方面有顯著改善(P0.05);對照組在焦慮抑郁自評量表評分上與治療前比較差異同樣均具有統(tǒng)計學(xué)差異(P0.05),但兩組間差異無統(tǒng)計學(xué)意義(P0.05)。3.中醫(yī)證候積分評價:治療28天后,除了小便短黃外,治療組其余中醫(yī)證候較治療前具有顯著改善(P0.05)。對照組除了小便短黃及大便稀溏外,其余中醫(yī)證候治療前后比較均有所改善(P0.05),治療組與對照組之間除了身重困倦、胸悶、小便短黃和大便稀溏等證候外,其余證候積分治療前、后差異均具有統(tǒng)計學(xué)意義(P0.05)。4.西醫(yī)癥狀積分評價:治療28天,治療組在西醫(yī)各項癥狀較治療具有顯著改善(P0.05)。對照組除上腹燒灼感外,其余各項癥狀亦有改善(P0.05)。治療組和對照組在西醫(yī)各項癥狀積分上差異具有統(tǒng)計學(xué)意義(P0.05),治療組西醫(yī)癥狀整體評定各變量積分均顯著低于對照組,即治療組在西醫(yī)癥狀整體評定各變量上均顯著優(yōu)于對照組。結(jié)論:半夏瀉心湯化裁方能夠改善FD寒熱錯雜證患者內(nèi)臟敏感性及不良情緒。
[Abstract]:Background and objective: functional dyspepsia (FDD) is a common disease of digestive system. "stomachache" and other categories. The current Western medicine efficacy is lack of specificity and selectivity, and Chinese medicine through the dialectical treatment of the basis of personalized diagnosis and treatment program, has achieved a good clinical effect. However, the mechanism of traditional Chinese medicine is not clear, it is difficult to be widely recognized. The purpose of this study was to observe the effect of Banxia Xiexin decoction on visceral sensitivity and psychological state of patients with FD cold and heat disorder syndrome. To explore the possible mechanism of its action, so that its efficacy can be followed, and further promote the application of Banxiaxiexin decoction in the treatment of FD. Research methods: this study was conducted by a randomized controlled trial. From March 2016 to December 2016, 70 cases of functional dyspepsia with cold and heat disorder syndrome were selected. There were 44 cases in the treatment group, 21 cases in the control group and 5 cases in the control group. The treatment group was treated with Banxia Xiexin decoction (10g, Scutellaria 10g, Huanglian 5g, calcined corrugated 30g). Ginger magnolia 10g, Codonopsis lanceolata 15g, dried ginger 10g, raw liquorice 5g, fried Shenqu 15g / day, mixed with 300ml water, divided into two equal parts in the morning and evening. The control group was treated with placebo. The control group was treated with placebo for 7 days for a course of 4 courses. The observation period was 28 days. After 28 days of treatment, the patients were evaluated with TCM syndrome integral and western medicine symptom score. Before and after the treatment, the patients were tested with water load. Self-rating anxiety and depression scale and other observation indicators were observed and evaluated. The two groups and between the two groups before treatment. All the data were counted by SPSS 21.0 software. Results: 5 cases were excluded and 65 cases were observed. There were 44 cases in the treatment group and 21 cases in the control group. The clinical observation evaluation was compared with that in the control group. The evaluation of visceral sensitivity: after 28 days of treatment, the threshold drinking water in the treatment group was significantly higher than that in the pre-treatment group (P 0.05). In the control group, there was no significant improvement before and after treatment, the treatment group and the control group in each index of water load. Psychological factor evaluation: after 28 days of treatment, the scores of anxiety and depression in the treatment group were significantly improved (P 0.05). The scores of self-rating anxiety and depression in the control group were also significantly different from those before treatment (P 0.05). However, the difference between the two groups was not statistically significant (P 0.05). Evaluation of TCM syndrome score: after 28 days of treatment, except for short yellow urine. The other TCM syndromes in the treatment group were significantly improved than before treatment P0.05.The control group except short yellow urine and loose stool, the other TCM syndromes were improved before and after treatment (P0.05). Treatment group and control group between the body heavy sleepiness, chest tightness, short yellow urine and loose stool, and other symptoms before treatment. The later differences were statistically significant (P0.05N. 4). Evaluation of western medicine symptom score: treatment for 28 days. The symptoms of western medicine in the treatment group were significantly improved than that of the treatment P0.05.The control group except upper abdominal burning sensation. The other symptoms were also improved P0.050.The difference between the treatment group and the control group in the western medicine symptom score was statistically significant (P0.05). The integral scores of all variables in the treatment group were significantly lower than those in the control group. Conclusion: Banxia Xiexin decoction can improve visceral sensitivity and bad emotion of FD patients with cold and heat disorder syndrome.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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