本文關(guān)鍵詞： 功能性腹痛綜合征 肝郁氣滯型 黛力新 加味柴胡疏肝散　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察加味柴胡疏肝散聯(lián)合黛力新對(duì)肝郁氣滯型功能性腹痛綜合征(FAPS)患者的臨床癥狀及焦慮、抑郁狀態(tài)的改善情況。挖掘中西醫(yī)結(jié)合治療FAPS患者的優(yōu)勢(shì),為臨床應(yīng)用及推廣提供更多依據(jù)。方法:收集2016年3月至2016年12月在昆山市中醫(yī)院脾胃肝膽科門診及病房確診為肝郁氣滯型功能性腹痛綜合征的患者60例。隨機(jī)分為對(duì)照組和治療組各30例,對(duì)照組予氟哌噻噸美利曲辛片每日一片口服,實(shí)驗(yàn)組在對(duì)照組基礎(chǔ)上加予加味柴胡疏肝散煎服。兩組均治療4周,記錄治療前后癥狀評(píng)分及焦慮抑郁積分,觀察對(duì)比兩組的治療效果,并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)疼痛改善情況:兩組組間治療后經(jīng)秩和檢驗(yàn),P=0.020(P0.05),差異具有統(tǒng)計(jì)學(xué)意義,證明治療組在緩解疼痛癥狀方面的效果更優(yōu)越。(2)中醫(yī)癥狀改善情況:治療組總有效率為86.7%,對(duì)照組為73.3%,對(duì)治療前后中醫(yī)療效及中醫(yī)癥候總積分進(jìn)行分析比較,治療后兩組間的差異有顯著的統(tǒng)計(jì)學(xué)意義(P0.01),證明治療組在緩解中醫(yī)癥狀方面較對(duì)照組具有顯著的優(yōu)勢(shì)。其中腹痛、兩脅脹痛、食欲減退、噯氣四項(xiàng)癥候的療效兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),證明治療組在緩解這幾項(xiàng)癥候方面相較對(duì)照組更有效。而對(duì)于失眠多夢(mèng),經(jīng)分析得出P=0.521(P0.05),差異無(wú)統(tǒng)計(jì)學(xué)意義,治療組與對(duì)照組療效相當(dāng)。(3)焦慮抑郁改善情況:通過(guò)比較治療前后SAS、SDS積分變化,治療組與對(duì)照組之間的差異具有統(tǒng)計(jì)學(xué)意義(P0.05),故認(rèn)為治療組在改善焦慮、抑郁方面療效更佳。結(jié)論:運(yùn)用加味柴胡疏肝散聯(lián)合黛力新能有效改善肝郁氣滯型FAPs患者的臨床癥狀以及焦慮抑郁的心理狀態(tài),在臨床中值得推廣與應(yīng)用。
[Abstract]:Objective: to observe the clinical symptoms and anxiety of Jiawei Chaihu Shugan San combined with Delixin in patients with functional abdominal pain syndrome of liver stagnation and qi stagnation. To explore the advantages of integrated traditional Chinese and western medicine in the treatment of FAPS patients. To provide more evidence for clinical application and promotion. Methods:. From March 2016 to December 2016, 60 patients diagnosed as functional abdominal pain syndrome of stagnation of qi and liver-qi type in outpatient department and ward of spleen, stomach and hepatobiliary department of traditional Chinese medicine hospital of Kunshan City were collected. They were randomly divided into two groups: control group and treatment group. 30 cases. The control group was treated with droperazothioate meritriaxine tablets once a day, the experimental group was treated with modified Chaihu Shugan Powder decoction on the basis of the control group. Both groups were treated for 4 weeks, the symptom score and anxiety and depression score were recorded before and after treatment. Observation and comparison of the therapeutic effects of the two groups, and statistical analysis. Results: 1) pain improvement: after the treatment between the two groups after the rank sum test, P0. 020 and P0. 05). The difference was statistically significant, which proved that the treatment group had better effect in relieving pain symptoms. 2) the improvement of TCM symptoms: the total effective rate of treatment group was 86.7, and that of control group was 73.3%. Before and after the treatment of TCM curative effect and the total integral of TCM symptoms were analyzed and compared, the difference between the two groups after treatment has significant statistical significance (P 0.01). It is proved that the treatment group has a significant advantage over the control group in alleviating the symptoms of traditional Chinese medicine, in which abdominal pain, two hypochondriac pain, anorexia and belching are significantly different between the two groups (P 0.05). It is proved that the treatment group is more effective than the control group in alleviating these symptoms. However, for insomnia and dream, the analysis shows that there is no significant difference between the treatment group and the control group. The improvement of anxiety and depression in the treatment group was similar to that in the control group: the changes of SDS scores before and after treatment were compared. The difference between the treatment group and the control group was statistically significant (P 0.05), so it was considered that the treatment group was improving anxiety. Conclusion: the combination of modified Chaihu Shugan Powder and Delixin can effectively improve the clinical symptoms and anxiety and depression of patients with FAPs with liver depression and qi stagnation. It is worth popularizing and applying in clinic.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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