本文選題：產(chǎn)褥期　切入點(diǎn)：抑郁癥　出處：《長(zhǎng)春中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:以疏肝解郁、養(yǎng)血健脾之法創(chuàng)制安產(chǎn)解郁湯治療產(chǎn)褥期抑郁癥肝郁脾虛型患者,探討其臨床應(yīng)用價(jià)值。方法:研究對(duì)象選自長(zhǎng)春中醫(yī)藥大學(xué)附屬醫(yī)院腦病科門診或療區(qū)收治的產(chǎn)褥期抑郁癥患者。研究資料收集時(shí)間為2014年1月至2015年12月。共納入72例患者,隨機(jī)分為研究組、對(duì)照組各36例。研究組采用安產(chǎn)解郁湯治療,藥物組成:柴胡10g、川芎10g、白芍15g、枳殼10g、陳皮10g、香附5g、當(dāng)歸15g、炮姜10g、茯苓15g、白術(shù)15g。用法:采用本院農(nóng)本方顆粒裝入醫(yī)用膠囊,每次6粒,每日3次,口服,連用1個(gè)月為1療程。對(duì)照組采用舒肝解郁膠囊(成都康弘藥業(yè)集團(tuán)股份有限公司生產(chǎn),國(guó)藥準(zhǔn)字YBZ10382008)治療,主要成分:貫葉金絲桃、刺五加。用法用量:口服,一次6粒,一日3次,1個(gè)月為l療程。主要的療效指標(biāo)的判定:(1)HAMD計(jì)分表;(2)肝郁脾虛郁證中醫(yī)癥侯評(píng)分。結(jié)果:治療后,研究組SDS評(píng)分總有效率為91.7%,顯愈率為69.4%,明顯優(yōu)于對(duì)照組(P0.01),具有統(tǒng)計(jì)學(xué)意義;研究組HAMD評(píng)分總有效率為91.7%,顯愈率為69.4%,明顯優(yōu)于對(duì)照組(P0.01),存在顯著性差異;治療后,兩組患者中醫(yī)癥狀均有所改善,除便溏和脅肋脹滿疼痛,其他各中醫(yī)癥狀研究組改善水平均優(yōu)于對(duì)照組(P0.05),差異具有統(tǒng)計(jì)學(xué)意義;經(jīng)秩和檢驗(yàn)分析,研究組中醫(yī)臨床證候療效判定總有效率為97.2%,顯愈率為72.2%,明顯優(yōu)于對(duì)照組(P0.01),存在顯著性差異。結(jié)論:以疏肝健脾為原則的中醫(yī)藥治療是目前產(chǎn)褥期抑郁癥的可行治療方法。安產(chǎn)解郁湯在改善產(chǎn)褥期抑郁癥肝郁脾虛證患者的癥狀和中醫(yī)證候上可收獲良好療效,同時(shí)避免了長(zhǎng)期服用抗抑郁藥物可能帶來(lái)的多種不良反應(yīng),有利于患者的治療依從性。安產(chǎn)解郁湯在疏肝解郁的同時(shí),還具有健脾養(yǎng)血之功效,有利于改善患者納呆、消化不良、失眠多夢(mèng)等癥狀,更好的提高患者的生存質(zhì)量。
[Abstract]:Objective: to treat patients with depression of liver and spleen in puerperium with the method of soothing liver and relieving depression and nourishing blood and invigorating spleen. Methods: patients with puerperal depression were selected from the Department of Encephalopathy, affiliated Hospital of Changchun University of traditional Chinese Medicine. The data were collected from January 2014 to December 2015. A total of 72 patients were included in the study. They were randomly divided into study group (n = 36) and control group (n = 36). Drug composition: Bupleurum 10g, Chuanxiong 10g, Radix Paeoniae Alba 15g, Fructus Aurantii 10g, Chen Pei 10g, Rhizoma Atractylodes 15g, Angelica sinensis 15g, Guangjiang 10g, Poria cocos 15g, Atractylodes Atractylodes 15g.Use: take Nong Benfang granules into medical capsule, 6 capsules per time, 3 times a day, oral. The control group was treated with Shugan Jie Yu capsule (produced by Chengdu Kanghong Pharmaceutical Group Co., Ltd., YBZ10382008). The main ingredients: Hypericum perforatum, Acanthopanax senticosus. Three times a day, one month as a course of treatment. Judgment of main curative effects: 1) score of Hamd score (2) TCM syndrome of liver stagnation and spleen deficiency. Results: after treatment, The total effective rate of SDS score in the study group was 91.7, and the apparent recovery rate was 69.4, which was significantly better than that in the control group (P 0.01). The total effective rate of HAMD score in the study group was 91.7% and the obvious recovery rate was 69.4%, which was significantly better than that in the control group (P 0.01). The TCM symptoms of the two groups were improved, except loose stools and full flank pain, the improvement level of other TCM symptom study groups was better than that of the control group (P 0.05), the difference was statistically significant, and the rank sum test analysis showed that the improvement level of TCM symptoms in the study group was higher than that in the control group. In the study group, the total effective rate of TCM clinical syndromes was 97.2g and the markedly cured rate was 72.2, which was obviously superior to that of the control group (P0.01a). Conclusion: the TCM treatment based on the principle of soothing liver and invigorating spleen is a feasible treatment for depression in puerperium. In improving the symptoms and syndromes of patients with liver depression and spleen deficiency syndrome in puerperium depression, it can obtain good curative effect. At the same time, it avoids a variety of adverse reactions that may be brought about by long-term antidepressant drugs, which is conducive to the treatment compliance of the patients. While relieving the liver and relieving the depression, it also has the effect of invigorating the spleen and nourishing the blood, which is conducive to improving the patient's retention. Dyspepsia, insomnia and dream symptoms, better improve the quality of life of patients.
【學(xué)位授予單位】：長(zhǎng)春中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R271.4

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