本文選題：功能性消化不良 + 柔肝醒脾湯　； 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本課題運(yùn)用自擬柔肝醒脾湯(炒白芍30g；柴胡、黨參、炒白術(shù)、茯苓、茯神、陳皮、焦山楂、神曲、炒枳殼、郁金各10g；砂仁后下5g；合歡花后下20g；炙甘草6g)聯(lián)合西藥雷貝拉唑鈉腸溶膠囊、枸櫞酸莫沙必利片、氟哌噻噸美利曲辛片治療功能性消化不良(FD).伴焦慮抑郁狀態(tài),觀(guān)察臨床療效及增效降低臨床復(fù)發(fā)率的作用,為臨床探索該病提供新思路新方法。方法：選取2014年1月至2015年6月期間于泰州市中醫(yī)院門(mén)診就診和住院治療的肝郁脾虛型FD伴焦慮抑郁狀態(tài)的患者95例,用簡(jiǎn)單隨機(jī)分組的方法,中藥+西藥的治療組為50例,單純西藥治療對(duì)照組45例。對(duì)照組予雷貝拉唑鈉腸溶膠囊20mg,每日1次,早飯前口服；枸櫞酸莫沙必利片5mg,每日3次,每次飯前口服；氟哌噻噸美利曲辛片1片,每日兩片、早中各一片。治療組在對(duì)照組的基礎(chǔ)上,加用柔肝醒脾湯為基礎(chǔ)方加味,中藥湯劑均由本院中藥房提供,統(tǒng)一機(jī)煎,每日2次,每次1袋,200ml/袋�？偗煶虨�4周,療程結(jié)束后隨訪(fǎng)3個(gè)月,觀(guān)察兩組患者治療前后中醫(yī)癥狀、HAMA、HAMD評(píng)分變化及復(fù)發(fā)率情況。結(jié)果：1、中醫(yī)癥候療效：治療組總有效率94%,對(duì)照組總有效率77.8%,提示治療組總療效率高于對(duì)照組(P0.05)。兩組患者治療后中醫(yī)癥狀總積分有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。而中醫(yī)癥狀單項(xiàng)積分中,治療組在改善胃脘脹滿(mǎn)、飲食減少、胃脘疼痛、噯氣反酸、神疲乏力、便溏不爽方面明顯優(yōu)于對(duì)照組(P0.01),在改善煩躁易怒、失眠多夢(mèng)方面優(yōu)于對(duì)照組(P0.05)。2、HAMA和HAMD評(píng)分比較：治療后兩組比較治療組HAMD評(píng)分和HAMA評(píng)分均顯著低于對(duì)照組,提示治療組優(yōu)于對(duì)照組。3、復(fù)發(fā)率比較：治療組復(fù)發(fā)率為10.6%,對(duì)照組復(fù)發(fā)率為37.1%,結(jié)果提示對(duì)照組復(fù)發(fā)率明顯高于對(duì)照組,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.005)。結(jié)論：柔肝醒脾湯加減聯(lián)合治療FD伴焦慮抑郁,治療組總有效率明顯高于單純西藥對(duì)照組,有效改善或消除了患者中醫(yī)臨床癥狀,明顯降低HAMA和HAMD的評(píng)分,有效改善患者的精神狀態(tài),提高了其生活質(zhì)量,且復(fù)發(fā)率明顯低于對(duì)照單純西藥組,充分說(shuō)明了本方案療效確切,且安全可靠,具有良好的臨床應(yīng)用前景。
[Abstract]:Objective: to study the application of Rugan Xingpi decoction (stir-fried white peony 30g; Radix Bupleurum, Codonopsis pilosula, stir-fried Atractylodes macrocephala, Poria cocos, Fu Shen, Chen Pei, Jiaohaw, Dianqu, fried Fructus aurantii, Tujin 10g each; Radix Glycyrrhizae (6 g) combined with Rabeprazole sodium enteric-coated capsule, mosapride citrate tablet and droperazothioate melitaxine tablet in the treatment of functional dyspepsia (FDN). In order to provide a new method for clinical exploration of the disease, the clinical efficacy and synergism were observed in order to reduce the clinical recurrence rate in patients with anxiety and depression. Methods: from January 2014 to June 2015, 95 cases of FD with anxiety and depression of liver depression and spleen deficiency were selected from outpatient and inpatients of Taizhou Hospital of traditional Chinese Medicine, and 50 cases were treated with traditional Chinese medicine and western medicine. There were 45 cases in the control group treated with western medicine alone. The control group was given rabeprazole enteric capsule 20mg once a day before breakfast; mosapride citrate tablet 5mg 3 times a day before meals; droperazol titration metroxine one tablet two times a day and one tablet in the morning and one in the middle of the day. On the basis of the control group, the treatment group was treated with Rugan Xingpi decoction as the basic prescription, and the traditional Chinese medicine decoction was provided by the pharmacy of our hospital. The total course of treatment was 4 weeks, followed up for 3 months after the end of the course of treatment, to observe the changes of Hamah Hamd score and the recurrence rate of the two groups before and after treatment. Results: the total effective rate of the treatment group was 945.The total effective rate of the control group was 77.8%, which indicated that the total effective rate of the treatment group was higher than that of the control group (P 0.05). After treatment, the total score of TCM symptoms in the two groups was significantly higher than that in the control group (P 0.05). In the single score of TCM symptoms, the treatment group was significantly better than the control group in improving stomachache, diet reduction, epigastric pain, belching and acid regurgitation, fatigue, loose stools, and improving irritability and irritability. The scores of Hamd and Hama in the treatment group were significantly lower than those in the control group after treatment, and the scores of Hamd and Hamd in the treatment group were significantly lower than those in the control group, and the scores of Hamd and Hama in the treatment group were significantly lower than those in the control group. The results showed that the recurrence rate of the treatment group was significantly higher than that of the control group (P 0.005), the recurrence rate of the treatment group was 10.6, and that of the control group was 37.1.The results showed that the recurrence rate of the treatment group was significantly higher than that of the control group. Conclusion: the total effective rate of the treatment group is significantly higher than that of the control group, which can effectively improve or eliminate the clinical symptoms of TCM and decrease the scores of Hama and Hamd. The patients' mental state and quality of life were improved effectively, and the recurrence rate was obviously lower than that in the control group, which fully showed that the therapeutic effect of this scheme was accurate, safe and reliable, and had a good prospect of clinical application.
【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】：2016
【分類(lèi)號(hào)】：R259;R277.7

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