發(fā)布時(shí)間：2018-06-26 08:58

  本文選題：抑郁癥 + 郁證��； 參考：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:觀察針刺結(jié)合“逍遙湯加減”治療肝氣郁結(jié)型郁證的臨床療效。材料與方法:將符合入選標(biāo)準(zhǔn)的70例肝氣郁結(jié)型郁證患者隨機(jī)分為治療組與對(duì)照組各35例。對(duì)照組35例(中藥治療),治法為疏肝解郁,理氣調(diào)中。方藥:以“逍遙湯加減”(當(dāng)歸、雞血藤、川芎、白芍、郁金、茯苓各20g,牡蠣、石決明、珍珠母、龍骨各30g,陳皮、木香、柴胡、白術(shù)、香附各15,甘草10g)治療,l劑/d,水煎400m L,早中晚口服。治療組35例(針?biāo)幹委?針灸治療取神庭、百會(huì)、膻中,率谷、太陽(yáng)、內(nèi)關(guān)、太沖、三陰交、安眠均雙側(cè);喉中有梗加天突。針刺得氣后,留針20min,l次/d;中藥治療同對(duì)照組。每組連續(xù)治療10d為l療程。連續(xù)治療2療程,判定兩組臨床療效,比較兩組治療前后HAMD評(píng)分變化、中醫(yī)癥候療效評(píng)分變化及治療過(guò)程中的不良反應(yīng)。治療期間禁食刺激性食物,注意避免情緒波動(dòng)。結(jié)果:1.HAMD評(píng)分判定總體療效:治療組總有效率97.14%,愈顯率為82.86%,對(duì)照組總有效率為88.57%,愈顯率為59.59%;中醫(yī)癥候療效評(píng)分判定總體療效:治療組總有效率97.14%,愈顯率為71.43%,對(duì)照組總有效率為91.43%,愈顯率為48.57%。兩種療效判定方法下的數(shù)據(jù)均用秩和檢驗(yàn)計(jì)算比較療效,治療組療效均優(yōu)于對(duì)照組(P0.05)。2.兩組治療前后自身比較HAMD評(píng)分變化、中醫(yī)癥候療效變化,統(tǒng)計(jì)結(jié)果均P0.01,說(shuō)明治療組與對(duì)照組在郁證治療上療效肯定。3.治療后組間比較HAMD評(píng)分、中醫(yī)癥候療效評(píng)分變化,統(tǒng)計(jì)結(jié)果分別是P0.01和P0.05,即治療組在改善郁證癥狀上也優(yōu)于對(duì)照組。結(jié)論:1.針刺結(jié)合“逍遙湯加減”的治療方法能明顯改善肝氣郁結(jié)型郁證患者的癥狀。2.針?biāo)幗Y(jié)合治療郁證在臨床療效、改善癥狀方面均優(yōu)于單純中藥療法。3.針?biāo)幉⑴e治療肝氣郁結(jié)型郁證,療效滿(mǎn)意,無(wú)嚴(yán)重不良反應(yīng),值得推廣。
[Abstract]:Objective: to observe the clinical effect of acupuncture combined with Xiaoyao decoction on stagnation of liver-qi syndrome. Materials and methods: 70 patients with stagnation of liver qi were randomly divided into treatment group and control group. In the control group, 35 cases were treated with traditional Chinese medicine. Prescription: "Xiaoyao decoction" (Angelica sinensis, chicken blood vine, Ligusticum chuanxiong, Radix Paeoniae Alba, Tulip, Poria cocos, oyster, stone cassia, mother of pearl, keel each 30g, Chen Pei, Muxiang, Chaihu, Atractylodes macrocephala, Rhizoma Cyperus, 15 each, 10 g Glycyrrhiza (10 g) for 1 day, 400 mL decoction, early, middle and late oral. Treatment group 35 cases (acupuncture and medicine treatment) acupuncture and moxibustion treatment of Shenting, Baihui, Tanzhong, rate Valley, Sun, Neiguan, Taichong, Sanyinjiao, sleep are bilateral; After acupuncture to get qi, the needle was kept for 20 mins / d, and the control group was treated with traditional Chinese medicine. Each group was treated continuously for 10 days as a course of treatment. The clinical efficacy of the two groups was evaluated after two consecutive courses of treatment. The changes of Hamd score, TCM symptom score and adverse reactions were compared before and after treatment. During the treatment fasting stimulating food, pay attention to avoid emotional fluctuations. Results: the total effective rate was 97.14 in the treatment group, 82.86 in the treatment group, 88.57 in the control group and 59.59 in the control group; the total effective rate was 97.14 in the treatment group and 71.43 in the control group. The total effective rate was 91.43 and the effective rate was 48.57. The data of the two methods were calculated and compared by rank sum test. The curative effect of the treatment group was better than that of the control group (P0.05). 2. Before and after treatment, the changes of Hamd score and TCM syndromes were compared between the two groups (P 0.01), which indicated that the therapeutic effect of treatment group and control group on depression syndrome was positive. 3. After treatment, Hamd scores and TCM symptom scores were compared, the statistical results were P0.01 and P0.05 respectively, that is, the treatment group was also superior to the control group in improving the symptoms of depression. Conclusion 1. Acupuncture combined with Xiaoyao decoction can obviously improve the symptoms of patients with stagnation of liver-qi syndrome. Acupuncture combined with medicine in the treatment of depression in clinical efficacy, improve symptoms are better than simple Chinese medicine therapy. 3. 3. The treatment of stagnation of liver-qi syndrome with acupuncture and medicine has satisfactory curative effect and no serious adverse reaction, so it is worth popularizing.
【學(xué)位授予單位】：遼寧中醫(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)】：R277.7

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