胡國(guó)俊教授診治郁證學(xué)術(shù)思想與經(jīng)驗(yàn)總結(jié)及臨床研究
發(fā)布時(shí)間：2018-07-28 07:33
【摘要】：祖國(guó)醫(yī)學(xué)通過(guò)辨證論治,在郁證治療方面有自己的特色和優(yōu)勢(shì)。胡國(guó)俊教授從醫(yī)五十余年,在治療郁證方面積累了豐富的臨床經(jīng)驗(yàn)。本研究擬通過(guò)文獻(xiàn)研究和理論研究的方式,對(duì)胡國(guó)俊教授診治郁證的學(xué)術(shù)思想進(jìn)行溯源,進(jìn)一步深入研究,提煉出對(duì)臨床工作具有指導(dǎo)意義的學(xué)術(shù)思想；通過(guò)跟師學(xué)習(xí)、授課等形式,總結(jié)出胡國(guó)俊教授治療郁證的臨床經(jīng)驗(yàn)；并隨機(jī)選取氣虛血瘀型卒中后抑郁患者112例,運(yùn)用益氣活血解郁湯化裁與氟西汀進(jìn)行對(duì)照研究,比較兩者的臨床療效,檢驗(yàn)跟師成果。本研究分為三個(gè)部分。第一部分胡國(guó)俊學(xué)術(shù)思想淵源胡國(guó)俊教授出身中醫(yī)世家,其父胡翹武為新安醫(yī)學(xué)流派傳承人。通過(guò)仔細(xì)拜閱胡國(guó)俊教授的著作、文章,跟師學(xué)習(xí)以及與胡國(guó)俊教授的朝夕交流,總結(jié)出胡國(guó)俊教授學(xué)術(shù)思想源于《內(nèi)經(jīng)》,秉承于新安醫(yī)學(xué)流派。第二部分胡國(guó)俊診治郁證學(xué)術(shù)思想和臨床經(jīng)驗(yàn)的整理與研究胡國(guó)俊教授在郁證的診治過(guò)程中非常重視臟腑辨證,認(rèn)為氣機(jī)郁滯是郁證早期的主要機(jī)因；氣滯痰結(jié),氣郁化火為病情進(jìn)一步進(jìn)展；郁證后期多表現(xiàn)為虛證,茹陰虛血虧。1.總結(jié)出胡國(guó)俊教授診治郁證“郁證調(diào)氣,必先疏肝”,“郁證實(shí)多虛少”“治療以理氣為主,顧護(hù)陰液”的學(xué)術(shù)思想。(1)郁證調(diào)氣,必先疏肝：胡國(guó)俊教授認(rèn)為肝為木臟主疏泄,性喜暢達(dá),最惡抑郁。木郁則生機(jī)萎頓,肝郁則失于疏泄,凡情志不遂,肝者最易郁滯,則疏泄不及,氣逆厥陰經(jīng)絡(luò)。此外,肝氣具有直接調(diào)暢情志的作用,氣機(jī)條暢,氣血和調(diào)則心情開(kāi)朗。(2)郁證實(shí)多虛少：郁證病機(jī)是隨著病程的發(fā)展而不斷變化的,以實(shí)證多見(jiàn)。氣機(jī)郁滯為郁證早期的主要機(jī)因；氣機(jī)疏解不利,則進(jìn)一步導(dǎo)致氣滯痰結(jié),氣滯血郁,氣郁化火。此階段主要病理因素為“氣”、“火”、“痰”、“血”；病程后期多表現(xiàn)為虛證,如陰虛血虧、心脾兩虛。(3)治療以理氣為主,顧護(hù)陰液：胡國(guó)俊教授認(rèn)為,顧護(hù)陰液的思想應(yīng)貫穿于郁證治療的全過(guò)程。郁證早期,以氣機(jī)郁滯為主,此階段宜采用疏理氣機(jī),行氣解郁之品,但不宜長(zhǎng)久運(yùn)用,以免耗津傷液,以變他病。針對(duì)氣郁化火、痰結(jié)之候,在清熱瀉火,化痰散結(jié)的同時(shí),應(yīng)適當(dāng)佐以養(yǎng)陰生津之品,以顧護(hù)陰液�；馃嶂斑M(jìn)一步加劇,灼津耗液,加之治療郁證病程中多有運(yùn)用芳香理氣,燥烈之品,郁證病程后期無(wú)不具有陰液暗耗之候,此時(shí)期,應(yīng)以養(yǎng)陰生津治其本虛為當(dāng)務(wù)之急,忌用理氣解郁等芳香燥烈之品。2.此外,還總結(jié)出了胡國(guó)俊教授治療圍絕經(jīng)期抑郁,睡眠障礙,癔癥,奔豚等臨床經(jīng)驗(yàn)。(1)圍絕經(jīng)期抑郁：胡國(guó)俊教授認(rèn)為圍絕經(jīng)期抑郁患者通常表現(xiàn)為兩大癥候群,一類以煩躁不安,焦慮緊張,情緒不寧為主要癥候；一類以憂郁,情緒低落,不善言語(yǔ)為主。雖表現(xiàn)出兩類不同的癥候群,但其發(fā)病機(jī)制均為氣機(jī)郁滯,然氣機(jī)郁滯亦各有不同。煩躁不安,焦慮緊張多由于肝氣不舒所致,其病位在肝,當(dāng)從肝治,應(yīng)予疏肝解郁法；圍絕經(jīng)期表現(xiàn)出來(lái)的憂郁,情緒低落表現(xiàn)當(dāng)與肺臟相關(guān),其病位在肺,當(dāng)從肺治,應(yīng)予開(kāi)降肺氣之法。(2)郁而失眠論治：胡國(guó)俊教授認(rèn)為郁證本身是一種情志疾病,同時(shí)也是引起失眠的一個(gè)病因。失眠與郁證發(fā)病有著共同的病理機(jī)制。隨著社會(huì)的不斷發(fā)展與進(jìn)步,現(xiàn)代人們的學(xué)習(xí)、工作節(jié)奏越來(lái)越快；生活、精神壓力不斷增加,由此引發(fā)的情緒不寧,心情怫郁等郁證引起的失眠也越來(lái)越多,從郁治失眠,郁解而寐安,是治病求本的體現(xiàn),也是對(duì)失眠辨證論治方法的一種補(bǔ)充。(3)癔癥治療經(jīng)驗(yàn)：胡師認(rèn)為,雖然癔癥的臨床表現(xiàn)形式繁雜,但情志不遂或精神刺激為其主要機(jī)因。癔癥時(shí)久,亦可變生他病,最多見(jiàn)的為喘促過(guò)度以致陽(yáng)虛氣脫；汗淚俱下以致陰液不足。治療的原則以心理疏導(dǎo)為主,輔以藥物治療。(4)降斂沖氣治療奔豚：胡國(guó)俊教授認(rèn)為,奔豚之癥狀,可表現(xiàn)于各種疾病當(dāng)中,其關(guān)鍵機(jī)因?yàn)椤皻饽胬锛薄?與肝肺腎三臟關(guān)系密切。對(duì)于奔豚的治療,在治本臟不應(yīng)時(shí),應(yīng)投降斂沖氣之法,或可收立竿見(jiàn)影之效。3.通過(guò)對(duì)208例郁證患者病案的整理以及中藥使用頻次的數(shù)據(jù)挖掘,整理出郁證的10種辨證分型,包括肝氣郁結(jié)型、氣郁化火型、肝火犯胃型、氣滯血郁型、痰氣郁結(jié)型、肺失宣肅型、陰虛血虧型、心脾兩虛型、肝腎陰虛型、脾虛氣滯型。處方中使用中藥共計(jì)213種,其中使用超過(guò)100次的有13味,包括柴胡、枳殼、郁金、生龍骨、生牡蠣、茯神、半夏、遠(yuǎn)志、黃芪、夜交藤、酸棗仁、白術(shù)、黃芩；使用次數(shù)在40-100次之間的有24味,包括太子參、焦山梔、炙甘草、黃連、白芍、知母、薏苡仁、桂枝、桔梗、柏子仁、甘草、旱蓮草、玄參、茯苓、旋復(fù)花、龜板、蒼術(shù)、珍珠母、生地、香附、葛根、瓜蔞皮、琥珀、合歡皮、川貝母；使用比例超過(guò)50%的單味藥有四味,分別為柴胡、枳殼、郁金、茯神。第三部分益氣活血解郁法治療卒中后抑郁氣虛血瘀型臨床研究觀察運(yùn)用益氣活血解郁法治療卒中后抑郁臨床療效,為中醫(yī)藥防治卒中后抑郁提供臨床依據(jù)。選擇112例符合診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)的卒中后抑郁患者,隨機(jī)分為治療組(n=57),采用益氣活血解郁法治療；對(duì)照組(n=55),采用鹽酸氟西汀治療,均以6周為療程。在治療前后觀察兩組的HAMD評(píng)分、NIHSS評(píng)分、Barthe1評(píng)分,評(píng)價(jià)益氣活血解郁湯的臨床療效。通過(guò)比較,兩組治療前HAMD評(píng)分、NIHSS評(píng)分、Barthe1評(píng)分比較無(wú)差異,P0.05;治療6周后兩組在iAMD評(píng)分、NIHSS評(píng)分、Barthe1評(píng)分上與治療前相比較,均有明顯差異P0.01。治療組在治療6周后,患者HAMD評(píng)分、NIHSS評(píng)分、Barthe1評(píng)分均較對(duì)照組改善明顯,兩組比較,P0.01。說(shuō)明中藥益氣活血解郁湯可以明顯改善患者HAMD評(píng)分,減輕抑郁癥狀,同時(shí)可以改善了卒中患者的神經(jīng)功能缺損的體征,以及提升了患者的日程生活能力。較鹽酸氟西汀在改善患者抑郁癥狀,神經(jīng)功能康復(fù)及提升生活能力方面更有優(yōu)勢(shì)。
[Abstract]:Chinese medicine has its own characteristics and advantages in the treatment of stagnation by syndrome differentiation. Professor Hu Guojun has accumulated rich clinical experience in the treatment of depression for more than fifty years. This study intends to trace the academic thought of Professor Hu Guojun's Zhen Zhiyu's evidence through literature research and theoretical research. In this paper, the academic thought which has guiding significance to clinical work is extracted, and the clinical experience of Professor Hu Guojun's treatment of depression is summarized through the form of learning with teachers and teaching, and 112 patients with depression after stroke are randomly selected and compared with fluoxetine by using Yiqi Huoxue Jieyu Decoction and fluoxetine to compare the clinical treatment of the two. This study is divided into three parts. The first part of this study is divided into three parts. The first part of Hu Guojun's academic thought, Professor Hu Guojun, is a family of traditional Chinese medicine, and his father Hu Qiaowu is the inheritor of the school of medicine. Through careful reading of Professor Hu Guojun's works, articles, learning from teachers, and exchanges with Professor Hu Kuo Jun, Professor Hu Guojun learns to learn from Professor Hu Guojun. The thought originated from < inner Jing >, adhering to the medical school of Xin'an. The second part of Hu Guojun's academic thought and clinical experience in the diagnosis and treatment of Yu syndrome. Professor Hu Guojun pays great attention to the syndrome differentiation of the viscera during the diagnosis and treatment of the qi stagnation syndrome. The Qi stagnation is the main cause of the early depression; the qi stagnation, the qi stagnation and the qi stagnation fire are the further progress of the disease. At the later stage of Yu syndrome, many manifestations of the deficiency syndrome and the deficiency of the yin deficiency.1. summed up professor Hu Guojun's diagnosis and treatment of qi stagnation syndrome, "qi stagnation and Qi regulating", "Qi deficiency is required first", "Qi is proved to be more deficiency and less", and the academic thought of "treating with Qi and protecting Yin liquid" is "the treatment of Qi and Yin liquid". (1) qi stagnation and Qi adjustment is necessary to remove the liver first: Professor Hu Guojun thinks that the liver is the main discharge of the wood dirty, sexual joy unimpeded and most depressive depression Wood depression, the vitality of the stagnation, liver depression is lost, the liver is the most likely to stagnant, the liver is the most stagnant, and the Qi reverse Yin meridian. In addition, the liver Qi has a direct unobstructed emotion, Qi Qi, Qi and blood and the mood is bright. (2) depression is proved to be more virtual and less: Qi stagnation pathogenesis is constantly changing with the development of the course, with empirical evidence. Qi stagnation is the main cause of the early stagnation of the syndrome; the qi stagnation is unfavorable, then the qi stagnation phlegm knot, qi stagnation and qi stagnation, qi stagnation fire. The main pathological factors in this stage are "Qi", "fire", "phlegm" and "blood"; the period of the course of disease is manifested as deficiency syndrome, such as yin deficiency and blood loss, two deficiency of the heart and spleen. (3) the treatment is mainly physical Qi and Gu Yin liquid, Hu Guo Professor Jun thinks that the thought of Gu Yin Yin liquid should run through the whole process of the treatment of qi stagnation. In the early stage of depression, qi stagnation is the main factor. This stage should be used to remove the Qi, but it should not be used for a long time. Nourishing yin and nourishing Yin fluid, taking care of the nourishing Yin fluid, further aggravation of the fever, burning the fluid, and treating the stagnation of the stagnation of the syndrome with the fragrance of Qi, the hot and dry product, the late period of the stagnation of the syndrome with Yin liquid and dark consumption. At this time, it should be taken by the nourishing yin to treat its deficiency as an urgent matter, and avoid the aromatic and dry products,.2., and so on. The clinical experiences of Professor Hu Guojun in the treatment of perimenopausal depression, sleep disorder, hysteria and dolphin were summarized. (1) perimenopausal depression: Professor Hu Guojun believed that perimenopausal depression patients usually showed two major syndromes, one with irritability, anxiety, and emotional restlessness as the main symptom, and a class of melancholy, depression, and bad words. Although there are two different syndromes, the pathogenesis is all the qi stagnation, but the qi stagnation is also different. Irritability, anxiety and tension are caused by liver qi, the disease is in the liver, when the liver is treated, it should be removed from the liver, and the depression and depression of the peri menopause are related to the lung, and its disease is related to the lung, its disease Position in the lung, when the lung treatment, should be given the method of reducing lung qi. (2) depression and insomnia treatment: Professor Hu Guojun thinks that depression itself is a kind of emotional disease, but also a cause of insomnia. Insomnia and depression have a common pathological mechanism. With the continuous development and progress of the society, modern people study, work rhythm is getting faster and faster. Life, the mental pressure is increasing, the emotion caused by the emotional restlessness, depression and other depression caused by insomnia is also more and more, from depression to insomnia, depression and insomnia, is the embodiment of treatment, but also a supplement to the syndrome differentiation method of insomnia. (3) hysteria treatment experience: Although the clinical manifestations of hysteria, although hysteria clinical manifestations of complex, complex hysteria, complicated, although hysteria clinical manifestations forms, complicated, hysteria clinical manifestations, complex clinical forms, although hysteria clinical manifestations, complex clinical forms, hysteria, though the clinical forms of hysteria, complex, hysteria clinical manifestations of complex, But there is no attempt or mental stimulation for the main cause. When hysteria is long, he can also change his disease, and most of them are overdue to excessive asthmatic and asthenia, so that sweat and tears are so bad that the Yin fluid is insufficient. The principle of treatment is psychological guidance, supplemented by drug treatment. (4) Professor Hu Guojun believes that the symptoms of the dolphin can be displayed in each of the symptoms. Among the diseases, the key machine is closely related to the three organs of the liver, lung and kidney, which is closely related to the "Qi reverse in the inside". For the treatment of the run of the dolphin, in the treatment of the cure, we should surrender the method of collecting and punching the gas, or receive the immediate effect.3. through the arrangement of 208 cases of depression and the data mining of the frequency of traditional Chinese medicine, to sort out the 10 types of syndrome differentiation. Type, including liver qi stagnation type, qi stagnation and stomach type, qi stagnation and blood depression type, phlegm stagnation type, lung lost Xuan Su type, yin deficiency and blood loss type, deficiency of heart and spleen two, liver kidney yin deficiency type, spleen deficiency syndrome type, 213 kinds of traditional Chinese medicine used in the prescription, including 13 flavors with more than 100 times, including Bupleurum bupleurum, Fructus aurantii, tulips, raw oysters, raw oysters, portral God, half In summer, Radix Polygala, Radix Astragali, Radix Astragalus, Chinese jujube kernel, Rhizoma Atractylodes, Radix Scutellariae, 24 flavors, including Radix Aconiti, jaman gardenia, licorice, Rhizoma Coptidis, Coix Paeonia, coix seed, cassia branch, Platycodon, Platycodon Zi Ren, Rhizoma licorice, Rhizoma cassia, tuckahoe, Rhizoma cangifera, tortoise board, Atractylodes, pearl mother, root, Pericarpium, pericarp, amber, and bark of Acacia The clinical study on the treatment of depression Qi deficiency and blood stasis in the third part of the treatment of post stroke depression Qi deficiency and blood stasis, the clinical effect of treating post apoplexy depression with the method of Supplementing Qi and activating blood and relieving depression, and providing clinical basis for the prevention and treatment of post stroke depression in Chinese medicine, the third part of the clinical study on the treatment of qi deficiency and blood stasis after stroke. 112 cases of post-stroke depression were randomly divided into treatment group (n=57), the treatment group was treated with Supplementing Qi and activating blood and relieving depression, and the control group (n=55) was treated with fluoxetine hydrochloride for 6 weeks. The HAMD score, NIHSS score, and Barthe1 score of two groups were observed before and after the treatment, and the clinical efficacy of Yiqi Huoxue Jieyu Decoction was evaluated. By comparison, there was no difference between the two groups before treatment HAMD score, NIHSS score, and Barthe1 score, P0.05. After 6 weeks of treatment, the two groups in the iAMD score, the NIHSS score, and the Barthe1 score were significantly different from those before the treatment, and the HAMD score, NIHSS score, and Barthe1 score of the patients were significantly better than the control group after 6 weeks of treatment, and the two groups were compared with the control group. P0.01. shows that the TCM Yiqi Huoxue Jieyu Decoction can obviously improve the patient's HAMD score, reduce the depressive symptoms, improve the signs of the nerve function defect in the stroke patients, and improve the patient's ability to live. There is an advantage.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R277.7
本文編號(hào)：2149368
[Abstract]:Chinese medicine has its own characteristics and advantages in the treatment of stagnation by syndrome differentiation. Professor Hu Guojun has accumulated rich clinical experience in the treatment of depression for more than fifty years. This study intends to trace the academic thought of Professor Hu Guojun's Zhen Zhiyu's evidence through literature research and theoretical research. In this paper, the academic thought which has guiding significance to clinical work is extracted, and the clinical experience of Professor Hu Guojun's treatment of depression is summarized through the form of learning with teachers and teaching, and 112 patients with depression after stroke are randomly selected and compared with fluoxetine by using Yiqi Huoxue Jieyu Decoction and fluoxetine to compare the clinical treatment of the two. This study is divided into three parts. The first part of this study is divided into three parts. The first part of Hu Guojun's academic thought, Professor Hu Guojun, is a family of traditional Chinese medicine, and his father Hu Qiaowu is the inheritor of the school of medicine. Through careful reading of Professor Hu Guojun's works, articles, learning from teachers, and exchanges with Professor Hu Kuo Jun, Professor Hu Guojun learns to learn from Professor Hu Guojun. The thought originated from < inner Jing >, adhering to the medical school of Xin'an. The second part of Hu Guojun's academic thought and clinical experience in the diagnosis and treatment of Yu syndrome. Professor Hu Guojun pays great attention to the syndrome differentiation of the viscera during the diagnosis and treatment of the qi stagnation syndrome. The Qi stagnation is the main cause of the early depression; the qi stagnation, the qi stagnation and the qi stagnation fire are the further progress of the disease. At the later stage of Yu syndrome, many manifestations of the deficiency syndrome and the deficiency of the yin deficiency.1. summed up professor Hu Guojun's diagnosis and treatment of qi stagnation syndrome, "qi stagnation and Qi regulating", "Qi deficiency is required first", "Qi is proved to be more deficiency and less", and the academic thought of "treating with Qi and protecting Yin liquid" is "the treatment of Qi and Yin liquid". (1) qi stagnation and Qi adjustment is necessary to remove the liver first: Professor Hu Guojun thinks that the liver is the main discharge of the wood dirty, sexual joy unimpeded and most depressive depression Wood depression, the vitality of the stagnation, liver depression is lost, the liver is the most likely to stagnant, the liver is the most stagnant, and the Qi reverse Yin meridian. In addition, the liver Qi has a direct unobstructed emotion, Qi Qi, Qi and blood and the mood is bright. (2) depression is proved to be more virtual and less: Qi stagnation pathogenesis is constantly changing with the development of the course, with empirical evidence. Qi stagnation is the main cause of the early stagnation of the syndrome; the qi stagnation is unfavorable, then the qi stagnation phlegm knot, qi stagnation and qi stagnation, qi stagnation fire. The main pathological factors in this stage are "Qi", "fire", "phlegm" and "blood"; the period of the course of disease is manifested as deficiency syndrome, such as yin deficiency and blood loss, two deficiency of the heart and spleen. (3) the treatment is mainly physical Qi and Gu Yin liquid, Hu Guo Professor Jun thinks that the thought of Gu Yin Yin liquid should run through the whole process of the treatment of qi stagnation. In the early stage of depression, qi stagnation is the main factor. This stage should be used to remove the Qi, but it should not be used for a long time. Nourishing yin and nourishing Yin fluid, taking care of the nourishing Yin fluid, further aggravation of the fever, burning the fluid, and treating the stagnation of the stagnation of the syndrome with the fragrance of Qi, the hot and dry product, the late period of the stagnation of the syndrome with Yin liquid and dark consumption. At this time, it should be taken by the nourishing yin to treat its deficiency as an urgent matter, and avoid the aromatic and dry products,.2., and so on. The clinical experiences of Professor Hu Guojun in the treatment of perimenopausal depression, sleep disorder, hysteria and dolphin were summarized. (1) perimenopausal depression: Professor Hu Guojun believed that perimenopausal depression patients usually showed two major syndromes, one with irritability, anxiety, and emotional restlessness as the main symptom, and a class of melancholy, depression, and bad words. Although there are two different syndromes, the pathogenesis is all the qi stagnation, but the qi stagnation is also different. Irritability, anxiety and tension are caused by liver qi, the disease is in the liver, when the liver is treated, it should be removed from the liver, and the depression and depression of the peri menopause are related to the lung, and its disease is related to the lung, its disease Position in the lung, when the lung treatment, should be given the method of reducing lung qi. (2) depression and insomnia treatment: Professor Hu Guojun thinks that depression itself is a kind of emotional disease, but also a cause of insomnia. Insomnia and depression have a common pathological mechanism. With the continuous development and progress of the society, modern people study, work rhythm is getting faster and faster. Life, the mental pressure is increasing, the emotion caused by the emotional restlessness, depression and other depression caused by insomnia is also more and more, from depression to insomnia, depression and insomnia, is the embodiment of treatment, but also a supplement to the syndrome differentiation method of insomnia. (3) hysteria treatment experience: Although the clinical manifestations of hysteria, although hysteria clinical manifestations of complex, complex hysteria, complicated, although hysteria clinical manifestations forms, complicated, hysteria clinical manifestations, complex clinical forms, although hysteria clinical manifestations, complex clinical forms, hysteria, though the clinical forms of hysteria, complex, hysteria clinical manifestations of complex, But there is no attempt or mental stimulation for the main cause. When hysteria is long, he can also change his disease, and most of them are overdue to excessive asthmatic and asthenia, so that sweat and tears are so bad that the Yin fluid is insufficient. The principle of treatment is psychological guidance, supplemented by drug treatment. (4) Professor Hu Guojun believes that the symptoms of the dolphin can be displayed in each of the symptoms. Among the diseases, the key machine is closely related to the three organs of the liver, lung and kidney, which is closely related to the "Qi reverse in the inside". For the treatment of the run of the dolphin, in the treatment of the cure, we should surrender the method of collecting and punching the gas, or receive the immediate effect.3. through the arrangement of 208 cases of depression and the data mining of the frequency of traditional Chinese medicine, to sort out the 10 types of syndrome differentiation. Type, including liver qi stagnation type, qi stagnation and stomach type, qi stagnation and blood depression type, phlegm stagnation type, lung lost Xuan Su type, yin deficiency and blood loss type, deficiency of heart and spleen two, liver kidney yin deficiency type, spleen deficiency syndrome type, 213 kinds of traditional Chinese medicine used in the prescription, including 13 flavors with more than 100 times, including Bupleurum bupleurum, Fructus aurantii, tulips, raw oysters, raw oysters, portral God, half In summer, Radix Polygala, Radix Astragali, Radix Astragalus, Chinese jujube kernel, Rhizoma Atractylodes, Radix Scutellariae, 24 flavors, including Radix Aconiti, jaman gardenia, licorice, Rhizoma Coptidis, Coix Paeonia, coix seed, cassia branch, Platycodon, Platycodon Zi Ren, Rhizoma licorice, Rhizoma cassia, tuckahoe, Rhizoma cangifera, tortoise board, Atractylodes, pearl mother, root, Pericarpium, pericarp, amber, and bark of Acacia The clinical study on the treatment of depression Qi deficiency and blood stasis in the third part of the treatment of post stroke depression Qi deficiency and blood stasis, the clinical effect of treating post apoplexy depression with the method of Supplementing Qi and activating blood and relieving depression, and providing clinical basis for the prevention and treatment of post stroke depression in Chinese medicine, the third part of the clinical study on the treatment of qi deficiency and blood stasis after stroke. 112 cases of post-stroke depression were randomly divided into treatment group (n=57), the treatment group was treated with Supplementing Qi and activating blood and relieving depression, and the control group (n=55) was treated with fluoxetine hydrochloride for 6 weeks. The HAMD score, NIHSS score, and Barthe1 score of two groups were observed before and after the treatment, and the clinical efficacy of Yiqi Huoxue Jieyu Decoction was evaluated. By comparison, there was no difference between the two groups before treatment HAMD score, NIHSS score, and Barthe1 score, P0.05. After 6 weeks of treatment, the two groups in the iAMD score, the NIHSS score, and the Barthe1 score were significantly different from those before the treatment, and the HAMD score, NIHSS score, and Barthe1 score of the patients were significantly better than the control group after 6 weeks of treatment, and the two groups were compared with the control group. P0.01. shows that the TCM Yiqi Huoxue Jieyu Decoction can obviously improve the patient's HAMD score, reduce the depressive symptoms, improve the signs of the nerve function defect in the stroke patients, and improve the patient's ability to live. There is an advantage.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R277.7
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