【摘要】：目的:采用隨機對照的方法,驗證蠲郁顆粒治療肝郁痰阻型郁癥臨床療效,通過探討蠲郁顆粒治療肝郁痰阻型郁癥的有效性,從理論和臨床兩個方面系統(tǒng)分析蠲郁顆粒治療肝郁痰阻型郁癥的理論基點。方法:選取長春中醫(yī)藥大學(xué)附屬醫(yī)院中西醫(yī)結(jié)合睡眠中心門診就診,符合課題研究納入標(biāo)準(zhǔn)的肝郁痰阻型郁癥患者作為觀察對象,將72例患者隨機分為治療組(蠲郁顆粒組)36例與對照組(鹽酸氟西汀組)36例;在研究過程中治療組與對照組各有1例未按本方案服用藥物,剔除病例,未列入統(tǒng)計結(jié)果。最終將符合肝郁痰阻型郁癥患者70例列入統(tǒng)計。兩組分別給予蠲郁顆粒和鹽酸氟西汀口服治療,蠲郁顆粒按中藥口服方法,每袋10g,每次1袋,每日早晚2次口服;鹽酸氟西汀1片(20mg),晨起口服,每日1次,14天為1療程,共4療程。療程結(jié)束后,進(jìn)行療效觀察,采用SPSS19.0統(tǒng)計軟件對治療前后蠲郁顆粒組和鹽酸氟西汀組兩組患者進(jìn)行治療前后的數(shù)據(jù)統(tǒng)計。結(jié)果:治療前通過對病例的性別、年齡、病程進(jìn)行比較,兩組具有可比性(P均0.05),治療4個療程后,兩組治療后臨床療效分析、中醫(yī)證候療效、HAMDL抑郁量表評分及SDS自評量表評分比較,經(jīng)統(tǒng)計處理,P0.05,說明治療組療效優(yōu)于對照組。治療組同對照組治療前后中醫(yī)證候積分比較有顯著統(tǒng)計學(xué)意義(P0.01)。治療后治療組與對照組在中醫(yī)癥候積分比較,P0.05,有差異。說明兩組均能改善肝郁痰阻型郁癥患者的癥狀,但應(yīng)用中藥蠲郁顆粒組治療更優(yōu),并未見到不良反應(yīng)。本項研究證實了蠲郁顆粒在改善肝郁痰阻型郁癥方面療效顯著。結(jié)論:中藥蠲郁顆粒能明顯改善HAMD總評分,并能夠改善患者情緒低落、活動能力減退、思維與認(rèn)知功能遲緩等癥狀,同時中藥治療組能明顯對患者情緒低落、反應(yīng)遲鈍、口中黏膩、咽堵、腹脹等癥狀具有明顯改善作用。
[Abstract]:Objective: to verify the clinical efficacy of Juanyu granule in the treatment of liver stagnation and phlegm blocking depression, and to explore the effectiveness of Juanyu granule in treating liver depression and phlegm blocking depression. The theoretical basis of Juanyu granule in the treatment of stagnation of liver stagnation phlegm and phlegm was analyzed theoretically and clinically. Methods: the patients with liver depression and phlegm obstruction were selected from the clinic of sleep center of integrated traditional Chinese and western medicine in Changchun University of traditional Chinese Medicine (Changchun University of traditional Chinese Medicine). 72 patients were randomly divided into treatment group (Juanyu granule group) 36 cases and control group (fluoxetine hydrochloride group) 36 cases; In the course of the study, one case in the treatment group and one case in the control group did not take the drug according to this scheme, but the cases were excluded and not included in the statistical results. Finally, 70 patients with stagnation of liver and phlegm were included in the statistics. The two groups were treated with Juanyu granules and fluoxetine Hydrochloride orally respectively. Juanyu granules were taken orally according to the traditional Chinese medicine method, 1 bag per bag, 2 times a day in the morning and evening. Fluoxetine hydrochloride (20mg) tablet was taken orally once a day, 14 days as a course of treatment for 4 courses. After the course of treatment, the curative effect was observed, and the data of Juanyu granule group and fluoxetine hydrochloride group before and after treatment were analyzed by SPSS19.0 software. Results: by comparing the sex, age and course of disease of the cases before treatment, the two groups were comparable (P 0.05). After 4 courses of treatment, the clinical effect of the two groups was analyzed, and the curative effect of TCM syndrome was analyzed. The scores of HAMDL depression scale and SDS self-rating scale were compared, the results showed that the therapeutic effect of the treatment group was better than that of the control group (P 0.05). The scores of TCM syndromes in treatment group and control group were significantly different before and after treatment (P 0.01). After treatment, there was a difference between the treatment group and the control group in TCM symptom score (P0.05). The results showed that both groups could improve the symptoms of patients with stagnation of liver and phlegm, but the treatment of Juanyu granule was better than that of traditional Chinese medicine. This study confirms that Juanyu granule is effective in improving stagnation of liver and phlegm. Conclusion: Juanyu granule can obviously improve the total score of HAMD, and can improve the symptoms of depression, decreased activity, delayed thinking and cognitive function, etc. At the same time, the traditional Chinese medicine treatment group is obviously depressed and slow to respond to the patients. Sticky mouth, pharynx obstruction, abdominal distension and other symptoms have a significant improvement.
【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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