【摘要】：躁狂癥是以情緒過(guò)分活動(dòng)、高漲為主的一種情感性精神障礙疾病。中醫(yī)中并無(wú)躁狂癥之病名,但根據(jù)其癥狀可以歸到“狂證”范疇。本文從現(xiàn)代醫(yī)學(xué)和中醫(yī)學(xué)兩方面論述陽(yáng)明腑實(shí)之躁狂癥的病因病機(jī)、治法及研究進(jìn)展。并通過(guò)臨床觀察來(lái)總結(jié)大承氣湯腸療治療陽(yáng)明腑實(shí)之躁狂癥的療效,為今后中醫(yī)治療躁狂癥提供了一種安全有效的治療方法,同時(shí)也為以后研究躁狂癥的病因病機(jī)及治療方向奠定了一定的理論基礎(chǔ)。目的:觀察大承氣湯腸療治療陽(yáng)明腑實(shí)之躁狂癥的臨床效果,揭示大承氣湯腸療治療陽(yáng)明腑實(shí)之躁狂癥的臨床意義和優(yōu)點(diǎn),為進(jìn)一步研究中醫(yī)治療狂躁癥尋求一條新的途徑。方法:本研究課題把60例符合中醫(yī)和西醫(yī)診斷標(biāo)準(zhǔn)的陽(yáng)明腑實(shí)之躁狂癥患者隨機(jī)分為治療組30例和對(duì)照組30例。其中治療組給予大承氣湯腸療,對(duì)照組給予碳酸鋰口服治療,治療時(shí)間為14天。兩組患者經(jīng)治療后分別觀察精神癥狀并給予BRMS評(píng)分,比較兩組的差異從而總結(jié)治療前后療效。結(jié)果:(1)疾病療效的比較:治療組總有效率為86.67%,對(duì)照組總有效率為63.33%,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)治療后BRMS比較:治療后治療組的BRMS分值與對(duì)照組的BMRS分值相對(duì)比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:大承氣湯腸療治療躁狂癥患者優(yōu)于碳酸鋰。一方面大承氣湯具有通腑瀉熱、蕩滌胃腸、活血行滯、推陳致新的功效,另一方面由于直腸粘膜上有很豐富的血液循環(huán),吸收能力強(qiáng),當(dāng)通過(guò)腸療給藥時(shí)藥物不僅能被充分吸收,而且不經(jīng)過(guò)肝臟和胃,直接進(jìn)入血液循環(huán),減少對(duì)肝臟的損害,同時(shí)也減少了胃酸對(duì)藥物的影響。大承氣湯腸療治療躁狂癥的臨床療效肯定,值得醫(yī)學(xué)者對(duì)其更深一步探討研究。
[Abstract]:Mania is a kind of affective disorder with emotional overactivity and upsurge. There is no name for mania in Chinese medicine, but according to its symptoms can be classified as "mad syndrome" category. This paper discusses the etiology, pathogenesis, treatment methods and research progress of mania in Yangmingfushi from two aspects of modern medicine and traditional Chinese medicine. And through clinical observation to summarize the therapeutic effect of Dachengqi decoction on mania of Yangmingfu, which provides a safe and effective method for the treatment of mania in Chinese medicine in the future. It also lays a theoretical foundation for the study of the etiology, pathogenesis and treatment direction of mania. Objective: to observe the clinical effect of Dachengqi decoction (Dacheng Qi decoction) on treating mania of Yangming Fu and solid. To reveal the clinical significance and advantages of Dachengqi decoction for treating mania of Yangmingfu-shenshi, and to seek a new way for further study on the treatment of mania by traditional Chinese medicine (TCM). Methods: 60 patients with mania of Yangmingfu were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Dachengqi decoction and the control group was treated with lithium carbonate orally for 14 days. After treatment, the patients in the two groups were observed their mental symptoms and BRMS scores, and the differences between the two groups were compared to sum up the curative effect before and after treatment. Results: (1) comparison of the curative effect of disease: the total effective rate of the treatment group was 86.67 and the total effective rate of the control group was 63.33. The difference was statistically significant (P0.05). (2) after the treatment of BRMS comparison: the treatment group BRMS scores compared with the control group BMRS score, the difference was statistically significant (P0.05). Conclusion: Dachengqi decoction is superior to lithium carbonate in the treatment of mania. On the one hand, Dachengqi decoction has the effect of relieving heat, purging stomach and intestine, activating blood circulation, pushing Chen Zhixin, on the other hand, because of the abundant blood circulation on the rectal mucosa, it has a strong absorptive capacity. When administered by intestinal therapy, the drug can not only be fully absorbed, but also directly enter the blood circulation without going through the liver and stomach, thus reducing the damage to the liver and the influence of gastric acid on the drug. The clinical effect of Dachengqi decoction on mania is confirmed, which is worthy of further study.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【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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