中西医结合疗法对抑郁症患者辨证施治的效果  

Effect of integrated therapy of Chinese and western medicine on differentiation of symptoms and signs of patients with depression

作　　者：牛素英[1] 李凝[1] 尤红[1] 史少霞[1] 刘春梅[1] 

机构地区：[1]河北医科大学第一医院精神卫生中心,河北省石家庄市050031

出　　处：《中国临床康复》2006年第39期7-9,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察中医药方剂加针刺疗法,配合西医抗抑郁药物对抑郁症患者辨证施治的治疗效果。方法:①选取2004-01/2005-05河北医科大学第一医院精神卫生中心收治的100例抑郁症住院患者,随机数字表法分为中西医结合治疗组、抗抑郁剂对照组,各50例。两组患者均签署知情同意书,符合CCMD-3抑郁症的诊断标准,性别、年龄、病程等基线资料基本相似(P>0.05)。②抗抑郁剂对照组单纯给予常规抗抑郁药物帕罗西汀片剂(中美史克天津药业公司生产,批号0401351,商品名赛乐特)进行治疗,20mg/片,20～40mg/d。中西医结合治疗组除给予等量帕罗西汀片剂进行治疗外,同时根据患者不同的临床表现辨证施治,每天口服中药方剂1剂+针刺1次(针刺留针30min/次),15d为1个疗程,两个疗程期间休息5d,以3个疗程为宜。③中西医结合辨证分型包括肝郁痰结型(方药以柴胡疏肝散为主,针刺合谷、太冲、中脘、丰隆、内关穴)、气郁化火型(方药以丹栀逍遥丸为主,针刺合谷、太冲、期门、神门穴)、气滞血瘀型(方药以血府逐瘀汤为主,针刺肝腧、膈腧、血海、三阴交穴)、肝肾亏虚型(方药以滋水清肝饮为主,针刺太溪、照海、三阴交、百会、肝俞、肾俞穴)、肝郁脾虚型(方药以越鞠丸为主,针刺太冲、太白、中脘、足三里、神门穴)。④两组治疗时间均为8周。分别于治疗前、治疗后2,4,8周由经过培训的统一人员采用汉密顿抑郁量表(包括焦虑/躯体化、体质量、认识障碍、日夜变化、阻滞、睡眠障碍、绝望感7类因子,5级评分法:0分为无症状,1分为轻度,2分为中度,3分为重度,4分为极重度)、汉密顿焦虑量表(分为躯体性和精神性焦虑两大类因子,分级与评分标准同抑郁量表)对患者进行抑郁、焦虑疗效评定,同时观察两组治疗后副反应。结果:100例抑郁症住院患者均进入结果分析。①两组患者治疗前后抑郁�To observe the curative effect of Chinese medicine prescription and acupuncture combined with western antidepressant drugs on differentiation of symptoms and signs of patients with depression, METHODS： ① 100 inpatients with depression admitted to the Mental Health Center, First Hospital of Hebei Medical University between January 2004 and May 2005 were selected and randomly divided into integrated treatment group and antidepressant drug group with 50 cases in each group. All the patients signed the agreement, and they were accordance with the diagnosis criteria of CCMD-3 depression, No significant difference was found in the baseline data such as sex, age and course of disease （P 〉 0,05）, ②The patients in the antidepressant drug group were only given routine antidepressant drug Paroxetine 20 mg per pallet, 20-40 mg daily （produced by the Tianjin Sino-America Squibb Pharmaceutics Co., Ltd. No. 0401351）. Additional to Seroxat, the patients in the integrated treatment group orally took one dose of Chinese prescription and acupuncture （retaining the needle for 30 minutes every time） once daily with 15 days as one course of treatment, and 5 days relaxed between two courses for 3 courses, ③The differentiation of symptoms and signs included liver stagnated phlegm （the prescription was composed of Caihu Sugan San, and acupunctured Hegu, Taichong, Zhongwan. Fenglongand Neiguan）, firetransmission due to stagnation of qi （the prescription was composed of Dan Zhi Xiaoyao Wan, and acupunctured Hegu, Taichong, Qimen and Shenmen）, stagnancy of qi and blood stasis （the prescription was composed of Xuefu Zhuyu Tang, and acupunctured Ganshu, Keshu, Xuehai and Sanyinjiao）, deficiency of liver-yin and kidney-yin （the prescription was composed of Zishui Qinggai Yin, and acupunctured Taixi, Zhaohai, Sanyinjiao, Baihui, Ganshu and Shenshu）, stagnation of the liver-qi and deficiency of the spleen （the prescription was composed of Yueju Wan, and acupunctured Taichong, Taibai, Zhongwan, Zusanli and

关 键 词：中药疗法 中药配伍 针刺疗法 抗抑郁药 抑郁症/治疗 

分 类 号：R749.41[医药卫生—神经病学与精神病学]