心身同治法治疗类风湿关节炎伴发抑郁症27例临床观察  

Clinical Observation on Psychosomatic Therapy for Depression in 27 Rheumatoid Arthritis Patients

作　　者：王建东[1] 阎小萍[2] 

机构地区：[1]中国中医科学院广安门医院 [2]卫生部中日友好医院

出　　处：《中医杂志》2013年第13期1131-1134,共4页Journal of Traditional Chinese Medicine

摘　　要：目的评价心身同治法治疗类风湿关节炎(RA)伴发抑郁症的临床疗效。方法将RA伴发抑郁症患者56例随机分为治疗组27例和对照组29例,治疗组采用补肾治尪汤配合燮枢解郁方及心理干预;对照组仅给予补肾治尪汤加减治疗,两组疗程均为4周。疗程结束后观察两组患者中医、西医及抑郁症疗效,并于治疗前后观察两组患者中医证候积分、抑郁自评量表积分(SDS)、疼痛VAS评分、总体情况VAS评分、晨僵时间、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)。结果治疗组中医疗效、西医疗效、抑郁症疗效总有效率分别为88.88%、59.26%、85.19%,对照组分别为75.86%、48.28%、62.06%,治疗组中医疗效、抑郁症疗效均优于对照组(P<0.05)。治疗后两组ESR、CRP、RF均较治疗前明显改善(P<0.05或P<0.01)。治疗后治疗组中医证候积分、SDS积分、疼痛VAS评分、总体情况VAS评分及晨僵时间均较治疗前明显改善(P<0.05或P<0.01);对照组中医证候积分、疼痛VAS评分、晨僵时间均较治疗前改善(P<0.05)。治疗后治疗组SDS积分、疼痛VAS积分和晨僵时间均较对照组明显改善(P<0.05)。结论补肾祛寒治尪汤配合燮枢解郁方及心理干预的心身同治法能够有效缓解RA患者伴发的抑郁症状及RA症状。Objective To evaluate the therapeutic effect of Bushen Quhan Zhiwang Decoction （Kidney-Supplementing Cold- Dispelling Lameness Decoction）, Xieshu Jieyu Formula （Pivot-Harmonizing Depression-Resolving Formula） and psychological intervention for depression in rheumatoid arthritis （RA） patients. Methods Totally 56 RA patients with depression were randomized into treatment group of 27 cases and control group of 29 cases. The treatment group was given Bushen Zhiwang Decoction, Xieshu Jieyu Formula and psychological intervention. The control group was given Bushen Zhiwang Decoction. The treatment lasted for 4 weeks. The TCM efficacy, western medicine efficacy and depression efficacy were observed after treatment. The TCM pattern score, self-rating depression scale （SDS） score, visual analog scale （VAS） pain score, VAS overall score, duration of morning stiffness （h）, erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP） and rheumatoid factor （RF） were observed before and after treatment. Results The total effective rate of TCM, western medicine and depression in the treatment group was 88. 88o/00, 59. 26% and 85. 19% respectively. The total effective rate of TCM, western medicine and depression in the control group was 75.86 %, 48.28 % and 62.06 0% respectively. The total effective rate of TCM and depression in the treatment group was superior to those in the control group （P（0.05）. The ESR, CRP and RF was significantly improved in both groups after treatment （P〉0.05 or P〉0. 01）. The TCM pattern score, SDS score, VAS pain score, VAS overall score and duration of morning stiffness was significantly improved in the treatment group after treatment （P〈0. 05 or P〈0. 01）. The TCM pattern score, VAS pain score and duration of morning stiffness was significantly improved in the control group after treatment （P〈0.05）. Comparing with the control group, the SDS score, VAS pain score and duration of morning stiffness was significantly improved in the treatmen

关 键 词：类风湿关节炎 抑郁症 心身同治 补肾祛寒治尪汤 燮枢解郁方 

分 类 号：R259[医药卫生—中西医结合]