疏肝利胆和胃方联合心理疗法对反流性食管炎患者神经递质水平及焦虑抑郁状态的影响  

Effect of Shugan Lidan Hewei Recipe combined with psychotherapy on neurotransmitter level and anxiety and depression in patients with reflux esophagitis

作　　者：张晓军[1] 韩涛[2] ZHANG Xiao-jun;HAN Tao(The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China;The Theory and Application of Traditional Chinese Medicine Visceral Manifestations Key Laboratory of the State Ministry of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032 [2]辽宁中医药大学中医脏象理论及应用国家教育部重点实验室,辽宁沈阳110032

出　　处：《实用药物与临床》2021年第11期1024-1027,共4页Practical Pharmacy and Clinical Remedies

基　　金：辽宁省自然科学基金(20170540609);辽宁中医药大学中医脏象理论及应用国家教育部重点实验室开放基金(3130217010)。

摘　　要：目的探讨疏肝利胆和胃方联合心理疗法对反流性食管炎患者神经递质水平及焦虑抑郁状态的影响。方法将我院2019年10月-2020年9月诊治的反流性食管炎患者112例,以随机数字表法分为2组,每组56例。对照组予常规治疗,治疗组在此基础上加用疏肝利胆和胃方联合心理疗法进行治疗,疗程共14 d。观察两组患者的胃肠激素、神经递质水平及患者焦虑抑郁情绪变化情况,比较两组临床疗效。结果治疗前,两组各项指标差异无统计学意义(P>0.05)。治疗后,两组胃肠激素指标P物质(SP)、血管活性肠肽(VIP)、胃泌素(GAS)及神经递质指标多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)均较治疗前改善(P<0.05),且治疗组各指标较对照组改善更显著(P<0.05);治疗后,两组患者焦虑抑郁程度均减轻,焦虑自评量表(SAS)和抑郁自评量表(SDS)评分下降,且治疗组各项评分较对照组下降更显著(P<0.05);治疗组的临床总有效率明显高于对照组(96.43%vs.83.93%,P<0.05)。结论疏肝利胆和胃方具有利胆和胃、疏肝理气之效,联合心理疗法可明显缓解患者焦虑抑郁程度,恢复体内胃肠激素水平,调节血清中神经递质含量,改善反酸等症状,治疗反流性食管炎疗效显著。Objective To explore the effect of Shugan Lidan Hewei Recipe combined with psychotherapy on neurotransmitter level and anxiety and depression in patients with reflux esophagitis.Methods A total of 112 patients with reflux esophagitis treated in our hospital from October 2019 to September 2020 were selected and were randomly divided into two groups based on random number table method,56 cases in each group.The control group received routine treatment,while the treatment group received routine treatment plus Shugan Lidan Hewei Recipe combined with psychotherapy.All patients were treated for 14 days.The levels of gastrointestinal hormones,neurotransmitters and the changes in anxiety and depression were observed in the two groups,and the clinical efficacy between the two groups were compared.Results Before treatment,there were no differences in the indexes between the two groups(P>0.05).After treatment,gastrointestinal hormone indexes,such as SP,VIP and GAS,and neurotransmitter indexes,such as 5-HT,NE and DA,in the two groups were improved(P<0.05),and each index in the treatment group improved more significantly(P<0.05).After treatment,the degree of anxiety and depression of patients in both groups was reduced,accompanied by the decrease of SAS and SDS scores.SAS and SDS scores of patients in the treatment group decreased more significantly(P<0.05).The total clinical effective rate of the treatment group was significantly higher than that of the control group(96.43%vs.83.93%,P<0.05).Conclusion Shugan Lidan Hewei Recipe has the effects of harmonizing the gallbladder and stomach and relieving qi stagnancy in liver.Shugan Lidan Hewei Recipe combined with psychotherapy can obviously relieve the anxiety and depression of patients,restore the gastrointestinal hormone level in vivo,regulate the content of neurotransmitters in serum,improve the symptoms such as acid reflux,and has good efficacy in treating reflux esophagitis.

关 键 词：疏肝利胆和胃方 心理疗法 反流性食管炎 神经递质 焦虑 抑郁 

分 类 号：R259[医药卫生—中西医结合]