四逆散合四君子汤加减联合腹部推拿治疗肝郁脾虚型慢性疲劳综合征随机对照研究  

Randomized controlled study of therapy of modified Sini Powder combined with Sijunzi Decoction and manipulation at abdomen on the treatment of chronic fatigue syndrome with liver depression and spleen deficiency

作　　者：卢燚[1] 张玮[1,2] 李华南 谭涛[1] 苏志超 张海蛟[1] LU Yi;ZHANG Wei;LI Hua-nan;TAN Tao;SU Zhi-chao;ZHANG Hai-jiao(Massage Department,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;Level 3 Laboratory for Biological Effects of Tuina,National Administration of Traditional Chinese Medicine,Tianjin 300193,China)

机构地区：[1]天津中医药大学第一附属医院推拿科,天津300193 [2]国家中医药管理局推拿手法生物效应三级实验室,天津300193

出　　处：《中华中医药杂志》2022年第2期1188-1192,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81873393)。

摘　　要：目的:评价四逆散合四君子汤加减联合腹部推拿治疗肝郁脾虚型慢性疲劳综合征(CFS)的临床疗效及对炎症因子和氧化应激的影响。方法:将128例患者随机分为对照组和试验组,各64例。对照组给予腹部推拿手法,1次/d,5次/周。试验组腹部推拿手法同对照组,并给予四逆散合四君子汤加减口服,1剂/d,疗程均8周。比较两组治疗前后疲劳评定量表(FAI)、肝郁脾虚证、焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数(PSQI)和SF-36健康状况调查简表(SF-36)评分,检测治疗前后外周血丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化脂质(LPO)、白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)、γ干扰素(IFN-γ)和肿瘤坏死因子α(TNF-α)水平。结果:试验组患者的疾病疗效优于对照组(Z=2.012,P<0.05);治疗后试验组FAI、肝郁脾虚证、SAS、SDS和PSQI评分低于对照组(P<0.01),SF-36量表各因子评分高于对照组(P<0.01),MDA、LPO、IL-1β、TNF-α水平低于对照组(P<0.01),SOD、GSH-Px、IL-2、IFN-γ水平高于对照组(P<0.01)。结论:四逆散合四君子汤加减联合腹部推拿治疗CFS,能减轻抑郁、焦虑程度,提高睡眠质量和生活质量,并能调节炎症因子和氧化应激。Objective: To discuss clinical effect on chronic fatigue syndrome with liver depression and spleen deficiency when addition and subtraction therapy of Sini Powder combined with Sijunzi Decoction and manipulation at abdomen, and to study the influence to inflammatory factors and oxidative stress. Methods: One hundred and twenty-eight patients were divide into control group(64 cases) and experimental group(64 cases). Patients in control group got manipulation at abdomen, 1 time/day, 5 times/week. Based on the treatment of massage in control group, patients in experimental group got addition and subtraction therapy of Sini Powder combined and Sijunzi Decoction, 1 dose/day, the treatment was continued for 8 weeks. Before and after treatment,scores of fatigue assessment instrument(FAI), liver depression and spleen deficiency syndrome, self rating anxiety scale(SAS), self rating depression scale(SDS), pittsburgh sleep quality index(PSQI) and SF-36 of health survey(SF-36) were graded, and levels of malondialdehyde(MDA), superoxide dismutase(SOD), glutathione peroxidase(GSH-Px), lipid peroxide(LPO), interleukin-1β(IL-1β), interleukin-2(IL-2), interferon-γ(IFN-γ) and tumor necrosis factor(TNF-α) in peripheral blood were detected.Results: The curative effect of the experimental group was better than that of the control group(Z=2.012, P<0.05);After treatment,the scores of FAI, liver depression and spleen deficiency syndrome, SAS, SDS and PSQI in the experimental group were lower than those in the control group(P<0.01), and the factor scores of SF-36 scale were higher than those in the control group(P<0.01).The levels of MDA, LPO, IL-1β and TNF-α were lower than the data recorded from control group(P<0.01), levels of SOD,GSH-Px, IL-2 and IFN-γ were higher than the data recorded from control group(P<0.01). Conclusion: It can reduce fatigue,relieve depression and anxiety, improve sleep quality and quality of life, and regulate inflammatory factors and oxidative stress when addition and subtraction therapy of Sini Powde

关 键 词：慢性疲劳综合征 肝郁脾虚 四逆散 四君子汤 腹部推拿 炎症因子 氧化应激 

分 类 号：R259[医药卫生—中西医结合]