枳术汤合柴桂温胆定志汤加味治疗功能性消化不良伴焦虑状态的临床疗效观察  

Clinical Observation of Zhizhu Decoction Plus Chaigui Wendan Dingzhi Decoction with Additions for the Treatment of Functional Dyspepsia Complicated with Anxiety State

作　　者：刘莹[1] 周军怀[2] 褚雪菲[2] 杜希 黄小倩 LIU Ying;ZHOU Jun-Huai;CHU Xue-Fei;DU Xi;HUANG Xiao-Qian(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Sanya Traditional Chinese Medicine Hospital,Sanya 572019 Hainan,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]海南省三亚市中医院,海南三亚572019

出　　处：《广州中医药大学学报》2023年第3期603-608,共6页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察枳术汤合柴桂温胆定志汤加味治疗肝胃不和型功能性消化不良(FD)伴焦虑状态的临床疗效。【方法】将100例肝胃不和型FD伴焦虑状态患者随机分为治疗组和对照组,每组各50例。对照组给予多潘立酮片治疗,治疗组给予枳术汤合柴桂温胆定志汤加味的中药颗粒剂治疗,疗程为4周。观察2组患者治疗前后中医证候积分和汉密尔顿焦虑量表(HAMA)评分的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)研究过程中,治疗组脱落3例,对照组脱落2例,最终共有95例患者纳入疗效统计,其中,治疗组47例,对照组48例。(2)治疗4周后,治疗组的总有效率为87.23%(41/47),对照组为60.42%(29/48),组间比较,治疗组的临床疗效明显优于对照组(P<0.01)。(3)治疗后,2组患者的各项中医证候积分(包括胃脘痞满或疼痛、两胁胀满、情志不遂易诱发或加重、心烦易怒、嗳气频作、善太息等)和总积分均较治疗前降低(P<0.05),且治疗组对胃脘痞满或疼痛、两胁胀满、情志不遂易诱发或加重等证候积分和总积分的降低幅度均明显优于对照组(P<0.05)。(4)治疗后,治疗组患者HAMA量表的焦虑心境、紧张、害怕、失眠、记忆或注意障碍、抑郁心境、肌肉系统症状、胃肠道症状、植物神经症状、会谈时行为表现评分和总评分均较治疗前降低(P<0.05),而对照组仅焦虑心境、紧张、抑郁心境、植物神经症状评分和总评分较治疗前降低(P<0.05);组间比较,除心血管系统症状、呼吸系统症状、植物神经症状评分外,治疗组对HAMA量表的各项评分和总评分的降低幅度均明显优于对照组(P<0.05)。(5)治疗期间,2组患者均无明显不良反应发生,具有较高的安全性。【结论】枳术汤合柴桂温胆定志汤加味治疗肝胃不和型FD伴焦虑状态患者疗效确切,可有效改善FD症状及焦虑状态,提高患者生活质量。Objective To observe the clinical efficacy of Zhizhu Decoction(mainly composed of Aurantii Fructus Immaturus and Atractylodis Macrocephalae Rhizoma, indicated for stomach disorders)plus Chaigui Wendan Dingzhi Decoction(mainly composed of Bupleuri Radix and Cinnamomi Ramulus,with the actions of warming and invigorating kidney yang to relieve mental depression) with additions in treating functional dyspepsia(FD)complicated with anxiety of disharmony of liver and stomach syndrome. Methods A total of 100 FD patients complicated with anxiety of liver and stomach disharmony syndrome were randomly divided into the treatment group and the control group, with 50 cases in each group. The control group was given Domperidone Tablets orally,while the treatment group was given the granules of Zhizhu Decoction plus Chaigui Wendan Dingzhi Decoction with additions orally. The treatment for both groups lasted for 4 weeks. The changes in the traditional Chinese medicine(TCM)syndrome score and Hamilton Anxiety Scale(HAMA)score in the two groups before and after treatment were observed,and the clinical efficacy and safety of the two groups were also evaluated after treatment. Results(1)During the trial,3 cases in the treatment group and 2 cases in the control group fell off. And finally,a total of95 patients were included into the efficacy statistics,of which 47 were in the treatment group and 48 were in the control group.(2)After 4 weeks of treatment,the overall effective rate of the treatment group was 87.23%(41/47)and that of the control group was 60.42%(29/48),and the intergroup comparison showed that the clinical efficacy of the treatment group was significantly superior to that of the control group(P<0.01).(3)After the treatment,the scores of TCM syndromes of epigastric fullness or pain, hypochondriac distending pain, easy induction or aggravation of emotional disorder,restlessness and irritability,belching frequently,and preference of deep sign as well as the total TCM syndrome scores of the two groups were all decreased compa

关 键 词：枳术汤 柴桂温胆定志汤 功能性消化不良 焦虑状态 肝胃不和 

分 类 号：R259.735[医药卫生—中西医结合]