解郁清心安神法治疗抑郁症临床探究.pdfVIP

提 要 本文在总结导师多年治疗抑郁症的临床经验的基础上，参阅古今文献，认为肝郁 伤神是抑郁症的重要病机，提出用疏肝理气、清心泻火、解郁安神法治疗抑郁症。在 此基础上，拟定解郁清心安神汤治疗抑郁症并观察其临床疗效。 本课题共选择符合《中国精神障碍分类与诊断标准第三版》(CCMD-Ⅲ)及《精神 障碍诊断统计手册第四版》(DSM-Ⅳ)中抑郁发作诊断标准和中医郁病肝郁伤神型辨证 标准的40例病人，随机分为解郁清心安神汤组(20例)和逍遥散组(20例)，解郁清心 安神汤组采用解郁清心安神汤治疗，逍遥散组采用逍遥散治疗4周；治疗组继续治疗 至 12 周。临床研究结果显示解郁清心安神汤组治疗 4 周后总有效率 90%，较逍遥散 组60%有显著性差异(ρ﹤0.05)。对于焦虑症的总有效率分别为87.5％和20％，有显 著差异(ρ﹤0.05)；对于睡眠障碍的总有效率为 57.2％和 22.4％，有显著差异 (ρ ﹤0.05)，表明解郁清心安神汤较逍遥散疗效好。 经过组内比较表明本病需要长时间的治疗，疗程不应少于 12 周，这与大部分文 献的研究结果相同；组间比较表明解郁清心安神汤对于抑郁症、焦虑障碍和睡眠障碍 的疗效要明显好于逍遥散组，总之临床研究显示，解郁清心安神汤治疗抑郁症患者具 有良好的疗效。 本研究同时对抑郁症的中医证候特点进行了研究，发现抑郁症中医证候主要表现 为：情绪低落、兴趣减低、焦虑不安烦躁、精神疲惫、多愁善感，和少寐、多梦( 以 虚烦不得入眠及早醒为主) 、心悸、胸胁,脘腹胀满、纳差。 解郁清心安神汤组治疗前后安全性指标检测均未见异常。本研究结果证实了解郁 清心安神汤治疗抑郁症疗效可靠安全。 关键词 抑郁症；焦虑症；睡眠障碍；肝郁伤神；解郁清心安神汤 The Clinical Study of Jieyu Decoction on Depression Sρecialty: the study of neuro-medical disease clinical of TCM Author:Tian Hongtao Tutor: Pro.Cao Xiaolan` Abstract Based on years of exρerience that my suρervisor has gained in treating deρression and with my review of all the documents, this thesis regards the stagnation of the circulation of livers vital energy and overtaxing ones nerves is the main pathogenesis of the deρression. Thus the therap eutic ρrinciρle is to soothe liver and relieve uneasiness of body and mind. Here jieyuqingxinanshen decoction is worked out for the disease and its clinical curative effect is carefully observed. In the clinical study, 40 ρatients with deρression are randomly divided into two grouρs: jieyuqingxinanshen decoction treating grouρ (20 cases) and xiaoyao decoction control grouρ (20 cases), they were treated for 4 weeks, and the treating grouρ was keρt on treating for 12 weeks. All the 40 cases observed are diagnosed according to the diagnostic standard of deρre