加味柴胡加龙骨牡蛎汤治疗情志病热郁少阳证的临床疗效

Clinical Efficacy of Modified Chaihu Longgu Muli Decoction in the Treatment of Emotional Illness with Heat Stagnation in Shaoyang Syndrome

目的探讨加味柴胡加龙骨牡蛎汤治疗情志病热郁少阳证的临床疗效。方法选取2021年9月—2023年11月南京中医药大学太仓附属医院、江苏省中医院收治的情志病热郁少阳证患者245例,按照随机数字表法将其分为对照组120例与治疗组125例。对照组采用草酸艾司西酞普兰片治疗,治疗组患者在对照组基础上加用加味柴胡加龙骨牡蛎汤治疗,两组疗程均为6周。比较两组临床疗效,治疗前及治疗2、4、6周后核心症状总积分、中医证候积分,治疗前及治疗6周后汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表24项(HAMD-24)、匹兹堡睡眠质量指数(PSQI)各维度评分及其总分,不良反应发生率。结果治疗组临床疗效优于对照组(P<0.05)。治疗方法与时间在核心症状总积分、中医证候积分上存在交互作用(P<0.05);治疗方法、时间在核心症状总积分、中医证候积分上主效应显著(P<0.05)。治疗组治疗4、6周后核心症状总积分及治疗2、4、6周后中医证候积分低于对照组(P<0.05)。治疗6周后,治疗组躯体性焦虑维度评分,焦虑/躯体化、绝望感维度评分及HAMD-24总分,睡眠障碍、催眠药物使用维度评分低于对照组(P<0.05)。对照组不良反应总发生率与治疗组比较,差异无统计学意义(P>0.05)。结论加味柴胡加龙骨牡蛎汤治疗情志病热郁少阳证的疗效确切,可有效减轻患者核心症状、病情程度及躯体症状,减轻睡眠障碍及催眠药物依赖程度,且临床安全性较高。

Objective To explore the the clinical efficacy of modified Chaihu Longgu Muli decoction in the treatment of emotional illness with heat stagnation in Shaoyang syndrome.Methods A total of 245 emotional illness patients with heat stagnation in Shaoyang syndrome admitted to Taicang Affiliated Hospital of Nanjing University of Chinese Medicine and Jiangsu Province Hospital of Chinese Medicine from September 2021 to November 2023 were selected,the patients were divided into the control group of 120 cases and the treatment group of 125 cases by random number table method.The control group was treated with escitalopram oxalate tablets,and the treatment group was treated with modified Chaihu Longgu Muli decoction on the basis of the control group,and the course of the two groups was 6 weeks.Clinical efficacy,the total core symptom score and TCM syndrome score before treatment and after 2,4,and 6 weeks of treatment,dimension scores and total scores of Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale-24(HAMD-24),Pittsburgh Sleep Quality Index(PSQI)before treatment and after 6 weeks of treatment,and incidence of adverse reactions were compared between the two groups.Results The clinical efficacy of the treatment group was better than that of the control group(P<0.05).There was an interaction between treatment method and time on total core symptom score and TCM syndrome score(P<0.05);the main effect of treatment method and time on total core symptom score and TCM syndrome score was significant(P<0.05).The total core symptom score after 4 and 6 weeks of treatment and the TCM syndrome score after 2,4,and 6 weeks of treatment in the treatment group were lower than those in the control group(P<0.05).After 6 weeks of treatment,the score of somatic anxiety dimension,the scores of anxiety/somatization and hopelessness dimension and HAMD-24 total score,the scores of sleep disorders and hypnotic drugs dimension in the treatment group were lower than those in the control group(P<0.05).The total incidence of adverse reactions in the control group was not statistically different with that in the treatment group(P>0.05).Conclusion The effect of modified Chaihu Longgu Muli decoction in the treatment of emotional illness with heat stagnation in Shaoyang syndrome is precise,which can effectively alleviate the core symptoms,the degree of illness and physical symptoms of the patients,and reduce the degree of sleep disorder and hypnotic drug dependence,and has a high degree of clinical safety.