滋阴清火法治疗乳腺癌术后伴焦虑患者的临床观察

Clinical Observation of Anxiety Disorder after Breast Cancer Surgery Treated with Nourishing Yin and Clearing Fire Therapy

目的观察乳腺癌术后伴焦虑症的患者应用滋阴清火法的临床疗效。方法将70例符合入组标准的乳腺癌术后伴焦虑同时中医辨证属于阴虚火旺型患者,随机分为治疗组和对照组,每组各35例,治疗组给予具有滋阴清火作用的天王补心丹合丹栀逍遥散加减治疗,对照组给予帕罗西汀10～20 mg,每日1次治疗,分别在治疗前和治疗后第2、4、6周根据汉密尔顿焦虑量表(HAMA)进行评分,以HAMA的减分率为指标评定疗效,对比两组临床疗效,同时观察两组不良反应的发生情况。结果两组临床疗效比较,差异无统计学意义(P>0.05);治疗后第4、6周时,两组HAMA评分与各自治疗前比较,均明显下降(P<0.05或P<0.01),组间比较差异无统计学意义;治疗组不良反应发生率及严重程度略优于对照组。结论乳腺癌术后伴发焦虑症患者,给予滋阴清火法治疗有较好的临床疗效并且能明显提高肿瘤患者生活质量。

Objective To observe the clinical efficacy on anxiety disorder after breast cancer sur- gery treated with nourishing yin and clearing fire therapy. Methods In compliance with the diagnostic crite- ria of anxiety ＂after breast cancer surgery and Chinese medicine differentiation as excessive fire due to yin de- ficiency pattern/syndrome, 70 cases were enrolled and randomized into a treatment group and a control group,35 cases in each one. In the treatment group, the modified formula of tianwang buxin dan and danzhi xiaoyao san was prescribed for nourishing yin and clearing fire. In the control group, paroxetine was pre- scribed,10-20 rag, once a day. Separately, before treatment and in the 2ha,4th and 6th weeks after treat- ment,the Hamiltone Anxiety Scale（HAMA） was adopted for the assessment. The score reducing rate of HA- MA was taken as the indicator of the efficacy assessment. The clinical effieaey was compared between two groups and the adverse reactions were observed. Results The difference in the clinical efficacy was not sig- nificant statistically between two groups （ P 〉 0.05 ）. In the 4th and 6th weeks after treatment, HAMA scores were all reduced remarkably in both groups as compared with those before treatment （P 〈 0.05 or P 〈 0.01 ）. The difference between two groups was not significant statistically. The incidence and the severity of the ad- verse reactions in the treatment group were slightly lower than those in the control groups. Conclusion For the patients with anxiety disorder after breast cancer surgery,the therapy for nourishing yin and clearing fire achieves the good clinical efficacy and can remarkably improve the quality of life for cancer patients.