滋阴疏肝法对2型糖尿病患者焦虑抑郁情绪及生活质量的影响

The effect of Nourishing Yin and Soothing Liver Therapy on the depression and life quality of patients with type 2 diabetes

目的探讨滋阴疏肝法对2型糖尿病患者焦虑抑郁情绪及生活质量的影响。方法随机选取136例确诊2型糖尿病的患者作为调查对象,应用汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)评定患者焦虑、抑郁状况,筛选出其中HAMA评分>14分、HAMD评分>20分的患者64例分为2组,治疗组和对照组病例数均等。治疗组在西药常规降糖方案的基础上予加减一贯煎(生地黄、北沙参、麦冬、当归等)以滋阴疏肝治疗;对照组在西药常规降糖方案的基础上予谷维素口服治疗。比较2组治疗前、后HAMA、HAMD评分及生活质量量表(SF-36)评分。结果 47.06%(64/136)的2型糖尿病患者HAMA评分>14分、HAMD评分>20分。治疗组治疗后HAMA和HAMD评分分别为(11.9±6.4)、(15.2±6.9)分,较治疗前和对照组差异有统计学意义(P<0.05)。治疗组治疗后SF-36评分除躯体疼痛外各项评分均明显高于治疗前,其中一般健康状况、躯体健康总评、精力、社会功能、情感职能、心理健康及心理健康总评7项评分较对照组差异有统计学意义(P<0.05)。结论临床上有相当一部分2型糖尿病患者存在明显的焦虑抑郁情绪,滋阴疏肝法配合西药降糖方案能显著改善患者焦虑抑郁情绪,提高患者生活质量。

Objective To investigate the effect of Nourishing Yin and Soothing Liver therapy on the depression and life quality of patients with type 2 diabetes. Methods 136 cases of patients with type 2 diabetes were randomly chosen as objects of investigation. Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale （HAMD） were used to evaluate depression status of patients with anxiety. Those patients with HAMA score 〉 14 and HAMD score 〉 20 were divided into 2 groups, the treatment group and control group （with same number）. Treatment group was treated with modified Yiguanjian therapy （radix rehmanniae, Radix Glehniae, Ophiopogon japonicus, etc） to nourish Yin and soothe liver based on routine therapy;the control group was given oral treatment of oryzanol based on conventional western medicine therapy. HAMA, HAMD score and quality of life scale （SF-36） score of the two groups were compared before and after treatment.Results 47.06% （64/136） type 2 diabetic patients are with HAMA score 〉 14 and HAMD score 〉 20. After treatment, HAMA and HAMD scores of the treatment group were （11.9 ± 6.4）, （15.2 ± 6.9）, which had significant difference compared with before treatment and the control group （ P 〈 0.05）. After the treatment, the treatment group＇s SF-36 score except for body pain scores was significantly higher than that before treatment, and the general state of health, physical health evaluation, energy, social function, emotional function, mental health and the mental health review were statistically significant difference compared with those of the control group（ P 〈 0.05）. Conclusion By clinical observation, we found a considerable part of the patients with type 2 diabetes have obvious anxiety and depression. Nourishing Yin and soothing liver therapy combined with western medicine therapy can significantly improve the mood of patients with anxiety and depression and their life qualities.