从脾胃理论结合六经辨证思想诊治抑郁症临床观察

Clinical Scheme for the Treatment of Depression under the Theory of Spleen and Stomach in Combination with Syndrome-differentiation of the Six Meridians

目的:探索从脾胃理论结合六经辨证思想诊治抑郁症的临床疗效。方法:采用RCT方案收集轻中度抑郁症患者共120例,试验组共76例予补中益气丸合半夏泻心汤/小柴胡汤/当归四逆汤/温氏奔豚汤中药颗粒剂治疗,对照组44例予左洛复50 mg/d治疗,评估HAMD-17及SDS。结果:(1)治疗4周后及随访期试验组与对照组HAMD-17总分减分率(%)相当,差异无统计学意义(P>0.05)。(2)HAMD-17总分各时点与筛选期比较发现,试验组太阴组疗效较优,少阳组次之,差异有统计学意义(P<0.05)。结论:脾胃理论结合六经辨证理论指导下辨证使用中药方剂对轻中度抑郁症患者具有与西药相当的良好疗效,太阴证、少阳证者疗效更显著。

Objective ：To explore the curative effect of the treatment of depression base on the theory of spleen and stomach in combination with syndrome-differentiation of the six meridians. Methods ：Adopting the RCT plan,all 120 objects of this study were with mild-to-moderate depression. The experimental group of 76 cases,was treated by Buzhong Yiqi Wan,combining with Banxia Xiexin Tang/Xiaochaihu Tang/Danggui Sini Tang/Wensi Bentun Tang. The control group of 44 cases was given treated by Zoloft 50 mg/d. Evaluating the state of depression via HAMD-17 and SDS. Results ：（1）According to the reduce rate（%）of HAMD-17 total score（P〈0.05）,there was no statistically significant difference between them 4 weeks after the beginning of the treatment.（2）Compared with screening period,the curative effect difference of HAMD-17 total score is statistically significant over time（P〈0.05）,Taiyin group is the best,Shaoyang group the second. Conclusion ：Treating patients with mild-to-moderate depression by TCM with the syndrome differentiation deserved a good curative effect,which under the guidance of the theory of spleen and stomach in combination with syndrome-differentiation of the six meridians. Both the Taiyin group and Shaoyang group are representative samples.