补虚劳经典药膳粥改善脾肾阳虚证慢性疲劳综合征患者临床症状研究

Role of classical restorative porridge on clinical symptoms in patients with chronic fatigue syndrome caused by spleen and kidney yang deficiency

目的探讨补虚劳经典药膳粥对脾肾阳虚证慢性疲劳综合征(CFS)患者临床症状的改善效果。方法在成都市某三甲中医院门诊选取符合纳入标准的CFS(脾肾阳虚证)患者86例,采用随机数字表法分成试验组和对照组,各43例。对照组采用发放健康教育手册、面对面交谈的个体指导与讲座、微信群的集体指导相结合的形式实施为期8周的健康教育,每2周1次,共4次;试验组在此基础上食用改良后的补虚劳经典药膳粥,隔天1次,每次400～500 ml,4周为1个疗程,共2个疗程。两组患者均于干预前、干预4周末、干预8周末采用疲劳量表-14(FS-14)、躯体和心理健康报告(SPHERE)分别评价患者疲劳症状和伴随症状,采用脾肾阳虚中医证候积分评价患者中医证候的改善情况。结果试验组干预后各时间点FS-14总分和SPHERE评分均低于同期对照组(P<0.05);FS-14总分和SPHERE评分组间效应、时间效应及两者交互效应差异均有统计学意义(P<0.05)。试验组干预后各时间点中FS-14总分和SPHERE评分两两比较,后一时间点得分均低于前一时间点(P<0.05)。中医证候:干预4周后,试验组脾肾阳虚证候总分、倦怠乏力、食少纳呆、脘腹胀满条目低于对照组(P <0.05),干预8周后,除腰部冷痛条目外,其余条目及总分试验组均低于对照组(P <0.05);中医证候总分组间效应、时间效应及两者交互效应差异有统计学意义(P <0.05)。试验组干预后各时间点中医证候总分两两比较,后一时间点得分均低于前一时间点,差异有统计学意义(P <0.05)。结论补虚劳经典药膳粥可改善CFS患者的疲劳,减少伴随症状,并能有效改善患者的中医证候。

Objective To explore the therapeutic effects of classical restorative porridge(CRP)on clinical symptoms in patients with chronic fatigue syndrome(CFS)caused by spleen and kidney yang deficiency.Methods A total of 86 patients with CFS caused by spleen and kidney yang deficiency admitted in our hospital were included,who were randomly divided into experimental group(n=43)and control group(n=43).All patients received health education with individual and collective guidance for a period of eight weeks by health education instruction manuals,lectures and online learning.Patients in experimental group received additional CRP(400-500 ml)for 8 weeks once every other day.Clinical syndrome was recorded pre and post treatment by several scales such as the Fatigue Scale-14(FS-14),Somatic and Psychological Health Report(SPHERE).Results Patients in both group experienced improvement in scores of FS-14 and SPHERE(P<0.05).However,scores of FS-14 and SPHERE and the total score of spleen and kidney yang deficiency syndrome were decreased significantly when compared with those in control group(P<0.05).Repeated ANOVA analysis showed those scores were significant in group effect,time effect and interactive effect(P<0.05).Four weeks post intervention,9 items of spleen and kidney yang deficiency syndromes in experimental group were lower than control group,among which fatigue poor appetite and abdominal distention experienced dramatic improvement(P<0.05).Eight weeks post intervention,the total score and 8 items(except waist cold and pain)in experimental group were lower than control group(P<0.05).Conclusions CRP can relieve fatigue symptoms and TCM syndrome.