补肾疏肝方治疗维持性血液透析伴焦虑抑郁状态患者的疗效观察

Observation on Therapeutic Effect of Bushen Shugan Recipe for Treatment of Maintenance Hemodialysis Patients Complicated with Anxiety and Depression

【目的】探讨补肾疏肝方治疗维持性血液透析(MHD)伴焦虑和抑郁状态(肾虚肝郁证)患者的疗效及安全性。【方法】将88例MHD伴焦虑和抑郁状态(肾虚肝郁证)患者随机分为观察组和对照组,每组各44例。2组患者均予常规治疗,包括维持性血液透析,合理的饮食作息,控制血压血糖、纠正贫血、维持水电解质酸碱平衡等对症治疗,在此基础上,对照组给予氟哌噻吨美利曲辛片(黛力新)治疗,观察组在对照组的基础上加用补肾疏肝方治疗,疗程为2个月。观察2组患者治疗前后中医证候评分、汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分的变化情况,并评价2组患者的中医证候疗效和安全性。【结果】(1)中医证候疗效方面:观察组的总有效率为97.73%(43/44),对照组为84.09%(37/44),观察组的总体疗效和总有效率均明显优于对照组,差异均有统计学意义(P<0.05或P<0.01)。(2)治疗后,2组患者的各项中医证候评分及HAMA和HAMD评分均较治疗前明显降低(P<0.05),且观察组对各项中医证候评分及HAMA和HAMD评分的降低作用均明显优于对照组,差异均有统计学意义(P<0.05)。(3)观察组的不良反应发生率为2.27%(1/44),对照组为9.09%(4/44),组间比较,差异无统计学意义(P>0.05)。【结论】补肾疏肝方可明显提高氟哌噻吨美利曲辛片对MHD伴焦虑和抑郁患者的治疗效果,且无明显毒副作用,安全性高。

Objective To investigate the efficacy and safety of Bushen Shugan Recipe for the treatment of maintenance hemodialysis patients complicated with anxiety and depression differentiated as the syndrome of kidney deficiency and liver stagnation.Methods A total of 88 cases of maintenance hemodialysis patients complicated with anxiety and depression differentiated as the syndrome of kidney deficiency and liver stagnation were randomly divided into observation group and control group,with 44 cases in each group.Patients in the two groups were given conventional symptomatic treatment including maintenance hemodialysis,proper diet and regular activity of daily life,control of blood pressure and blood glucose,correction of anemia,maintenance of the balance of water,electrolyte,acid and base.Additionally,the control group was treated with Flupentixol and Melitracen Tablets(Deanxit),and the observation group was treated with Bushen Shugan Recipe plus Deanxit.The treatment lasted 2 months.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome,Hamilton Anxiety Scale(HAMA)scores,and Hamilton Depression Scale(HAMD)scores in the two groups were observed.After 2 months of continuous treatment,the efficacy for TCM syndrome and clinical safety in the two groups were evaluated.Results(1)After treatment,the total effective rate for TCM syndrome in the observation group was 97.73%(43/44)and that of the control group was 84.09%(37/44).The overall efficacy and total effective rate in the observation group were significantly superior to those of the control group(P<0.05 or P<0.01).(2)After treatment,the scores of each symptom of TCM syndrome,HAMA scores and HAMD scores of the two groups after treatment were obviously lower than those before treatment(P<0.05),and the observation group had stronger effect on decreasing TCM syndrome scores,HAMA scores and HAMD scores than the control group,the difference being statistically significant between the two groups(P<0.05).(3)The incidence of adverse reaction in the observation group was 2.27%(1/44),and that in the control group was 9.09%(4/44),the difference being not statistically significant between the two groups(P>0.05).Conclusion Bushen Shugan Recipe can significantly enhance the efficacy of Deanxit for the treatment of maintenance hemodialysis patients complicated with anxiety and depression,and has no obvious side effects with high safety.