基于调神理论治疗肝胃不和型功能性消化不良合并抑郁情绪临床研究

Clinical study on acupuncture treatment of Tiaoshen theory for the patients with functional dyspepsia with depression and liver-stomach disharmony

目的评价基于调神理论针刺治疗肝胃不和型功能性消化不良(functional dyspepsia,FD)合并抑郁情绪的临床疗效。方法将符合入选标准的2018年5月-2019年8月黑龙江中医药大学附属第二医院针灸科76例FD患者,采用随机数字表法分为2组,每组38例。常规组施以常规针刺,调神组在常规组基础上配合调神法针刺治疗。2组均治疗28 d。采用尼平消化不良指数(Nepean Dyspepsia Index,NDI)、中医证候积分及24项汉密尔顿抑郁量表(Hamilton Depression Scale-24,HAMD-24)对结果进行评价。结果调神组总有效率为94.6%(35/37)、常规组为75.0%(27/36),2组比较差异有统计学意义(χ^(2)=6.125,P=0.011)。调神组NDI症状评分低于常规组(t=3.038,P=0.003),生活质量中干扰领域、控制领域、食物饮料领域及睡眠打扰领域评分高于常规组(t值分别为3.096、2.460、2.225、2.732,P<0.05);中医证候积分低于常规组(t=3.241,P=0.002);HAMD-24评分低于常规组(t=2.767,P=0.007)。结论基于调神理论针刺治疗可明显提高肝胃不和型FD合并抑郁情绪患者在疾病过程中对被症状干扰、控制、食物饮料及睡眠打扰领域的生活质量,改善患者抑郁情绪。

Objective To observe the clinical effect of acupuncture treatment based on Tiaoshen theory for the patients with functional dyspepsia(FD)and depression with liver-stomach disharmony syndrome.Methods A total of 76 FD patients from May 2018 to August 2019 were randomly divided into 2 groups with 38 patients in each group.In the routine group,acupoints were selected routinely,and in Tiaoshen group,acupoints were selected by Tiaoshen theory.Both groups were treated for 28 days.The results were evaluated by Nepean Dyspepsia Index(NDI),TCM Syndrome Score and Hamilton Depression Scale-24(HAMD-24).Results The total effective rate of both groups was 94.6%(35/37)in Tiaoshen group and 75.0%(27/36)in routine group.There was significant difference between the two groups(χ^(2)=6.125,P=0.011).The NDI in Tiaoshen group was significantly lower than that of routine group(t=3.038,P=0.003).The scores of interference domain,control domain,food and beverage domain and sleep disturbance domain in Tiaoshen group were significantly higher than those in routine group(t=3.096,2.460,2.225,2.732,P<0.05);the TCM Syndrome Score in Tiaoshen group was significantly lower than that of routine group(t=3.241,P=0.002),and that of HAMD-24 was significantly lower than that of routine group(t=2.767,P=0.007).Conclusion Treatment based on Tiaoshen theory can improve the quality of life of FD patients in the fields of interference,control,food and beverage and sleep disturbance,and reduce the patients’depression.