柴朴汤联合化痰消瘀方治疗胃癌前病变伴焦虑抑郁

Chaipu Decoction Combined with Huatan Xiaoyu Decoction in Treatment of Precancerous Lesions of Gastric Cancer with Anxiety and Depression

目的:观察柴朴汤联合化痰消瘀方治疗胃癌前病变伴焦虑抑郁(脾虚肝郁证)患者的临床疗效。方法:68例胃癌前病变伴焦虑抑郁状态(脾虚肝郁证)患者按随机数字表法分为对照组33例和治疗组35例。两组患者均给予抑制胃酸、保护胃黏膜、促胃肠动力、改善消化、补充叶酸和抗焦虑等西医常规疗法。治疗组在常规治疗的基础上给予柴朴汤联合化痰消瘀方,两组疗程均为6个月。治疗后,比较两组患者治疗前后中医证候积分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)和汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分、胃镜下黏膜病理积分,并比较两组患者HAMA和HAMD疗效。结果:(1)胃镜下黏膜病理积分:治疗后,两组患者内镜下胃黏膜萎缩评分、肠化评分、异型增生评分均显著降低(P<0.05),治疗组胃黏膜萎缩评分、肠化评分低于对照组(P<0.05)。(2)中医证候积分:治疗后,两组患者脘胀纳呆、胁下满痛、反酸欲呕、烦躁不安、咽中异物感、便溏不爽、舌质暗脉弦数等证候评分均显著下降(P<0.05),治疗组胁下满痛、反酸欲呕、烦躁不安、咽中异物感评分低于对照组(P<0.05)。(3)HAMA和HAMD评分:治疗后,两组患者HAMA和HAMD积分显著降低(P<0.05),治疗组HAMA和HAMD积分低于对照组(P<0.05)。(4)HAMA和HAMD疗效:治疗后,治疗组HAMA疗效的有效率为88.57%(31/35),对照组为72.73%(24/33),治疗组HAMD疗效的有效率为91.43%(32/35),对照组为75.76%(25/33),治疗组HAMA和HAMD疗效均优于对照组(P<0.05)。结论:柴朴汤联合化痰消瘀方治疗胃癌前病变伴焦虑抑郁(脾虚肝郁型)患者疗效显著,可有效降低胃黏膜内镜病理萎缩和肠化积分,改善患者焦虑抑郁状态。

Objective:To observe the clinical effect of Chaipu Decoction combined with Huatan Xiaoyu Decoction on patients with precancerous lesions of gastric cancer with anxiety and depression(Spleen deficiency and Liver depression).Methods:68 patients with precancerous lesions of gastric cancer with anxiety and depression(Spleen deficiency and Liver depression) were randomly divided into 33 cases in the control group and 35 cases in the treatment group.Both groups were treated with conventional western medicine,such as inhibiting gastric acid,protecting gastric mucosa,promoting gastrointestinal motility,improving digestion,supplementing folic acid,and anti-anxiety.The treatment group was given Chaipu Decoction combined with Huatan Xiaoyu Decoction on the basis of conventional treatment.The course of treatment in both groups was 6 months.After treatment,the scores of TCM syndromes,Hamilton anxiety scale(HAMA) and Hamilton depression scale(HAMD) scores,and mucosal pathology scores under gastroscopy were compared between the two groups of patients before and after treatment,and the curative effect of HAMA and HAMD was evaluated.Results:(1)Mucosal pathological score under Gastroscope:after treatment,the endoscopic gastric mucosal atrophy score,intestinal metaplasia score,and dysplasia score of the two groups were significantly reduced(P<0.05),and the pathological scores of atrophy and intestinal metaplasia in the treatment group were lower than those in the control group(P<0.05).(2)TCM syndrome score:after treatment,the syndrome scores of epigastric fullness,hypochondriac fullness of pain,acid nausea,irritability,foreign body sensation in pharynx,loose stool and dark tongue and string-like pulse scores decreased significantly(P<0.05).The scores of hypochondriac fullness pain,acid nausea,irritability,and foreign body feeling in pharynx in the treatment group were lower than those in the control group(P<0.05).(3)HAMA and HAMD scores:After the treatment,the HAMA and HAMD scores of the two groups decreased significantly(P<0.05),and the scores of the treatment group were lower than those of the control group(P<0.05).(4)HAMA and HAMD curative effect:After treatment,the effective rate of HAMA curative effect in the treatment group was 88.57%(31/35),the control group was 72.73%(24/33),and the effective rate of HAMD curative effect in the treatment group was 91.43%(32/35),the control group was 75.76%(25/33),and the therapeutic effects of HAMA and HAMD in the treatment group were better than those in the control group(P<0.05).Conclusion:Chaipu Decoction combined with Huatan Xiaoyu Decoction is effective on patients with precancerous lesions of gastric cancer with anxiety and depression(spleen deficiency and liver depression type).It can effectively reduce the points of gastric mucosal atrophy and intestinal metaplasia in endoscopic pathology,and improve the state of anxiety and depression.