摘要
目的:观察解郁合欢汤加减治疗肝郁气滞型慢性乙型肝炎(CHB)合并抑郁症的临床疗效。方法:采用前瞻性队列研究设计,纳入2019年2月—2020年2月就诊于首都医科大学附属北京中医医院感染科门诊肝郁气滞型CHB合并抑郁症患者,对照组予心理疏导进行治疗,治疗组采用解郁合欢汤加减和心理疏导进行治疗,2组疗程均为4周。比较2组患者中医证候积分、慢性肝病问卷评分及抑郁自评量表(SDS)评分。结果:治疗4周后,治疗组患者中医证候积分、肝郁各主要症状及次要症状评分、SDS评分均较治疗前显著下降(P<0.01),且治疗组显著低于对照组(P<0.01);治疗组患者慢性肝病问卷总分及全身症状、腹部症状、乏力、活动、情感功能、焦虑评分均较治疗前显著改善(P<0.01),治疗组患者慢性肝病问卷评分明显高于对照组(P<0.01);治疗组中医证候总有效率(85.7%)显著高于对照组中医证候总有效率(8.6%)(χ^(2)=42.036,P<0.01)。结论:解郁合欢汤加减能够降低肝郁气滞型CHB合并抑郁症患者的抑郁程度,改善患者的临床症状和生活质量,临床总有效率较高,并且优于单一的心理疏导治疗,值得临床推广应用。
Objective:To observe the clinical effect of Jieyu Hehuan Decoction on chronic hepatitis B(CHB)complicated with depression of liver depression and Qi stagnation syndrome.Methods:A prospective cohort study design was used to include patients with liver stagnation and Qi stagnation CHB complicated with depression in the outpatient Department of Infections of our hospital from February 2019 to February 2020.The control group was treated with psychological counseling.The treatment group was treated with Jieyu Hehuan Decoction on the basis of the control group.The course of treatment of both groups was 4 weeks.SDS scores,chronic liver disease questionnaire scores and TCM syndrome scores were compared between the two groups before and after treatment.Results:After 4 weeks of treatment,the SDS scores,TCM syndrome scores,major and minor symptom scores of liver depression in the treatment group were significantly lower than those before treatment(P<0.01);The SDS scores,TCM syndrome scores,major and minor symptom scores of liver depression in the treatment group were significantly lower than those in the control group(P<0.01);The total scores of chronic liver disease questionnaire and the scores of systemic symptoms,abdominal symptoms,fatigue,activity,emotional function and anxiety in the treatment group were significantly improved compared with those before treatment(P<0.01);The score of chronic liver disease questionnaire in the treatment group was significantly higher than that in the control group(P<0.01);The total effective rate of TCM syndrome in the treatment group(85.7%)was significantly higher than that in the control group(8.6%),and the difference was statistically significant(χ^(2)=42.036,P<0.01).Conclusion:The addition and subtraction of Jieyu Hehuan Decoction can reduce the degree of depression in patients with liver stagnation and Qi stagnation type CHB complicated with depression,improve the clinical symptoms and life quality of patients,and has a high total clinical effective rate.It is better than single psychological counseling treatment,which is worthy of clinical promotion.
作者
李晓玲
孙凤霞
张燕洁
LI Xiaoling;SUN Fengxia;ZHANG Yanjie(Department of Infections,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing,100010,China)
出处
《中国中西医结合消化杂志》
CAS
2022年第6期402-406,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
国家科技重大专项(No:2018ZX10725-505)
首都卫生发展科研专项项目(No:首发2018-2-2173)
北京市属医院科研培育计划项目(No:PZ2018023)。
关键词
解郁合欢汤
肝郁气滞型
慢性乙型肝炎合并抑郁症
疗效观察
Jieyu Hehuan Decoction
liver depression and Qi stagnation syndrome
chronic hepatitis B complicated with depression
curative effect observation
