柴胡疏肝汤与帕罗西汀治疗功能性消化不良的对照研究
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[摘要] 目的 比较柴胡疏肝汤与帕罗西汀治疗功能性消化不良的疗效和不良反应。方法 将符合研究条件的患者随机分成研究组和对照组，研究组服用柴胡疏肝汤，对照组服用帕罗西汀，应用汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA) 、临床疗效总评量表(CGI)和副反应量表(TESS)评定疗效和不良反应。结果 研究过程中脱落13例。治疗后两组病人HAMD、HAMA评分均明显下降，与治疗前比较差别显著(p<0.01)，组间比较无明显差别(p>0.05)。两组有效率比较无显著差别(x2=0.93 p>0.05)。研究组不良反应小于对照组。结论 功能性消化不良应为躯体形式障碍中的一种。柴胡疏肝汤治疗功能性消化不良与帕罗西汀疗效相当，不良反应更小。
[关键词] 柴胡疏肝汤； 帕罗西汀； 功能性消化不良
[中图分类号] R723.11 [文献标识码] B [文章编号] 1005-0515(2011)-05-023-02
A control study of chaihushugan decoction with paroxetine in the treatment of functional dyspepsia
Ma Chuangsheng Yu HaitingZhang Shufang Yang Yongchao
(The Eighth People's Hospital of Zhengzhou Henan 450006)
[Abstract] Objective To evaluate the efficacy and side effects of chaihushugan decoction with paroxetine in the treatment of functional dyspepsia. Methods patients with functional dyspepsia were randomly assigned into study group and control group, chaihushugan decoction was given to study group ,and paroxetine was given to control group, The efficacy and side effects were evaluated with Hamilton anxiety scale(HAMA)、Hamilton Depression Scale(HAMD) 、Clinical Global Impression(CGI) and Treatment Emergent Symptom Scale (TESS). Results 13 cases were missing. After treatment, the scores of HAMA、HAMD were reduced significantly in two groups (p<0.01), there were no difference between two groups at same time (p>0.05).The effective rate of study group and control group were 79.41% and 81.82%, there were no significantly difference (x2=0.93, p>0.05). The side effect of study group was lower than control group. Conclusion Functional dyspepsia should be the one of somatoform disorder. chaihushugan decoction has same efficacy like paroxetine in the treatment of functional dyspepsia with low side effect.
[Keywords] Chaihushugan decoction； Paroxetine； Functional dyspepsia
功能性消化不良是消化科常见的疾病，主要表现为上腹胀痛、早饱、嗳气泛酸、食欲不振、恶心呕吐等，症状常持续或反复发作，病因和发病机制至今不明确，一般认为其病理生理基础是上消化道动力障碍[1]，临床上常以止酸、促进胃肠蠕动和助消化为主要治疗手段。功能性消化不良的患者常伴有焦虑抑郁情绪，其症状表现在精神科多数诊断为躯体形式障碍[2]，单一抗抑郁抗焦虑治疗也能取得满意疗效。随着近几年生物-心理-社会医学模式的转变和临床各学科之间交流增多，消化科也开始重视患者的心理问题，对消化科疗效不好的患者配合抗抑郁剂治疗取的了满意疗效[3、4]。精神心理疾病在祖国传统医学中称作“郁症、狂病、癫病”，有着悠久的历史和丰富的治疗经验。作者应用中药方剂柴胡疏肝汤治疗功能性消化不良与抗抑郁剂帕罗西汀作了对照研究，报道如下。
1 对象与方法
1.1 对象 选取2009年8月至2010年12月在精神心理科和消化科住院或门诊治疗的以消化道症状为主要表现的精神心理疾病患者 ......
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