丹栀逍遥散加减治疗纤维肌痛综合征20例临床观察
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摘要
目的观察丹栀逍遥散加减治疗纤维肌痛综合征的临床疗效。方法将40例纤维肌痛综合征患者采用随机数字表法分为治疗组和对照组,各20例。治疗组予丹栀逍遥散加减口服,对照组予盐酸曲马多缓释片及盐酸阿米替林口服,2组均治疗4周,治疗后随访4周。比较2组的近期疗效、远期疗效及治疗前后的中医证候积分、视觉模拟评分法(VAS)评分。结果治疗4周后,治疗组总有效率为95%,对照组为80%,2组比较差异无统计学意义(P>0.05);随访4周后,治疗组总有效率为80%,对照组为30%,2组比较差异有统计学意义(P<0.05)。治疗4周后,2组VAS评分均明显降低,与同组治疗前比较差异均有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);随访4周后,治疗组VAS评分明显低于对照组,2组比较差异有统计学意义(P<0.05)。治疗4周后及随访4周后,2组各项中医证候积分及总积分均明显降低,与同组治疗前比较差异有统计学意义(P<0.05),且治疗组降低程度更显著,组间比较差异均有统计学意义(P<0.05)。结论丹栀逍遥散加减治疗纤维肌痛综合征疗效显著,能明显改善患者的临床症状,值得临床推广运用。
Objective To observe the clinical efficacy of modified Danzhi Xiaoyao San(丹栀逍遥散) in the treatment of fibromyalgia syndrome.Methods Forty cases of fibromyalgia syndrome were divided into treatment group and control group according to random number table,with 20 cases in each.The treatment group was given oral modified Danzhi Xiaoyao San,while the control group was given oral tramadol hydrochloride sustained release tablets and amitriptyline hydrochloride.Both groups were treated for 4 weeks and followed up for 4 weeks after treatment.The short-term and long-term effects,TCM symptom scores and visual analogue scale(VAS) scores of the 2 groups before and after treatment were compared.Results After treatment for 4 weeks,the total effective rate of the treatment group was 95%,that of the control group was 80%,there was no statistically significant difference between the two groups(P>0.05).Followed up for 4 weeks,the total effective rate of the treatment group was 80%,that of the control group was 30%,there was statistically significant difference between the two groups(P<0.05).After treatment for 4 weeks,the VAS scores of the two groups both decreased significantly,there was statistically significant difference compared with the same group before treatment(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Followed up for 4 weeks,the VAS scores of the treatment group were significantly lower than those of the control group,there were statistically significant differences between the two groups(P<0.05).Four weeks after treatment and after 4 weeks of follow-up,all TCM symptom scores and the total score of the two groups both decreased significantly,there were statistically significant differences compared with the same group before treatment(P < 0.05),moreover,those decreased more significantly in the treatment group,there were statistically significant differences between the two groups(P<0.05).Conclusion It has significant curative effects to use modified Danzhi Xiaoyao San in the treatment of fibromyalgia syndrome.It can significantly improve the clinical symptoms of the patients,which deserves clinical promotion and application.
Objective To observe the clinical efficacy of modified Danzhi Xiaoyao San(丹栀逍遥散) in the treatment of fibromyalgia syndrome.Methods Forty cases of fibromyalgia syndrome were divided into treatment group and control group according to random number table,with 20 cases in each.The treatment group was given oral modified Danzhi Xiaoyao San,while the control group was given oral tramadol hydrochloride sustained release tablets and amitriptyline hydrochloride.Both groups were treated for 4 weeks and followed up for 4 weeks after treatment.The short-term and long-term effects,TCM symptom scores and visual analogue scale(VAS) scores of the 2 groups before and after treatment were compared.Results After treatment for 4 weeks,the total effective rate of the treatment group was 95%,that of the control group was 80%,there was no statistically significant difference between the two groups(P>0.05).Followed up for 4 weeks,the total effective rate of the treatment group was 80%,that of the control group was 30%,there was statistically significant difference between the two groups(P<0.05).After treatment for 4 weeks,the VAS scores of the two groups both decreased significantly,there was statistically significant difference compared with the same group before treatment(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).Followed up for 4 weeks,the VAS scores of the treatment group were significantly lower than those of the control group,there were statistically significant differences between the two groups(P<0.05).Four weeks after treatment and after 4 weeks of follow-up,all TCM symptom scores and the total score of the two groups both decreased significantly,there were statistically significant differences compared with the same group before treatment(P < 0.05),moreover,those decreased more significantly in the treatment group,there were statistically significant differences between the two groups(P<0.05).Conclusion It has significant curative effects to use modified Danzhi Xiaoyao San in the treatment of fibromyalgia syndrome.It can significantly improve the clinical symptoms of the patients,which deserves clinical promotion and application.
引文
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[12]张宝宝,姚菁,金海燕,等.柴胡-白芍醇提液抗抑郁和保肝作用实验研究[J].甘肃中医药大学学报,2016,33(6):10-15.
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[14]吴修红,胡妮娜,李宝龙,等.赤芍与白芍脐中穴给药的药理作用比较研究[J].针灸临床杂志,2014,30(5):54-56.
[15]汲广全.白术有效成分对巨噬细胞和树突状细胞免疫活性的研究[D].广州:华南理工大学,2014.
[16]徐国柱,刘锐克,王伟,等.盐酸曲马多缓释片镇痛效果临床评价[J].中国新药杂志,1999(7):41-44.
[17]张传红.盐酸吗啡缓释片联合阿米替林对重度癌症疼痛伴抑郁患者的疗效[J].临床医学研究与实践,2018,3(2):15-16.
[18]凌先传.帕罗西汀治疗抑郁症的临床对照研究[J].中国医疗前沿,2012,7(1):42-43.
[2]中华医学会风湿病学分会.纤维肌痛综合征诊断和治疗指南[J].中华风湿病杂志,2011,15(8):559-561.
[3]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:115-125.
[4]Epstein S A,Kay G,Clauw D,et al.Psychiatric disorders in patients with fibromyalgia a multicenter investigation[J].Psychosomatics,1999,40:57-63.
[5]Richards S,Cleare A.Treating fibromyalgia[J].Rheumatology,2000,39(4):343-346.
[6]林秋吉,石学敏.纤维肌痛综合征的中医诊治概况[J].针灸临床杂志,2006,22(8):59-61.
[7]高玉中.纤维肌痛综合征中医分型论治探讨[J].上海中医药杂志,2010,44(9):32-33.
[8]刘渡舟,杨波,侯钦丰,等.肝胆源流论[M].天津:天津科学技术出版社,1989:595.
[9]冯兴华.浅论痹证从肝论治[J].中医杂志,2007,48(7):666.
[10]王丽娜,王巍,徐驰,等.柴胡醋制前后抗炎作用比较研究[J].中成药,2013,35(5):1079-1081.
[11]朱双龙,段会全,刘英富,等.柴胡皂苷a对大鼠急性脊髓损伤的神经保护作用与机制研究[J].中国修复重建外科杂志,2017,31(7):825-829.
[12]张宝宝,姚菁,金海燕,等.柴胡-白芍醇提液抗抑郁和保肝作用实验研究[J].甘肃中医药大学学报,2016,33(6):10-15.
[13]马清钧,王淑玲.常用中药现代研究与临床[M].天津:天津科技翻译出版公司,1995:622.
[14]吴修红,胡妮娜,李宝龙,等.赤芍与白芍脐中穴给药的药理作用比较研究[J].针灸临床杂志,2014,30(5):54-56.
[15]汲广全.白术有效成分对巨噬细胞和树突状细胞免疫活性的研究[D].广州:华南理工大学,2014.
[16]徐国柱,刘锐克,王伟,等.盐酸曲马多缓释片镇痛效果临床评价[J].中国新药杂志,1999(7):41-44.
[17]张传红.盐酸吗啡缓释片联合阿米替林对重度癌症疼痛伴抑郁患者的疗效[J].临床医学研究与实践,2018,3(2):15-16.
[18]凌先传.帕罗西汀治疗抑郁症的临床对照研究[J].中国医疗前沿,2012,7(1):42-43.