甘麦大枣汤加减联合西医常规疗法治疗恶性肿瘤抑郁临床研究
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R277.7

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河南省中医药科学研究专项课题(2014ZY02103)


Clinical Study on Modified Ganmai Dazao Tang Combined with Routine Western Medicine Therapy for Depression Caused by Malignant Tumor
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    摘要:

    目的:观察甘麦大枣汤加减联合西医常规疗法对恶性肿瘤抑郁患者免疫状态、心理状态和生活质量的影响。方法:选取92 例恶性肿瘤抑郁患者,按随机数字表法分为观察组和对照组各46 例。对照组给予常规对症治疗,观察组在对照组基础上加用甘麦大枣汤加减口服。比较2 组治疗前后免疫状态、生活质量以及心理状态。结果:治疗前,2 组血清免疫球蛋白(IgA、IgG、IgM)、T 细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+) 以及NK 细胞水平比较,差异均无统计学意义(P>0.05)。治疗后,对照组IgA、IgG、IgM 水平较治疗前降低(P<0.05);观察组IgA、IgG、IgM 水平较治疗前升高,且高于对照组(P<0.05)。治疗后,对照组CD3+、CD4+较治疗前降低,CD8+较治疗前升高(P<0.05);观察组CD4+及CD8+较治疗前降低,但CD4+高于对照组,CD8+低于对照组,差异均有统计学意义(P<0.05)。治疗后,对照组NK 细胞绝对数值较治疗前降低,但观察组NK 细胞绝对数值较治疗前升高,且高于对照组(P<0.05)。治疗前,2 组欧洲癌症研究与治疗组织生活质量核心量表(EORTCQLQ-C30)各项评分比较,差异无统计学意义(P>0.05)。治疗后,观察组功能领域中躯体功能和情绪功能评分高于治疗前和对照组,症状领域中疲劳、恶心呕吐、疼痛评分及单一症状气促、失眠评分低于治疗前和对照组,总体健康状况评分高于治疗前和对照组,差异均有统计学意义(P<0.05)。治疗前,2 组抑郁自评量表(SDS) 及汉密顿抑郁量表(HAMD) 评分比较,差异无统计学意义(P>0.05)。治疗后,对照组SDS 及HAMD 评分较治疗前升高(P<0.05);观察组SDS 及HAMD 评分较治疗前降低,且各项评分均低于对照组(P<0.05)。结论:甘麦大枣汤加减联合西医常规疗法治疗恶性肿瘤抑郁,能够显著改善患者免疫功能,同时提高患者生活质量,并改善其心理状态。

    Abstract:

    Abstract: Objective: To observe the effect of modified Ganmai Dazao tang combined with routine western medicine therapy on the immune state, mental state and quality of life in patients with depression caused by malignant tumor. Methods: A total of 92 cases of patients with depression caused by malignant tumor were selected and divided into the observation group and the control group according to the random number table method,46 cases in each group. The control group was given routine symptomatic treatment,and the observation group was additionally given the oral administration of modified Ganmai Dazao tang based on the treatment of the control group. Before and after treatment, the immune state, mental state and quality of life in the two groups were compared. Results: Before treatment, there was no significant difference being found in the comparison of the levels of immunoglobulin including IgA,IgG and IgM,T cell subsets including CD3 +,CD4 +,CD8 + and CD4 +/CD8 + as well as NK cells in serum between the two groups(P>0.05). After treatment,the levels of IgA,IgG and IgM in the control group were decreased when compared with those before treatment(P<0.05);the levels of IgA,IgG and IgM in the observation group were increased when compared with those before treatment,and the above levels were higher than those in the control group(P<0.05). After treatment,CD3 + and CD4 + in the control group were decreased when compared with those before treatment, and CD8 + was increased(P<0.05); CD4 + and CD8 + in the observation group were decreased when compared with those before treatment;CD4+ in the observation group was higher than that in the control group,and CD8 + was lower,differences being significant(P<0.05). After treatment,the absolute count of NK cells in the control group were decreased when compared with that before treatment,and the absolute count of NK cells in the observation group was increased,and it was higher than that in the control group(P<0.05). Before treatment, there was no significant difference being found in the comparison of the scores of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTCQLQ-C30) between the two groups(P>0.05). After treatment,the scores of physical function and emotional function in the observation group were higher than those before treatment and those in the control group;the symptoms scores of fatigue,nausea,vomiting and pain as well as shortness of breath and insomnia were lower than those before treatment and those in the control group,and the overall health score was higher than that before treatment and that in the control group,differences being significant(P<0.05). Before treatment,there was no significant difference being found in the comparison of the scores of Self- rating Depression Scale(SDS) and Hamilton Depression Scale(HAMD) between the two groups(P>0.05). After treatment, the scores of SDS and HAMD in the control group were increased when compared with those before treatment(P<0.05); the scores of SDS and HAMD in the observation group were decreased when compared with those before treatment, and the above scores in the observation group were lower than those in the control group(P<0.05). Conclusion:Modified Ganmai Dazao tang combined with routine western medicine therapy for depression caused by malignant tumor can significantly improve the immune function and mental state of patients,and enhance their quality of life at the same time.

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熊伟,王清溪,王心东.甘麦大枣汤加减联合西医常规疗法治疗恶性肿瘤抑郁临床研究[J].新中医,2021,53(12):140-144

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  • 在线发布日期: 2021-06-23
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