摘要
目的观察腹部推拿为主治疗广泛性焦虑症(GDA)的临床疗效及其可能机制。方法将80例肝郁气滞型GAD患者随机分为腹部推拿组和西药对照组各40例。腹部推拿组给予按腹、揉腹、运腹、推腹、横擦胸胁、捏脊及推拿头项治疗,西药对照组给予盐酸帕罗西汀片治疗,两组治疗均每日1次,15天为1个疗程,均治疗2个疗程。观察两组临床疗效,于治疗前后及随访时(疗程结束后的3个月)对患者进行汉密顿焦虑量表(HAMA)评定,治疗前后检测其静脉血中5-羟色胺(5-HT)水平,于治疗后进行治疗副反应量表(TESS)评定。结果腹部推拿组临床疗效总有效率为92.5%,西药对照组总有效率为95.0%,两组比较差异无统计学意义(P>0.05)。治疗后两组患者血浆5-HT水平、HAMA量表评分较治疗前均有所下降(P<0.05),而治疗后组间比较差异无统计学意义(P>0.05),腹部推拿组患者随访时HAMA量表评分低于西药对照组(P<0.05)。腹部推拿组患者治疗后TESS量表评分、副反应发生率明显低于西药对照组(P<0.05)。结论腹部推拿为主与盐酸帕罗西汀片治疗肝郁气滞型GAD疗效相当,但腹部推拿为主远期效果好、副反应小,其作用机理可能与降低血浆5-HT水平有关。
Objective To observe the therapeutic effect and mechanism of abdominal tuina therapy for generalized anxiety disorder （GAD）. Methods Eighty GAD patients with liver depression and qi stagnation syndrome were randomized into the abdominal tuina group and western medication control group, with 40 in each. The abdominal tuina group was given tuina therapy such as pressing, rubbing, moving and pushing on the abdomen, horizontally rubbing on the chest and rib-side, spine pinching and massaging the head and neck. The western medication control group was given Paroxetine Hydrochloride Tablets. One treatment course lasted for 15 days and both groups were treated once daily for 2 courses. The therapeutic effect was observed in both groups after treatment. The patients were evaluated with Hamilton Anxiety Scale （HAMA） before and after treatment and during the follow-up. The content of 5-hydroxytryptamine （5-HT） was detected before and after treatment. Treatment Emergent Side-Effect Scale （TESS） was evaluated after treatment. Results The total effective rate of the abdominal tuina group and western medication control group was 92.5 % and 95.0% respectively, with no significant difference between groups （P〉0.05）. The contents of 5-HT and scores of HAMA were decreased in both groups after treatment （P〈 0.05）, but with no significant difference between groups （P〉0.05）. The score of HAMA in the abdominal tuina group was significantly lower than that in the western medication control group during the follow-up （P〈0.05）. After treatment, the score of TESS and incidence of side effects in the abdominal tuina group were significantly lower than those in the western med- ication control group （P〈0.05）. Conclusion The abdominal tuina therapy is as effective as Paroxetine Hydrochloride Tablets for GAD with liver depression and qi stagnation syndrome. The abdominal tuina therapy has a better long-term effect and fewer side effects and its mechanism may be related to reducing 5-HT.
出处
《中医杂志》
CSCD
北大核心
2013年第2期130-133,共4页
Journal of Traditional Chinese Medicine
