CAJ | 학술논문

[目的]观察中医情志疗法治疗寻常型银屑病患者的临床疗效,通过检测治疗前后患者汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)水平及血清单胺类神经递质表达水平的变化,探讨中医情志疗法治疗寻常型银屑病的可能机理.[方法]将符合诊断标准的60例进展期寻常型银屑病患者按照1:1随机分成两组.对照组口服复方甘草酸苷片(美能)每次50mg,3次/d;外用卤米松/三氯生乳膏(新适确得)、卡泊三醇软膏(达力士),涂擦于患处,各2次/d.治疗组在对照组西医治疗基础上配合中医情志疗法进行治疗,4周为1疗程,观察两组疗效.治疗前后分别对两组进行HAMD和HAMA评分,并采用高效液相色谱-荧光检测法测定血清中去甲肾上腺素(NE)、多巴胺(DA)及5-羟色胺(5-HT)等单胺类神经递质的含量,另取健康志愿者30例作为健康对照组.[结果]治疗组临床疗效优于对照组,总有效率分别为93.33%和66.67%,具有统计学差异(P<0.01).两组患者治疗前HAMD、HAMA评分及血清单胺类神经递质的水平明显高于健康对照组,有显著性差异(均P<0.01).治疗后HAMD、HAMA评分及血清单胺类神经递质的水平均有不同程度的下降,与治疗前相比均有显著统计学意义(P<0.05或P<0.01),但治疗组下降更显著,与对照组比较有显著性差异(P<0.01).[结论]银屑病患者存在明显的抑郁、焦虑情绪障碍,中医情志疗法能有效改善银屑病患者的临床症状及精神状态,其作用机制可能与降低外周血单胺类神经递质有关.
[목적]관찰중의정지요법치료심상형은설병환자적림상료효,통과검측치료전후환자한밀이돈억욱량표(HAMD)、한밀이돈초필량표(HAMA)수평급혈청단알류신경체질표체수평적변화,탐토중의정지요법치료심상형은설병적가능궤리.[방법]장부합진단표준적60례진전기심상형은설병환자안조1:1수궤분성량조.대조조구복복방감초산감편(미능)매차50mg,3차/d;외용서미송/삼록생유고(신괄학득)、잡박삼순연고(체력사),도찰우환처,각2차/d.치료조재대조조서의치료기출상배합중의정지요법진행치료,4주위1료정,관찰량조료효.치료전후분별대량조진행HAMD화HAMA평분,병채용고효액상색보-형광검측법측정혈청중거갑신상선소(NE)、다파알(DA)급5-간색알(5-HT)등단알류신경체질적함량,령취건강지원자30례작위건강대조조.[결과]치료조림상료효우우대조조,총유효솔분별위93.33%화66.67%,구유통계학차이(P<0.01).량조환자치료전HAMD、HAMA평분급혈청단알류신경체질적수평명현고우건강대조조,유현저성차이(균P<0.01).치료후HAMD、HAMA평분급혈청단알류신경체질적수평균유불동정도적하강,여치료전상비균유현저통계학의의(P<0.05혹P<0.01),단치료조하강경현저,여대조조비교유현저성차이(P<0.01).[결론]은설병환자존재명현적억욱、초필정서장애,중의정지요법능유효개선은설병환자적림상증상급정신상태,기작용궤제가능여강저외주혈단알류신경체질유관.
Objective] To observe the clinical efficacy of the TCM psychotherapy and the changes of serum monoamine neurotransmitter levels and HAMD/HAMA score in psoriatic patients after treatment, so as to discuss its function mechanism. [Methods] Clinical evaluations were made on 60 pa-tients suffering from psoriasis.They were randomly divided into two groups in the proportion of 1 to 1. The control group cases were given conventional therapy, on the basis of which, the treatment group cases were treated with TCM psychotherapy, four weeks as a period. Then observed HAMD/HAMA score and the serum monoamine neurotransmitter levels(NE, DA, 5-HT) in psoriatic patients were measured with high performance liquid chromatography, and compared the results before and after treatment. Put another 30 cases of healthy volunteers as normal control group. [Results] The clinical efficacy of treatment group was significantly higher than control group, the total effective rates were 93.33% and 66.67% respectively. Before treatment, the serum monoamine neurotransmitter levels and HAMD/HAMA score in psoriatic patients were higher than the healthy control group. The serum monoamine neurotransmitter levels and HAMD/HAMA score of both groups were significantly reduced after the treatment, but the changes in the treatment group were better than those of the control group. [Conclusion] TCM psychotherapy can lower the serum monoamine neurotransmitter levels and HAMD/HAMA score,so as to improve the clinical symptoms of psoriatic patients.