CAJ | 학술논문

目的：观察生物反馈辅助治疗焦虑症的疗效，并探讨其与不同中医证型的相关性。方法对符合纳入标准的焦虑症患者进行中医辨证分型，分为4大组，即肝郁化火组、痰火扰心组、心脾两虚组和心肾不交组，4组患者各分成2小组，即生物反馈组和非生物反馈组。所有患者接受每日1片氟哌噻吨美利曲辛片（黛力新）药物治疗，其中生物反馈组接受药物治疗同时接受生物反馈治疗，每周2次，共4周。所有患者入组前和入组后每2周进行汉密顿焦虑量表（HAMA）测定。结果各证型生物反馈组和非生物反馈组治疗前 HAMA 评分差异无统计学意义（P ＞0.05）。两组病例治疗后各证型 HAMA 评分均明显下降，治疗后2周和治疗后4周与本组治疗前比较差异有统计学意义（P ﹤0.01），且治疗后2周与治疗后4周比较差异有统计学意义（P ﹤0.01）；治疗后2周时，生物反馈组和非生物反馈组各证型 HAMA 评分差异无统计学意义（P ＞0.05），治疗后4周时，生物反馈组和非生物反馈组各证型 HAMA 评分差异有统计学意义，生物反馈组 HAMA 评分更低。生物反馈组肝郁化火型、痰火扰心型和心肾不交型之间比较差异无统计学意义（P ＞0.05）。心脾两虚型与肝郁化火型、心肾不交型、痰火扰心型 HAMA 评分相比差异有统计学意义（P ﹤0.05，P ﹤0.01）。结论生物反馈辅助治疗焦虑症较单纯药物治疗焦虑症效果明显，四种不同证型相比，生物反馈辅助治疗痰火扰心型和肝郁化火型患者效果最好，且痰火扰心型患者起效更快，生物反馈辅助治疗心脾两虚型患者效果最差。
목적：관찰생물반궤보조치료초필증적료효，병탐토기여불동중의증형적상관성。방법대부합납입표준적초필증환자진행중의변증분형，분위4대조，즉간욱화화조、담화우심조、심비량허조화심신불교조，4조환자각분성2소조，즉생물반궤조화비생물반궤조。소유환자접수매일1편불고새둔미리곡신편（대력신）약물치료，기중생물반궤조접수약물치료동시접수생물반궤치료，매주2차，공4주。소유환자입조전화입조후매2주진행한밀돈초필량표（HAMA）측정。결과각증형생물반궤조화비생물반궤조치료전 HAMA 평분차이무통계학의의（P ＞0.05）。량조병례치료후각증형 HAMA 평분균명현하강，치료후2주화치료후4주여본조치료전비교차이유통계학의의（P ﹤0.01），차치료후2주여치료후4주비교차이유통계학의의（P ﹤0.01）；치료후2주시，생물반궤조화비생물반궤조각증형 HAMA 평분차이무통계학의의（P ＞0.05），치료후4주시，생물반궤조화비생물반궤조각증형 HAMA 평분차이유통계학의의，생물반궤조 HAMA 평분경저。생물반궤조간욱화화형、담화우심형화심신불교형지간비교차이무통계학의의（P ＞0.05）。심비량허형여간욱화화형、심신불교형、담화우심형 HAMA 평분상비차이유통계학의의（P ﹤0.05，P ﹤0.01）。결론생물반궤보조치료초필증교단순약물치료초필증효과명현，사충불동증형상비，생물반궤보조치료담화우심형화간욱화화형환자효과최호，차담화우심형환자기효경쾌，생물반궤보조치료심비량허형환자효과최차。
Objective To observe the efficacy on anxiety treated with biological feedback and ex-plore the correlation with different TCM patterns. Methods The anxiety patients in compliance with the in-clusive criteria were differentiated based on TCM theory and divided into 4 groups,named liver stagnation transmitting into fire group,phlegm fire disturbing heart group,heart and spleen deficiency group and dishar-mony of heart and kidney group. The patients in 4 groups were subdivided into 2 subgroups,named biological feedback subgroup and non - biological feedback subgroup. All of the patients were treated with flupentixol and melitracen tablets,one tablet a day. In the biological feedback subgroup,the patients also received biolog-ical feedback therapy,twice a week,for 4 weeks totally. HAMA was used for determination before and after group division once every 2 weeks for all of the patients. Results There were no differences in HAMA scores between the biological feedback subgroup and the non - biological feedback subgroup before treatment(P >0. 05). HAMA scores were reduced apparently in each TCM pattern after treatment between the two sub-groups. The differences were significant in 2 weeks and 4 weeks of treatment as compared with those before treatment in each subgroup(P ﹤ 0. 01)and the difference was significant between the treatment in 2 weeks and that in 4 weeks(P ﹤ 0. 01). In 2 weeks of treatment,HAMA score of each pattern was not different signif-icantly between the biological feedback group and non - biological feedback group(P > 0. 05). In 4 weeks of treatment,HAMA score of each pattern was different significantly between the biological feedback group and non - biological feedback group and HAMA score was much lower in the biological feedback group. The differences were not significant among liver stagnation transmitting into fire pattern,phlegm fire disturbing heart pattern and disharmony of heart and kidney pattern in the biological feedback subgroup(P > 0. 05). The score was the least reduced in the heart and spleen deficiency group,which was significantly different as com-pared with liver stagnation transmitting into fire group,phlegm fire disturbing heart group and disharmony of heart and kidney group(P ﹤0.05,P ﹤0.01). Conclusion The biological feedback auxiliary treatment achieves the apparent efficacy on anxiety as compared with simple medication. In comparison among four patterns,the biological feedback auxiliary treatment achieves the best efficacy on phlegm fire disturbing heart pattern and liver stagnation transmitting into fire pattern. It presents the quick effect on phlegm fire disturbing heart pat-tern but has the worst effect on heart and spleen deficiency pattern in the patents.