调肝温阳活血法治疗桥本甲减期抑郁负性情感的临床研究

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1、提要目的：笔者通过对导师治疗桥本甲减患者情绪抑郁的临床经验的总结，提出治则治法——调肝温阳活血法。按此治则组成调肝温阳活血汤以治疗桥本甲减期伴情绪抑郁患者，证属肝郁血瘀，阳气虚，并观察临床疗效。方法：将符合桥本甲减抑郁负性情感诊断标准的患者60例，随机分为治疗组（30例）和对照组（30例），在基础治疗的同时，治疗组给予调肝温阳活血汤，对照组只进行基础治疗，四周后对患者的HAMD积分、中医证侯及相关证侯积分、实验室指标进行临床观察。结果：治疗组HAMD积分、中医证侯及相关证侯积分、甲状腺抗体水平改善均明显优于对照组。治疗组的临床疗效优于对照组，总有效率达96.7%，两组间治疗前后有

2、统计学意义（P＜0.01），结果显示调肝温阳活血法在改善患者情绪抑郁忧虑、胁胀、胁痛等肝郁证侯方面有显著作用。治疗过程中未见明显不良反应。结论：调肝温阳活血法治疗桥本甲减伴情绪抑郁是安全有效的方法，中医药治疗桥本甲减伴情绪抑郁负性情感有着明显优势。关键词桥本甲减抑郁负性情感调肝温阳活血法临床研究TheTuneLiverWenyanghuoxuetotheTreatmentofHashimoto'shypothyroidismwithClinicalDepressionandNegativeEmotionsSpeciality:InternalMedicineofTCMAuthor

3、:LiuXingyuTutor:ZhangJuanAbstractObjective:ThroughthementorclinicaltreatmentofHashimoto'shypothyroidismwithasummaryoftheclinicalexperienceofdepression,theproposedgovernanceruleoflaw-totunetheliverWenyanghuoxuelaw.ToobeytheruletoformtheTiaoganWenyanghuoxueTreatedHashimoto'shypothyroidismperiod

4、associatedwithdepressionisaliverstagnationandbloodstasisinpatientswithYangQiinordertoobservetheclinicalefficacy.Methods:Hashimoto'shypothyroidisminpatientswithdepressionandnegativeaffectdiagnosticcriteriawouldbeconsistentwith60caseswererandomlydividedintotreatmentgroup(30cases)andcontrolgroup

5、(30cases),whilebasictreatment,thetreatmentgroupisreceivedtheTiaoganWenyanghuoxuesoup,othecontrolgroupisonlyreceivebasictreatment,fourweeksafterthepatient'sHAMDpoints,TCMpointsandrelatedcertificatepointsintegration,laboratoryindicatorsofclinicalobservation.Results:HAMDpointsofthetreatmentgroup

6、,TCMpointsandrelatedcertificatepoints,improvedthyroidantibodylevelsweresignificantlybetterthanthecontrolgroup.Thetotalcurativeeffectoftreatmentgroupwas96.7%,higherthanthecontrolgroup,thetreatmentgroupthanthecontrolgroup(P<0.01).ResultsdisplaytonetheliverWenyanghuoxueImprovementofpatientswithd

7、epressionconcerns,inflationthreat,hypochondriacSyndromeofDepressedHouhasadistinctrole.Thecourseoftreatment,hasnosignificantadversereactions.Conclusion:regulatingtheliverWenyanghuoxuetreatmentofHashimoto'shypothyroidismwithdepressionissafeande