补气养阴疏肝汤治疗2型糖尿病合并郁证临床观察

目的:观察自拟补气养阴疏肝汤治疗气阴两虚型2型糖尿病合并郁证的临床疗效。方法:将52例气阴两虚型2型糖尿病合并郁证患者随机分为两组各26例。两组均给予糖尿病常规治疗,对照组在常规治疗基础上加用帕罗西汀抗抑郁,开始剂量为20 mg/d,若2～3周后症状无改善,则可以每周增加10 mg,最大量不超过50 mg/d。治疗组在对照组基础上合用自拟补气养阴疏肝汤,每日1剂,每周5次,连续治疗8周。分别于治疗前治疗后观察患者Hb A1c、HAMD评分及中医症状积分变化,进行临床疗效评定,并记录不良反应。结果:治疗后两组Hb A1c、HAMD评分均较治疗前明显改善(P<0.01),且治疗组改善程度优于对照组(P<0.01或P<0.05)。治疗组总有效率为84.62%,对照组总有效率为53.85%,治疗组优于对照组(P<0.05)。对照组中有12例患者出现口干、便秘、厌食、失眠症状;治疗组中有2例出现上述症状。结论:西药合用补气养阴疏肝汤治疗气阴两虚型2型糖尿病合并郁证,疗效优于单纯西医治疗,且可降低西药的不良反应。

Clinical observation of Buqi Yangyin Shugan decoction on type 2 diabetes mellites complicated by melancholia

Objective:To observe the clinical effect of self-made Buqi yanyin shugan decoction on type 2 diabetes mellites with melancholia of qi and yin deficiency syndrome. Methods:52 cases of patients with type 2 diabetes mellites with melancholia of qi and yin deficiency syndrome were randomly divided into two groups, 26 cases in each group. Both groups were given conventional treatment of diabetes. The control group was treated plus with paroxetine for antimelancholia on the basis of conventional treatment;the predose was 20 mg/d;if the symptoms were not improved after 2~3 weeks,the dose should be added by 10 mg / week, the maximum dose did not exceed 50 mg/d.The treatment group was treated plus with self-made Buqi Yangyin Shugan decoction on the basis of control group, 1 dose per day, 5 times a week, for 8 weeks of continuous treatment. Respectively before and after treatment,the scores of HbA1c and HAMD as well as the change of score of TCM symptoms were observed in the patients. The clinical effect was evaluated,and the adverse reactions were recorded. Results:After treatment in both groups,the scores of HbA1c and HAMD were significantly improved as compared with before treatment (P <0.01), and the improvement of treatment group was better than that of control group (P<0.01 or P<0.05). The total effective rate was 84.62% in treatment group and 53.85% in control group. The treatment group was better than control group (P<0.05).In the control group, the symptoms of xerostomia,constipation, anorexia and insomnia appeared in 12 cases of patients;while in the treatment group, above symptomsin appeared in 2 cases of patients. Conclusion:The clinical effect of Buqi Yangyin Shugan decoction combined with western medicine on type 2 diabetes mellites with melancholia of qi and yin deficiency syndrome is better than that of simple western medicine of control group, and which can reduce the adverse reactions of western medicine.