中西醫(yī)結(jié)合治療晚期癌癥相關(guān)性抑郁癥30例臨床觀察

安慧娟 白明貴

【摘?要】?目的：觀察中西醫(yī)結(jié)合治療晚期癌癥相關(guān)性抑郁癥的臨床療效。方法：將晚期腫瘤相關(guān)抑郁60例按入院時(shí)間隨機(jī)分為對(duì)照組和治療組，每組各30例，對(duì)照組用氟西汀膠囊治療，治療組以血府逐瘀湯為基礎(chǔ)方加減聯(lián)合氟西汀膠囊治療，對(duì)比兩組患者的效果，并通過(guò)漢密爾頓抑郁量表（HAMD，24項(xiàng)）評(píng)定患者治療前后的抑郁情況，同時(shí)比較治療過(guò)程中兩組不良反應(yīng)的發(fā)生情況。結(jié)果：治療后治療組HAMD減分率優(yōu)于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;兩組內(nèi)治療前后比較，差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療過(guò)程中兩組均無(wú)嚴(yán)重不良反應(yīng)發(fā)生，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），治療后治療組患者的有效率明顯優(yōu)于對(duì)照組，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：中西醫(yī)結(jié)合治療晚期癌癥相關(guān)性抑郁癥具有較好的臨床療效，副作用小，值得臨床推廣應(yīng)用。

【關(guān)鍵詞】?血府逐瘀湯;癌癥;抑郁癥;王清任

【中圖分類號(hào)】R749.4+1?【文獻(xiàn)標(biāo)志碼】 A?【文章編號(hào)】1007-8517（2019）17-0076-03

Abstract：Objective Clinical efficacy of Xuefu Zhuyu Decoction in the treatment of the advanced carcinoma related depression. Methods the 60 patients were randomly divided into control group and treatment group according to admission time， 30 cases in the control group were treated with fluoxetine capsule， and30 cases in the treatment group were treated with Xuefu Zhuyu Decoction combined with fluoxetine capsule， The efficacy of treatment was compared between the two groups， and the depression was assessed by Hamilton Depression Scale （HAMD， 24 items） before and after treatment，and recorded the occurrence of two groups of adverse reactions in the course of treatment， to compare their differences.Results According to the HAMD depression score， the two groups were compared after treatment （P<0.05）; the other two groups were compared before and after treatment （P<0.05）， the difference was significant. There was no significant difference between the two groups in the occurrence of serious adverse reactions （P>0.05） ;After treatment， the improvement of depression in the treatment group was significantly better than that in the control group， the difference was statistically significant （P<0.05）.Conclusion Combination of Chinese and Western Medicine in the treatment of advanced cancer related depression has a good clinical effect and small side effects. It is worthy of clinical application.

Key?words：XuefuZhuyu Decoction; cancer; depression; Wang Qing-ren

近20年來(lái)，在環(huán)境污染、食物添加劑的大量應(yīng)用以及人們生活、工作壓力增加等多種的因素的綜合作用下，惡性腫瘤的發(fā)病率急劇升高[1]，且多數(shù)患者在明確診斷時(shí)已為晚期。惡性腫瘤除了給患者帶來(lái)巨大的軀體痛苦外，還給社會(huì)、家庭帶來(lái)了巨大的經(jīng)濟(jì)壓力。由于目前醫(yī)學(xué)發(fā)展水平的限制，惡性腫瘤的治愈率仍較低，患者在診斷為癌癥后，多感到生存無(wú)望，精神壓力巨大，因此，癌癥相關(guān)性抑郁癥的發(fā)生率也較高[2]。抑郁癥屬于中醫(yī)“郁證”范疇，筆者臨床上應(yīng)用血府逐瘀湯加減聯(lián)合氟西汀膠囊中西醫(yī)結(jié)合治療癌癥相關(guān)性抑郁癥，療效顯著。現(xiàn)將觀察效果報(bào)道如下。

1?資料與方法

1.1?一般資料?所選60例患者均為2012年10月至2016年12月在平頂山市中醫(yī)院住院患者，大多數(shù)患者有生活消極，表情淡漠，害怕與外界接觸等癥狀。隨機(jī)分為兩組：對(duì)照組30例，其中男13例，女17例;年齡21～62歲，平均（37.5±5.3）歲;病程2個(gè)月至4年;治療組30例，其中男16例，女14例;年齡20～60歲，平均（38.3±4.1）歲;病程3個(gè)月至5年。兩組年齡、性別、病程等一般資料比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。