目前治疗躯体症状障碍(SSD)常用方法是药物治疗,但其疗效有限.本研究旨在观察正念训练对青少年躯体症状障碍的临床疗效. 1 对象和方法 将本院2020 年3 月至2021 年12 月期间的门诊SSD就诊患者纳入本次研究.

Objective:To observe the effect of Qijiao Shengbai Capsule in patients with NHL on bone marrow suppression after chemotherapy treatment.Methods:A total of 324 patients with NHL were randomly divided into observation group (CHOP chemotherapy + Qijiao Shengbai Capsule) and control group (CHOP chemotherapy).After four cycles of treatment,the clinical efficacy,adverse events and bone marrow suppression were observed.Results:The overall response rate in observation group was 58.60％ and the control group's was 57.14％.There was no significant difference between two groups (P ＜ 0.05).After treatment,the observation group's severe marrow suppression was 2.55％ (4/157),significantly lower than the control group's 15％ (21/140).1 week after treatment,the observation group's incidence of severe marrow suppression was 3.18％ (5/157),significantly lower than 17.14％ (24/140) in the control group.The difference was statistically significant (P ＜ 0.05).The lowest value of white blood cell count in the observation group was (2.61 ±0.57) × 109/L,which was higher than the control group's (1.21-±0.31) × 109/L.The difference was statistically significant (P ＜ 0.05).The lowest value of the hemoglobin count and platelet count was not statistically significant (P ＜0.05).The observation group's patients had 3 (1.91％) cases due to the serious adverse reactions withdrawn from this study.The control group had 18 (12.86％).After treatment,the incidence of anemia,infection,nausea and vomiting in the observation group were significantly lower than the control group's.The difference was statistically significant (P ＜ 0.05).Conclusion:Qijiao Shengbai Capsule can improve the bone marrow suppression situation of patients with malignant lymphoma,reduce the incidence of adverse reactionsand ensure the smooth progress of chemotherapy,which is worthy of clinical use.

目的 探讨正念训练治疗广泛性焦虑障碍(GAD)的临床疗效.方法 将84例广泛性焦虑障碍患者随机分成正念训练组或帕罗西汀治疗组,均治疗8周;采用汉密尔顿焦虑量表(HAMA)评定疗效.结果 正念训练组有36例完成研究,帕罗西汀治疗组有40例完成研究.两组HAMA评分均在治疗第1周末显著下降(均P＜0.05),但两组间差异均无统计学意义(均P＞0.05);两组临床疗效差异无统计学意义(P＞0.05).结论 正念训练治疗广泛性焦虑障碍疗效与帕罗西汀相当,值得推广.

目的 分析探讨团体心理治疗对躯体形式障碍患者的述情障碍的作用.方法 随机选取180例确诊躯体形式障碍患者,随机分为试验组(90例)和对照组(90例).对照组行常规治疗,试验组于此基础上行团体心理治疗,评估两组治疗结果.结果 干预因素和时间因素对TAS因子I、Ⅱ、Ⅳ存在交互作用,P＜0.01;干预前的TAS因子分数和团体心理治疗可显著预测TAS因子Ⅰ、Ⅱ、Ⅳ的减少值,P＜0.01;试验组疗效优于对照组,P＜0.01;团体心理治疗、TAS因子Ⅰ、Ⅱ和Ⅳ是影响治疗结果的主要因素(0R=9.322-1.240).结论 躯体形式障碍患者的述情障碍经团体心理治疗后疗效显著.

目的:探讨助阳舒心方对抑郁模型大鼠HPA轴调控的机制.方法:采用慢性轻度不可预见性刺激(CUMS)结合孤养建立大鼠抑郁模型,将60只雄性SD大鼠随机分为空白对照组、模型组、盐酸氟西汀组及助阳舒心方低、中、高剂量组,观察助阳舒心方对大鼠体质量及糖水消耗的影响;运用逆转录聚合酶联反应(RT-PCR)法检测大鼠下丘脑促肾上腺皮质激素释放激素(CRH)、糖皮质激素受体(GR)和垂体阿黑皮素原(POMC)mRNA表达情况.结果:助阳舒心方可逆转慢性应激大鼠体质量减轻、糖水消耗减少,下调下丘脑CRH和垂体POMC mRNA表达,上调下丘脑GR mRNA表达.结论:助阳舒心方对慢性应激大鼠具有抗抑郁作用,其调控HPA轴的机制与下调下丘脑CRH、垂体POMC mRNA表达和上调下丘脑GR mRNA表达有关.

目的：通过观察氟西汀对阳虚大鼠模型的影响探讨抑郁症与中医阳虚的关系。方法：将40只雄性 SD大鼠随机分为空白对照组、模型组、氟西汀组、金匮肾气丸组。采用注射氢化可的松的方法建立大鼠阳虚模型，观察大鼠生物表征、证候特征的变化。实验第22天采血，测定血中环磷酸腺苷（ cAMP）、环磷酸鸟苷（ cGMP）含量。结果：与空白对照组比较，模型组大鼠绝大多数表现为阳虚证和气虚证；氟西汀组和金匮肾气丸组大鼠的精神状况、体质量增长等一般情况较模型组有不同程度的改善，阳虚和气虚大鼠数量较模型组明显减少；氟西汀组较模型组cGMP 含量降低， cAMP 含量及cAMP／cGMP比值升高。结论：抑郁症与中医阳虚证机具有密切关系，氟西汀属中医“助阳药”范畴。

目的:建立肝肾阳虚型抑郁症大鼠模型.方法:将50只雄性SD大鼠随机分为空白对照组、应激组、利血平和氢化可的松低剂量组、利血平和氢化可的松中剂量组、利血平和氢化可的松高剂量组.观察造模前后大鼠的证候特征及行为学改变.实验第22天采血,测定血中环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)含量.结果:利血平和氢化可的松各剂量组大鼠表现出行为性抑郁,阳虚大鼠数量和气虚大鼠数量较空白组显著增加,cAMP含量、cAMP/cGMP比值降低.结论:利血平联合氢化可的松注射是建立肝肾阳虚型抑郁症动物模型的可行方法.

通过分析焦虑情绪在中医情志中的归属、焦虑情绪的病因病机、情绪焦虑的影响和危害，发现焦虑情绪与七情中的“惊”、“恐”关系最为密切，与部分“忧”、“思”有关；病因病机有阳气受损或运行失常、脏腑功能异常、经脉功能异常、气血功能异常、误治、体质和个性原因等方面；情绪焦虑可影响气机、损伤脏腑、影响经脉。

目的:观察氯化锂-匹罗卡品致痫大鼠海马组织S100B表达,探讨姜黄素对癫痫大鼠神经保护作用机制.方法:动物随机分为3组,空白对照组、癫痫组、姜黄素治疗组.癫痫模型采用氯化锂-匹罗卡品诱导大鼠癫痫持续状态(SE),给药SE后予姜黄素300 mg/kg腹腔,大鼠癫痫造模后24 h和72 h取海马组织,苏木素-伊红(HE)染色观察海马组织病理形态学变化,免疫组化染色和免疫印迹法检测海马组织S100B蛋白的表达.结果:癫痫组海马神经元脱失和损伤明显,姜黄素治疗组明显减轻;与对照组相比,海马神经元S100B免疫反应阳性表达增加,差异显著(P＜0.05);与模型组比较姜黄素治疗组海马神经元S100B阳性表达水平降低,差异显著(P＜0.05).结论:姜黄素治疗可降低匹罗卡品致痫大鼠海马神经元S100B蛋白表达,可能通过抑制星形胶质细胞活化来减轻癫痫发作脑损伤发挥神经保护作用.

Objective To investigate the effect of fluoxetine hydrochloride capsules (FHC) on symptoms and serum testosterone and thyroid hormones in model rats with Yan deficiency, in an attempt to explore the mecha-nism of depression with Chinese differentiation syndrome theory. Methods Forty male SD rats were randomly di-vided in to model group, FHC group, Jinkuishenqiwan group, and blank control group, 10 rats in each group. The rat model of Yan deficiency was made by injection of hydrocortisone. The drug group was given the corresponding drugs for 21d, respectively. At the end of the study, the biological characteristics were observed. Blood was drawn on D22 to detect the serum levels of testosterone(T), triiodothyronine(T3), tetraiodothyronine(T4), and thyroid stimulating hormone(TSH). Results Rats in model group had symptoms of Yan deficiency. The symptoms of Yan deficiency were improved in FHC group and Jinkuishenqiwan group. Compared with blank control group, the serum levels of T and T3 was decreased in model groups(P<0.05, P<0.01), while the levels of T4 and TSH was not dif-ferent (P>0.05). Compared with model group, the levels of T and T3 were increased in two drug groups (P<0.05). Conclusion FHC has similar effect as Chinese medicine of "increasing Yan".It can improve the symptoms of Yan deficiency and increase the levels of T and T3. Yan deficiency may play important role in development of depres-sion.

Objective: To investigate the syndrome characteristic,HPA axis of chronic unpredictable mild stress( CUMS) rats and interventional effect of Zhuyang Shuxin formula( ZYSX). Method: 60 male SD rats were randomly divided into control group,depression model group,fluoxetine group,and ZYSX formula high dose group,ZYSX formula medium dose group,ZYSX formula low dose group. We analyzed the syndrome characteristics by observing the rats' general conditions and four quantitative diagnosis indexes. Adrenocorticotropic hormone( ACTH) and cortisol( CORT) were detected after administration. Result: Most of the rats in model group were Yang deficiency and Qi deficiency. The rats of Yang deficiency and Qi deficiency were obviously decreased in ZYSX groups and fluoxetine group. Serum ACTH and CORT levels were significantly higher in model group than those in control group. Serum CORT level was obviously decreased in ZYSX groups than that in model group. Serum ACTH level was obviously decreased in ZYSX high dose group than that in model group. Conclusion: The syndrome characteristic of model group is Yang deficiency. Hyperfunction of hypothalamus-pituitary-adrenal( HPA) axis may be the microscopic description of Yang deficiency. ZYSX Formula could ameliorate Yang deficiency and HPA function in depression rats.

目的:探讨助阳舒心方对抑郁模型大鼠生物表征及血清甲状腺激素、睾酮的影响.方法:采用慢性轻度不可预见刺激(CUMS)结合孤养建立大鼠抑郁模型,将60只雄性SD大鼠随机分为空白对照组、模型组、盐酸氟西汀组及助阳舒心方高、中、低剂量组,观察造模前后大鼠的生物表征；给药21天后采血,测定血中三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、睾酮(T)含量.结果:模型组大鼠的生物表征类似中医阳虚证的表现；与空白组比较,模型组大鼠T3、T4含量显著升高,TSH含量无明显差异,T含量显著降低；与模型组比较,助阳舒心方高剂量组T3、T4含量明显降低,中、高剂量组T含量明显升高.结论:CUMS抑郁模型大鼠表现出的证候可能属中医的“阳虚证”,调控异常的内分泌功能可能是助阳舒心方治疗抑郁症的机制之一.

目的:观察助阳舒心方对抑郁模型大鼠行为学及血cAMP、cGMP含量的影响.方法:采用慢性轻度不可预见刺激(CUMS)结合孤养建立大鼠抑郁模型,将60只雄性SD大鼠随机分为正常对照组、模型组、盐酸氟西汀组及助阳舒心方高、中、低剂量组,观察实验过程中各组大鼠的体重、摄食量、敞箱实验、糖水消耗实验的变化;给药21天后采血,测定血环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)含量.结果:模型组大鼠的体重、水平穿越格数、直立次数、糖水消耗量及血cAMP含量、cAMP/cGMP比值均明显低于正常对照组;助阳舒心方高剂量组和盐酸氟西汀组大鼠体重明显高于模型组;助阳舒心方各剂量组和盐酸氟西汀组大鼠水平穿越格数、直立次数、糖水消耗量均明显高于模型组;助阳舒心方中、高剂量组和盐酸氟西汀组大鼠血cAMP含量、cAMP/cGMP比值明显高于模型组.结论:助阳舒心方具有一定的抗抑郁作用;抑郁模型大鼠的证候可能属中医“阳虚证”范畴.

抑郁症(depression)是一种常见的情感障碍性精神疾病,其临床特征主要以心境低落、快感缺失、负性思维和精力减退为核心,并常伴有睡眠异常、食欲减退、体重减轻、性欲减退等躯体症状,是目前世界上最易致残的疾病之一[1].笔者应用助阳舒心方治疗本病50例,取得满意的疗效.现报道如下.

Objective:To research the clinical curative effect of Zhuyang Shuxin Recipe on improving TCM syndrome of patients with depression with syndrome of yang deficiency of liver and kidney.Methods:100 subjects were randomly divided into treatment group and control group,50 cases were treated with Zhuyang Shuxin Recipe.The control group was treated with fluoxetine.The treatment course was 6 weeks.TCM syndrome in the treatment of 2 weeks,4 weeks,6 weeks changes and TCM symptoms before and after the treatment changes were observed.Results:TCM curative effect of the treatment group in the treatment of 2 weeks,4 weeks,6 weeks was better than that of control group(P0.01);cut scores of weakness and tiredness,loss of libido,aversion to cold,lassitude in loin and knee and pale tongue in treatment group after 6 weeks were better than those in control group(P0.05 or P0.01).The cut scores of the mood,interest waned,tension and fear,slow thinking,wordless and the enlarged tongue body decreased were equivalent in two groups(P0.05),cut scores of Hypobulia in treatment group was worse than that in the control group(P0.05).Conclusion:Zhuyang Shuxin Recipe has excellent improving effect in TCM symptoms of patients with depression with syndrome of yang deficiency of liver and kidney.

Objective:Characteristics and onset-related factors of liver-kidney yang deficiency syndrome of depression were analyzed.Methods:279 cases were selected to analyze the characteristics and onset-related factors of liver-kidney yang deficiency syndrome of depression.Results:Liver-kidney yang deficiency syndrome of depression occurs frequently in autumn and winter and even more serious than that occurs in spring and summer.Patients' conditions in Qi deficiency constitute group were more serious than that in non Qi deficiency constitute group and patients' conditions in Yang deficiency constitute group were more serious than that in non Yang deficiency constitute group.Syndrome score and HAMD score have high relativity with depressed factors.Conclusion:There are obvious changes of iver-kidney yang deficiency syndrome of depression;the severity has a certain relation with the constitution.There are 4 symptoms which can be considered as the characteristics of depression belonging to liver-kidney Yang deficiency syndrome.

目的:分析肝肾阳虚证患者的心理健康状况。方法:运用心理学量表SAS、SDS、SCL-90对肝肾阳虚证患者进行评估,并与相应的全国常模比较。结果:SAS、SDS总分及SCL-90中的躯体化、强迫、抑郁、焦虑、敌对性、恐怖、偏执、精神病性等8个因子的评分均高于相应的全国常模;有68.4%患者存在抑郁,其中35.5%为中重度抑郁症状;有55.2%患者存在焦虑症状,其中19.7%为中重度焦虑症状。结论:精神/心理症状尤其抑郁症状是肝肾阳虚证的突出临床表现。

Based on studying the injection of glucocorticoid,estrogen,reserpine and forced swimming test,we explore the relationship between depression and yang deficiency syndrome with animal model in appearance and biochemical mechanism.It is found that there are many similarities between depression and yang deficiency syndrome,Chinese herbs which have the funtion of warmly invigorating kidney and liver show positive anti-depressant effect.We speculated that the pathogenesis of depression is yang deficiency of liver and kidney.Studying depression animal model and pathological mechanism of it contributes to investigating the nature of syndrome of yang deficiency of liver and kidney.

By discussing the theoretical basis,clinical characteristics and treatment method of syndrome of yang deficiency of liver and kidney,we put forward the view that the same source of liver yang and kidney yang is the theoretical basis of the syndrome of yang deficiency of liver and kidney,spirit/psychological symptoms(encephalopathy symptoms) is the outstanding clinical manifestation of it,syndrome of yang deficiency of liver and kidney has a high correlation with depression,pungent-sweet and warm herbs or formula are the main treatment.

Based on studying the indications,efficacy and mechanism of Kaixin Powder and its similar prescriptions,we find that the drugs have the efficacy of tonifying deficiency,tranquilizing the mind,promoting intelligence,harmonizing heart and kidney.The treatment target symptoms include anxiety,depression,forgetfulness,words and actions abnormalities,spermatorrhea and vision loss.Yang-qi deficiency is the pathological basis of Kaixin Powder and its similar prescriptions,isolated yang-qi is the nature of disharmony between heart and kidney.