白龙解郁颗粒对地震灾害创伤后应激障碍的影响
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摘要
目的调查2008年汶川地震灾区灾民及救援部队的创伤后应激障碍(PTSD)情况,观察中药白龙解郁颗粒对PTSD的疗效。方法在地震后3个月对灾民及参与灾区救援工作的部队进行筛查,将符合PTSD诊断的患者采用症状自评量表SCL-90进行评估,分别给予白龙解郁颗粒及安慰剂,观察治疗前后SCL-90量表各因子分差异,并与正常人常模、军人常模比较。结果灾民的PTSD的发生率达20.7%,军人的PTSD发生率为3.1%。PTSD灾民SCL-90量表的躯体化、强迫、抑郁、焦虑、敌对及恐怖因子分高于中国正常人常模,人际关系敏感因子则低于中国正常人常模,差异均有统计学意义(P<0.05或P<0.01)。PTSD军人的躯体化因子分高于中国军人常模,偏执因子分则低于中国军人常模,差异均有统计学意义(P<0.05或P<0.01)。白龙解郁颗粒治疗后PTSD灾民的躯体化、强迫、抑郁、焦虑、敌对、恐怖、人际关系敏感等因子分较治疗前下降明显,差异有统计学意义(P<0.05或P<0.01),PTSD军人治疗后躯体化因子分、抑郁因子分及偏执因子分低于治疗前,差异有统计学意义(P<0.05),均优于安慰剂组。结论灾民及救援部队灾后均存在PTSD,白龙解郁颗粒对PTSD有显著作用,疗效优于安慰剂。
Objective To investigate the situation of posttraumatic stress disorder (PTSD) of victims and the rescue soldiers in 2008 Wenchuan earthquake,and to observe the effect of Bailong Jieyu Granule (Herbal granule for relieving the posttraumatic stress disorder) on PTSD.Methods Three months after the earthquake,an investigation on earthquake victims and rescue soldiers was carried out to screen out those who were in accordance with the diagnosis standard of PTSD.The PTSD cases were evaluated with Symptom Checklist 90 (SCL-90) and administrated Bailong Jieyu Granule or placebo.Scores of all SCL-90 factors before and after treatment was observed and the result was compared with that of the normal control and soldier control.Results The PTSD incidence of the disaster victims was 20.7% and that of the rescue soldiers was 3.1%.The result of SCL-90 displayed the scores of disaster victims' somatization,forcing,depression,anxiety,hostility,phobic factors were higher than those of Chinese norm,while the score of interpersonal sensitivity factor was lower than that of Chinese norm,the difference was significant (P<0.05 or P<0.01).The scores of rescue soldiers' somatization factor was higher than those of soldier norm,while the score of paranoid factor was lower than that of soldier norm,the difference was significant (P<0.05 or P<0.01).The scores of disaster victims' somatization,forcing,depression,anxiety,hostility,phobic factors after treatment of Bailong Jieyu Granule were significantly lower than before treatment (P<0.05 or P<0.01).The rescue soldiers' scores of somatization,depression factor,and paranoid factor after treatment were significantly lower than before treatment (P<0.05).Both were better than those of the placebo group.Conclusion The earthquake victims and rescue soldiers were all prone to PTSD.Bailong Jieyu Granule is effective for PTSD,better than the placebo group.
Objective To investigate the situation of posttraumatic stress disorder (PTSD) of victims and the rescue soldiers in 2008 Wenchuan earthquake,and to observe the effect of Bailong Jieyu Granule (Herbal granule for relieving the posttraumatic stress disorder) on PTSD.Methods Three months after the earthquake,an investigation on earthquake victims and rescue soldiers was carried out to screen out those who were in accordance with the diagnosis standard of PTSD.The PTSD cases were evaluated with Symptom Checklist 90 (SCL-90) and administrated Bailong Jieyu Granule or placebo.Scores of all SCL-90 factors before and after treatment was observed and the result was compared with that of the normal control and soldier control.Results The PTSD incidence of the disaster victims was 20.7% and that of the rescue soldiers was 3.1%.The result of SCL-90 displayed the scores of disaster victims' somatization,forcing,depression,anxiety,hostility,phobic factors were higher than those of Chinese norm,while the score of interpersonal sensitivity factor was lower than that of Chinese norm,the difference was significant (P<0.05 or P<0.01).The scores of rescue soldiers' somatization factor was higher than those of soldier norm,while the score of paranoid factor was lower than that of soldier norm,the difference was significant (P<0.05 or P<0.01).The scores of disaster victims' somatization,forcing,depression,anxiety,hostility,phobic factors after treatment of Bailong Jieyu Granule were significantly lower than before treatment (P<0.05 or P<0.01).The rescue soldiers' scores of somatization,depression factor,and paranoid factor after treatment were significantly lower than before treatment (P<0.05).Both were better than those of the placebo group.Conclusion The earthquake victims and rescue soldiers were all prone to PTSD.Bailong Jieyu Granule is effective for PTSD,better than the placebo group.
引文
[1]中华医学会精神科分会.中国精神障碍分类与诊断标准[M].3版.济南:山东科学技术出版社,2001:83-91.
[2]中国行为医学科学编辑委员会.行为医学量表手册[M].北京:中华医学电子音像出版社,2005:64-67.
[3]金华,吴文源,张明园.中国正常人SCL-90评定结果的初步分析[J].中国神经精神疾病杂志,1986,12(5):260-263.
[4]王焕林,陈继军.我国军人症状自评量表常模的建立及结果分析[J].中华精神科杂志,1999,32(1):38-40.
[5]Davidson JR.Recognition and treatment of posttraumatic stress disorder[J].JAMA,2001,286(5):584-588.
[6]Hoge CW,Lesikar SE,Guevara R,et al.Mental disorders among U.S.Military personnel in the1990s:association with high levels of health care utilization and early military attrition[J].Am J Psychiatry,2002,159(9):1576-1583.
[7]Deahl M,Srinivasan M,Jones N,et al.Preventing psychological trauma in soldiers:the role of operational stress training and psychological debriefing[J].Br J MedPsychol,2000,73(Pt1):77-85.
[8]秦虹云,季建林.PTSD及其危机干预[J].中国心理卫生杂志,2003,17(9):614-616.
[9]杨玉兴,魏品康,修丽娟,等.白龙解郁颗粒对67例肿瘤相关性抑郁患者生活质量的影响[J].中国中医药信息,2009,36(5):35-37.
[10]修丽娟,魏品康,刘龙,等.消痰解郁方对慢性强迫游泳应激后小鼠海马5-HT1A受体mRNA表达的影响[J].第二军医大学学报,2007,28(10):1126-1128.
[2]中国行为医学科学编辑委员会.行为医学量表手册[M].北京:中华医学电子音像出版社,2005:64-67.
[3]金华,吴文源,张明园.中国正常人SCL-90评定结果的初步分析[J].中国神经精神疾病杂志,1986,12(5):260-263.
[4]王焕林,陈继军.我国军人症状自评量表常模的建立及结果分析[J].中华精神科杂志,1999,32(1):38-40.
[5]Davidson JR.Recognition and treatment of posttraumatic stress disorder[J].JAMA,2001,286(5):584-588.
[6]Hoge CW,Lesikar SE,Guevara R,et al.Mental disorders among U.S.Military personnel in the1990s:association with high levels of health care utilization and early military attrition[J].Am J Psychiatry,2002,159(9):1576-1583.
[7]Deahl M,Srinivasan M,Jones N,et al.Preventing psychological trauma in soldiers:the role of operational stress training and psychological debriefing[J].Br J MedPsychol,2000,73(Pt1):77-85.
[8]秦虹云,季建林.PTSD及其危机干预[J].中国心理卫生杂志,2003,17(9):614-616.
[9]杨玉兴,魏品康,修丽娟,等.白龙解郁颗粒对67例肿瘤相关性抑郁患者生活质量的影响[J].中国中医药信息,2009,36(5):35-37.
[10]修丽娟,魏品康,刘龙,等.消痰解郁方对慢性强迫游泳应激后小鼠海马5-HT1A受体mRNA表达的影响[J].第二军医大学学报,2007,28(10):1126-1128.
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