补虚劳经典药膳粥改善脾肾阳虚证慢性疲劳 综合征患者临床症状研究

Role of classical restorative porridge on clinical symptoms in patients with chronic fatigue syndrome caused by spleen and kidney yang deficiency

摘要:

目的 探讨补虚劳经典药膳粥对脾肾阳虚证慢性疲劳综合征（CFS）患者临床症状的改善效果。 方法 在成都市某三甲中医院门诊选取符合纳入标准的CFS（脾肾阳虚证）患者86 例，采用随机数字表法分 成试验组和对照组，各43 例。对照组采用发放健康教育手册、面对面交谈的个体指导与讲座、微信群的集体 指导相结合的形式实施为期8 周的健康教育，每2 周1 次，共4 次；试验组在此基础上食用改良后的补虚劳 经典药膳粥，隔天1 次，每次400 ～ 500 ml，4 周为1 个疗程，共2 个疗程。两组患者均于干预前、干预4 周末、 干预8 周末采用疲劳量表-14（FS-14）、躯体和心理健康报告（SPHERE）分别评价患者疲劳症状和伴随症 状，采用脾肾阳虚中医证候积分评价患者中医证候的改善情况。结果 试验组干预后各时间点FS-14 总分和 SPHERE 评分均低于同期对照组（P <0.05）；FS-14 总分和SPHERE 评分组间效应、时间效应及两者交互效 应差异均有统计学意义（P <0.05）。试验组干预后各时间点中FS-14 总分和SPHERE 评分两两比较，后一时 间点得分均低于前一时间点（P <0.05）。中医证候：干预4 周后，试验组脾肾阳虚证候总分、倦怠乏力、食 少纳呆、脘腹胀满条目低于对照组（P <0.05），干预8 周后，除腰部冷痛条目外，其余条目及总分试验组均低 于对照组（P <0.05）；中医证候总分组间效应、时间效应及两者交互效应差异有统计学意义（P <0.05）。试验 组干预后各时间点中医证候总分两两比较，后一时间点得分均低于前一时间点，差异有统计学意义（P <0.05）。 结论 补虚劳经典药膳粥可改善CFS 患者的疲劳，减少伴随症状，并能有效改善患者的中医证候。

关键词:疲劳综合征，慢性;补虚劳经典药膳粥;脾肾阳虚证;临床症状

Abstract:

Objective To explore the therapeutic effects of classical restorative porridge (CRP) on clinical symptoms in patients with chronic fatigue syndrome (CFS) caused by spleen and kidney yang deficiency. Methods A total of 86 patients with CFS caused by spleen and kidney yang deficiency admitted in our hospital were included, who were randomly divided into experimental group (n = 43) and control group (n = 43). All patients received health education with individual and collective guidance for a period of eight weeks by health education instruction manuals, lectures and online learning. Patients in experimental group received additional CRP (400-500 ml) for 8 weeks once every other day. Clinical syndrome was recorded pre and post treatment by several scales such as the Fatigue Scale-14 (FS-14), Somatic and Psychological Health Report (SPHERE). Results Patients in both group experienced improvement in scores of FS-14 and SPHERE (P < 0.05). However, scores of FS-14 and SPHERE and the total score of spleen and kidney yang deficiency syndrome were decreased significantly when compared with those in control group (P < 0.05). Repeated ANOVA analysis showed those scores were significant in group effect, time effect and interactive effect (P < 0.05). Four weeks post intervention, 9 items of spleen and kidney yang deficiency syndromes in experimental group were lower than control group, among which fatigue poor appetite and abdominal distention experienced dramatic improvement (P < 0.05). Eight weeks post intervention, the total score and 8 items (except waist cold and pain) in experimental group were lower than control group (P < 0.05). Conclusions CRP can relieve fatigue symptoms and TCM syndrome.

Key words:fatigue syndrome; chronic; classical restorative porridge; spleen and kidney yang deficiency; clinical symptoms