| Somatoform disorders is one with afraid or believe of different body symptoms advantage idea for neuroses disorders of the characteristic lasting for form not to hinder. The patient seeks medical advice repeatedly because of these symptoms, various medical check are negative with the doctor’s explanation, can’t give up its doubt. Can’t explain the property, intensity of symptom told even if there is a certain body obstacle sometimes, or it aches with the advantage idea. Often with anxious or depression. Though the emergence and closely related to unpleasant life incident, the difficulty or conflict continuously of symptom, but the patient often denies the existence of the psychological factor.Traditional Chinese medicine consider the somatoform disorders belong to" depression","insomnia","fright palpitations","gastric stuffiness","gastric upset " and other. It is a common disease in interal medical, often misdiagnosed as digestive system such as gastritis, peptic ulcer, though the patient often seeks medical advice to different doctors repeatedly or had a long treatment,it’s still hard to obverve a evidence effect,. According to Chinese medicine with corresponding disease with disease pattern and mechanism of desease,obstacle patient behave with emotional disorders obstacle such as anxious, depressed, manic disorders. In Traditional Chinese medicine,people are a whole, the body and mind can’t be divided. Somatoform symptom of the patients somatoform symptom can reflect the psychological state. Body symptom and psychological disorder is the two of side of each other, act as the cause and effect of each other, form sick circulation.Most antidepressant drugs cause adverse reactions, such as agitation, anxiety, diarrhea, insomnia, nausea and vomiting, dry mouth, dizziness and constipation. However, different types of drugs may make adverse reactions of different natures be of different severity degrees. Here are some examples:NE reuptake inhibitors can cause tremors and insomnia;5-HT reuptake inhibitors can cause nausea and vomiting, headache and insomnia; and drugs with additional effect of antihistamine may cause sleepiness and increased appetite.Duloxetine is a kind of antidepressant drug with dual inhibitory effects of5-HT and NE reuptake inhibitors. It can not only be used to treat depression but also can be used to treat emotional disorder mainly involving a variety of somatic symptoms. It is the first drug approved by U.S. Food and Drug Administration to be used to treat diabetic peripheral neuropathic pain. The adverse reactions caused by such drug are closely related to its dual inhibitory effects. The most common adverse reactions reported in literature include:1) dry mouth, heartbeat tachycardia and sleep disorder;2) headache, weight loss, nausea and vomiting, and diarrhea [3]. For the adverse reactions of patients with somatoform disorders, clinicians shall in particular pay attention to one problem, i.e., they must identify whether their symptoms are somatic symptoms or real adverse reactions.Recent years witnesses gradually deepened understanding of traditional Chinese medicine. Despite that Chinese traditional medicine also causes adverse reactions, Chinese traditional medicine taken under the guidance of Chinese traditional medical theory is of higher safety compared with chemical drugs. Its toxic reaction, withdrawal reaction and dependence are significantly lower than those of antipsychotic drugs. Traditional Chinese medicine workers have been focusing on whether the combination of Chinese and Western medicines can reduce the incidence of side effects or not provided that the curative effect of the medicines are not reduced. This paper presents a preliminary discussion on this topic.Method:In this study, based on the patients’willingness, the patients are respectively classified into traditional Chinese medicine group, western medicine group, and Chinese and western medicine group, and controlled experiments are carried out to85patients with somatoform disorder with3intervention methods, i.e., intervention with traditional Chinese medicine, intervention with western medicine and intervention with Chinese and western medicine. Duloxetine’s clinical symptom improvement in somatoform disorders and the incidence of adverse reactions are observed, and statistical comparison and analysis are carried out. Indicators of curative effect are included in the Table of Symptoms Observed in Traditional Chinese Medicine Group, Scale of Somatoform Symptom Screening and Scale of Side Effect of Treatment.The results show that:1Comparison of Side Effects of Treatment in the Three GroupsThere are statistical differences among western medicine group, Chinese and western medicine group and traditional Chinese medicine group; the side effects of Chinese and western medicine group are roughly the same as those of western medicine group; the side effects of traditional Chinese medicine group are lower than those of western medicine group and Chinese and western medicine group, the remaining is without obvious side effects, and traditional Chinese medicine group is with the lowest side effects among the three groups. In the western medicine group, the treatment of3patients was stopped in first week due to adverse events. No patients in the traditional Chinese medicine group were subject treatment stoppage due to adverse events. The incidence of adverse events in Chinese and western medicine group is lower than that in western medicine group. Traditional Chinese medicine may be effective in reducing the incidence of adverse events.2Symptom Improvement2.1Scale of Somatoform Disorder2.1.1Total Positive ItemsThe drop of total positive items in the three groups after intervention is almost the same. Traditional Chinese medicine group, western medicine group and Chinese and western medicine group obtained nearly the same somatic symptoms improvement effect.2.1.2Comparison of Systemic Symptom IncidenceTraditional Chinese medicine led to more obvious improvement in digestive system symptoms than western medicine; what’s more, Chinese medicine group who participated in the intervention obtained a wider range of improved symptoms, which is consistent with the above-mentioned comparison results.2.2Table of Symptoms Observed in Traditional Chinese Medicine Group2.1.1Total Positive Items According to the data analysis, the drop of total positive items in the three groups after intervention is almost the same. The western medicine group achieved overall improvement in symptoms in the second week, while the traditional Chinese medicine group achieved earlier improvement in each symptom than western medicine group; the symptom improvement effect after the use of combined Chinese and western medicines was not that ideal, and the specific reasons are to be further explored.2.2.2Comparison of Various SymptomsMost symptoms in the Chinese medicine group can be improved, but there are some differences in the improvement effects for different symptoms. According to Chinese medicine theory, improved symptoms, such as choking sensation in chest, abdominal distension, dizziness, palpitation, depression and irritability, are closely related to factors causing stagnation of Liver-qi, which accords with the pesticide effect of basic prescription of Chinese traditional medicine group. On the contrary, western medicine group achieved great improvement in the incidence of some symptoms, but such improvement in all involved symptoms in western medicine group were not as widely as those in traditional Chinese medicine group. The Chinese and western medicine group achieved the least improvement in symptoms among the three groups.The above results show that the western medicine group treated with Duloxetine can achieve mood disorder improvement1week earlier than traditional Chinese medicine group. Although the Chinese medicine group achieved mood disorder improvement in the second week, the improvement degree was lower than that of western medicine group and Chinese and western medicine group.It is generally acknowledged that the combination of traditional Chinese medicine and western medicine can improve curative effect and reduce adverse reaction. However, in this study the incidence of adverse reactions caused by Duloxetine was reduced in the Chinese and western medicine group, and the overall curative effect was better than that of traditional Chinese medicine group, but was worse than that of Duloxetine group (i.e. the western medicine group). The combination of traditional Chinese medicine and western medicine was of low-toxicity but of no high efficiency, which was not consistent with the consumption that the combination of traditional Chinese medicine and western medicine can achieve "high efficiency and low toxicity". The effect of treatment through combination of traditional Chinese and Western medicine was not necessarily1+1>1. The reasons may be, in addition to the accuracy of differential treatment, closely related to the orientation of traditional Chinese medicine. In addition, the accuracy of differential treatment and the experience in prescription selection and drug usage are also important factors of curative effects.Limitations of this study include:as a preliminary clinical study, it failed to classify patients in a completely random manner, and the number of selected patients was small; therefore, the exact conclusion needs to be demonstrated by further studies strictly designed.At present, the main drugs used to treat somatoform disorders which have certain side effects. Whether Chinese traditional medicine can help to solve this problem, how to improve these side effects through correct differential treatment, and the specific treatment method and orientation of combination of traditional Chinese medicine and western medicine are to be further discussed. |
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