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Neurosis generalized anxiety disorder is more common in the disease, more common in neurotic patient. The in neurosis, psychosomatic outpatient period, the application Chaihujialonggumuli decoction for treatment of 72 patients with generalized anxiety disorder, to achieve better efficacy, are summarized below.
1 Clinical data
The 72 patients were in January 1997 to 12 months specialist out-patient neurological disorders. 29 males, 43 females; male to female ratio 1:1.48; aged 16 to 20 years in 2 cases, 21 to 40 years old in 38 cases, 41 to 60 years in 24 cases,> 61 years and 8 cases, mostly from 21 to 40 years old. Course of a minimum of 3 months and a maximum of 5 years. Of which 43 cases have been in General Hospital, 56 patients in treatment services than before, the West, drug treatment, efficacy was not obvious from our hospital specialist outpatient neurosis.
Generalized anxiety disorder in this group the major clinical manifestations: (1) anxiety and worry: the performance of the corresponding object for the lack of fear, anxious, upset all day long, restless, quiet as a mouse flu. A total of 72 patients (100%). (2) Sports disturbing: the performance of hand-wringing stamp their feet, nervous, unable to sit still, fingers, muscles tense, shaking, or pain. 43 cases (59.7%). (3) autonomic symptoms of hyperthyroidism: common are heart palpitations, shortness of breath, throat clogging or choking sensations, dizziness, headache, sweating, facial redness or pal


eness, dry mouth, stomach upset, nausea, abdominal pain, diarrhea, frequent urination , irregular menstruation, and impotence, premature ejaculation and other sexual dysfunction symptoms. A total of 67 cases (93%). (4) over-vigilance: the performance of the panic, easily startled, difficulty sleeping and irritability and easy to wake up and so on. A total of 51 patients (70.8%).
Diagnostic criteria CCMD2R (mental illness in China Classification and diagnostic criteria) in generalized anxiety neurosis (300.0; F41.1) diagnostic criteria [1]. (1) meet the diagnostic criteria of neurosis; (2) persistent symptoms of anxiety and major clinical primary phase. Performance anxiety symptoms consistent with the following two: a recurrent or persistent non-specific and fixed content object of fear or fear; b with autonomic symptoms or exercise-induced anxiety. (3) excluding obsessive-compulsive disorder, phobias, hypochondria and so on. HAMA (Hamilton Anxiety Scale) [2] evaluation. Into the group before the group of patients herein are HAMA scale assessment, 7 points or less free of anxiety. Mild anxiety in this group were 7 to 13 points in 8 cases (11.1%); moderate anxiety, 14 to 20 minutes, a total of 48 patients (66.7%); moderate to severe anxiety, 21 to 27 minutes, a total of 16 patients (22.2%) .
2 treatment
By Chaihujialonggumuli Decoction. Basic side: Bupleurum 10g, Scutellaria 10g, ginger Pinellia 10g, Gui 10g, made rhubarb 10g, Health keel, raw oysters 30g (Xian Jian), mother of pearl 30g (Xian Jian), wheat 30g, jujube 5, Licorice 10g, cooked Suanzaoren 10g. Modified: folder phlegm were added bile Southern Star, Zhuru or Tianzhu Huang; anger flaming plus gentian, gardenia; Yin Huo-wang, who go to Twig Anemarrhena, Cork; liver and stomach yin to Twig littoralis, Ophiopogon japonicus; chronic illness who added Codonopsis Qi 10g. 30 is a course of treatment, the total course of treatment for 3 months. This group served three courses of a total of 63 patients, 2 courses of a total of 9 cases. Served in 8 cases due to instability of 3 courses of the disease are still serving with the side plus or minus one every other day, a total of 15. Stable basic control symptoms, are spearheading change clothes (Pill, 8 pills each time, 3 times / day) for 3 months, 8 patients served 6 months to bring about consolidation. Reliance on antipsychotic and patients with more severe insomnia, the treatment is still given to half the original dose.
3 Clinical Analysis
Clinical criteria: After treatment of anxiety symptoms disappeared completely, HAMA <7 into recovery; anxiety symptoms significantly reduced, HAMA <13 into significant progress; anxiety symptoms reduced, down 2 points than the original points (light heavy differential in average 1 / 3) are valid; symptoms did not improve, HAMA did not decrease as invalid.
After treatment, patients in this group were given HAMA scale re. Including 8 cases of mild anxiety 2 in 3 cases (18.75%), 1 (6.25%) did not decrease. Results 49 patients were cured (68.06%), significant progress in 13 cases (18.05%), effective in 7 cases (9.72%) and 3 cases (4.17%), total effective rate was 95.83%. 3 were invalid because of the symptoms the patient can not control, less than 2 courses that use other treatments. Follow-up: The total group of patients observed for 1 year, were made after six months follow-up in withdrawal. Recovered in 5 patients who recurred significant progress in 3 patients the recurrence rate was 11.59%.
4 Discussion
Generalized anxiety disorder is a group of non-recurrent or persistent and fixed content targeted fear or fear as the main feature of neurological disorders, premorbid more certain basis for the quality and personality, onset often associated with psychosocial factors, outpatient neurosis about 1 / 3, psychotherapy and combined therapy of neurosis is the normal treatment. High recurrence rate, most patients require intermittent or long-term medication.
72 patients in this group of patients with generalized anxiety disorder diagnostic criteria in accordance with CCMD2R. TCM is depressed by the Shaoyang hot type, the pathogenesis of multiple violations of Shaoyang caused by the evil heat, so to Chaihujialonggumuli Decoction, Chaihujialonggumuli soup originates from "Treatise on", for the treatment of Shao Yang Yu heat and disrupt the mind. Xiao Chai Hu Tang reconciliation Shaoyang, Shaoyang specifically for the prescription drug Bupleurum, light rose clear scattered sparse evil through the table, and the stagnation of Qi Shu-based medicine, the bitter cold of Scutellaria good Qingxie secondary biliary organs of the evil heat drugs, with a casual Chai Hu Yiqing, a total solution Shaoyang evil heat, Pinellia and Heweijiangni, Sanjie Xiaopi, keel, oyster, mother of pearl Anticonvulsant nerves, Poria infiltration Lee urine, and total in order to keep the heart Semen nerves, rhubarb Tongfu Xiere Xiezhuo air-profit, Gui yang passage, Chaihu to scatter, Ganmai Dazao Yang Xin Gan slow. Compatibility of the drug played a total of reconciliation Shaoyang, heat Anticonvulsant. And some patients depending on the disease, were given heat phlegm, Liver Xiere, Yin Jiang Huo and other treatment. Some patients who have taken the Chinese herb before benzodiazepines and tricyclic class of antidepressants, antianxiety, for fear of addiction or can not be tolerated in the stability of anticholinergic side effects, and to the side treatment. Throughout the course of treatment found no significant side effects, a small number of patients might have mild abdominal pain, diarrhea, stomach discomfort, such as severe diarrhea may be reduced by rhubarb.
Anxiety as emotional disorder, especially with liver and gallbladder are closely related to the physiological dysfunction, its etiology and pathogenesis of many because of evil into the Shaoyang, liver failure Shuxie, the decision functional biliary disorders, loss of qi, Yu and hot, disturbing mind the emergence of anxiety, Zhu Zheng. Chaihujialonggumuli soup with reconciliation Shaoyang, heat Anticonvulsant effect, have always been caused by heat treatment of anxiety disorders Shaoyang Yu recipe.
The stable group of patients treated after the switch to spearheading the maintenance treatment, and follow-up in the withdrawal made after six months, the recurrence rate was 12% and the recurrence of patients and caused by life events. That the quality of patients with neurosis and personality-based defect and has a close relationship between life events, self-psychological adjustment, to develop good mental state is important to prevent recurrence. The situation is still a good short-term efficacy, long-term effect needs further observation.


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