不同中医证型原发性高血压患者心理情绪表现特征

Characteristics of the psychological emotion in patients with essential hypert ension of different traditional Chinese medicine syndromes

目的:观察不同中医证型原发性高血压患者心理状况。方法:选择2003-05/2005-01营口市中心医院心内科门诊就诊或住院治疗的原发性高血压患者251,男148例,女103例;年龄36～77岁,病程1个月～17年。全部患者为首次发病,均自愿接受各种量表和问卷调查且无精神性疾病。原发性高血压患者按中医证型分为4组,肝火亢盛证71例,阴虚阳亢证62例,阴阳两虚证58例,痰湿壅盛证60例。在治疗前1周内接受了症状自评量表评估,以评估患者精神状况。结果:按意向处理分析,251例均进入结果分析。高血压患者的不同中医证型患者的症状自评量表总分、总均分、阳性项目数和阳性症状均分均明显高于正常人常模(t=1.92～2.56,P<0.05～0.01);阴虚阳亢证患者和痰湿壅盛证患者症状自评量表总分(156.32±29.25,149.32±32.60)、阳性项目数(37.50±16.27,34.32±10.24)、阳性症状均分(2.98±0.44,2.87±0.43)明显低于肝火亢盛证患者(172.28±31.13,41.90±12.38,3.06±0.35)(t=1.92～2.45,P<0.05);痰湿壅盛证患者症状自评量表、阳性项目数、阳性症状均分明显低于阴阳两虚证患者(149.32±32.60,34.32±10.24,2.87±0.43;178.18±40.37,45.42±1316,3.13±0.37,t=1.89～2.23,P<0.05);阴虚阳亢证患者症状自评量表总分明显低于阴阳两虚证患者(156.

AIM:To observe the psychological status of patients with essential hypertensio n(EH) of different traditional Chinese medicine(TCM) syndromes. METHODS:Totally 251 EH patients(148 males and 103 females) at 36 to 77 years o f age with disease course of 1 month to 17 years,who were treated or hospitalize d in the Department of Cardiology,Yingkou Central Hospital from May 2003 to Janu ary 2005,were involved in this study.All the patients were at the first episode without any mental disease,and voluntarily took part in various investigations o f scale and questionnaires.The EH patients were divided into 4 groups according to their TCM syndromes:liver fire hyperactivity group(group A,n=71), hyperactiv ity of yang due to yin deficiency group(group B,n=62),deficiency of both yin and yang group(group C,n=58) and hypertension due to excessive accumulation of phle gm dampness group(group D,n=60).The mental status of the patients was evaluated with symptom checklist 90(SCL 90) during the last week before treatment. RESULTS:According to intention to treat analysis,all the 251 cases were invo lved in the analysis of results.The SCL 90 total score, mean total score,number of positive items and mean score of positive symptoms were all obviously higher in the EH patients of different TCM syndromes than in norms(t=1.92 to 2.56,P< 0 .05 to 0.01).The SCL 90 total score,number of positive items and mean score of positive symptoms in group B(156.32±29.25,37.50±16.27,2.98±0.44) and group D( 149.32±32.60,34.32±10.24,2.87±0.43) were obviously those in group A(172.28±3 1.13,41.90±12.38,3.06±0.35)(t=1.92 to 2.45,P< 0.05);Those were markedly lower in group D(149.32±32.60,34.32±10.24,2.87±0.43) than in group C(178.18±40.37, 45.42 ±1316,3.13±0.37)(t=1.89 to 2.23,P< 0.05).The total score of SCL 90 in g roup B(156.32±29.25) was remarkably lower than that in group C(178.18±40.37)(t =1.89,P< 0.05). CONCLUSION:Hypertensive patients of different TCM syndromes have different man ifestations of negative emotion,which are more significant in patients of liver fire hyperactivity and deficiency of both yin and yang syndromes than those wi th the syndromes of hyperactivity of yang due to yin deficiency and hypertension due to excessive accumulation of phlegm dampness.