抑郁症中医证候要素相关分析

Analysis on the Relevance of Elements of TCM Syndromes in Depression Patients

目的探讨抑郁症患者中医证候要素的分布、组合等情况。方法由两名具有副主任医师以上职称的医生进行中医证候要素的判断,用汉密尔顿焦虑量表(HAMA)与汉密尔顿抑郁量表(HAMD)对患者的焦虑抑郁情绪进行评定。结果气虚、血虚是抑郁症的基本证候,占100%,气滞占98%,火热占89%,瘀血占43%,痰浊占36%,阴虚占22%;抑郁症证候要素组合以4个、5个、6个证候要素组合最常见;聚类分析显示,气滞、火热与阴虚聚为一类,痰浊与瘀血常聚为一类;Logistic回归分析显示伴有焦虑的抑郁症与瘀血关系密切。结论抑郁症属本虚标实之证,本虚以气血亏虚多见,可涉及阴虚,标实以气滞、火热、痰浊、瘀血常见,其中瘀血的有无在一定程度上可以反映抑郁症病情轻重。

Objective To study the distributions and combinations of elements of TCM syndromes in depression patients. Methods Two consultant doctors were engaged to determine the elements ofTCM syndromes and the Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale （HAMD） were adopted to evaluate the severity of anxiety and depression of the patients in the observation. Results The qi and blood deficiency were the basic syndromes, occupying 100%, qi stagnation syndrome occupied 98%. fire heat 89%, blood stasis syndrome 43%, phlegm retention syndrome 36%. and yin deficiency syndrome 22 %. The TCM syndrome of depression took usually 4, 5, 6 elements in combination. The cluster analysis showed that the qi sragnauon, fire heat, and yin deficiency were commonly clustered with each other, while the phlegm retention and blood stasis were often in combination. The Logisnc regression analysis showed that those patients accompanied with anxiety usually had blood stasis. Conclusion Depression is of deficiency in root and excess in symptom. Root-deficiency takes qi and blood deficiency, and with yin involved in deficiency, as common syndromes. Symptom-excess takes qi stagnation, fire heat, phlegm retention, and blood stasis as common elements of syndromes. Of the pathological conditions, the severity of depression can be expressed by whether there is blood stasis or not,