冠心病患者A型性格与情绪障碍及中医辨证分型关系的探讨

The Relationship between A-type Character with Different Classification of TCM and Emotional Disturbance in Coronary Artery Disease Patients

目的探讨冠心病不同行为类型的患者与情绪障碍及不同中医分型之间的关系。方法采用A型行为问卷(TABPQ)、症状自评量表(Symptom Check-list 90,SCL-90)对242例冠心病患者进行调查并分组。分为A型行为组和B型行为组,同时对2组进行情绪障碍的对比研究及中医辨证分型关系的观察。结果在SCL-90中,冠心病患者与中国常模比较,其焦虑、抑郁等因子分明显高于中国常模。A型行为组的抑郁、焦虑、敌对、恐怖、偏执、精神病性明显高于B型行为组,差异有统计学意义(P<0.05)。A型行为组热痰血瘀型患者明显高于B型行为组,而B型行为组气阴两虚兼血瘀型明显高于A型行为组。结论冠心病患者中,抑郁、焦虑等负性情绪更多见,其中A型行为患者较B型行为更易产生情绪障碍。冠心病不同人格特点的患者中医辨证分型不同,提示在冠心病的预防与治疗中采用中西医结合、心身同治的方法会有更好效果。

Objective To investigate the relationship between different behavior types with classification of TCM and emotional disturbance in coronary artery disease （CAD） patients. Methods Two hundred and forty-two CAD patients were investigated and grouped to A or B type behavior with type A behavior pattem questionnaire （TABPQ） and symptom check-list 90 （SCL-90）. To analysis the emotional disturbance in two groups and investigate their relations with syndrome classification of TCM. Results SCL-90 factor score of anxiety and depression in CAD patients was obviously higher than Chinese norm. Factor score of depression, anxiety, hostility, phobia, paranoid and psychotic state in A-type behavior group was obviouslyhigher than that in B-type group, with statistical significance （P〈0.05）. Patients of heat-phlegm and blood stasis type in A-type group were obviously more than B-type group, while patients of deficiency of both vital energy and yin with blood stasis type in B-type group were more than A-type group. Conclusion The negative emotion e.g. athymia and anxiety is more common in CAD patients, and A-type behavior CAD patient is easier to get emotional disturbance than B-type patient. Different personality traits of CAD patients have different syndrome differentiation of TCM. Combination of TCM, western medicine and psychosomatic therapy should be applied in prevention and therapy of CAD.