变应性鼻炎患者的心理学特点及影响因素分析

Psychological characteristics in patients with allergic rhinitis and its associated factors analysis

目的观察变应性鼻炎（allergicrhinitis，AR）患者的心理学特点，分析其相关影响因素。方法采用心理症状自评量表（SymptomChecklist90，SCL-90）对377例AR患者进行评估，与我国标准常模进行对比，并分析相关影响因素。结果AR患者中10％心理健康状态不佳，13％处于心理亚健康状态，77％心理状况良好。AR患者在躯体化、强迫症状、焦虑、敌对以及精神病性上的表现与常模的差异具有统计学意义（t值分别为7．128、3．943、2．777、6．423和7．507，P值均〈0．01）。男性AR患者在强迫、抑郁、焦虑、偏执和精神病性方面得分高于女性AR患者，差异具有统计学意义（t值分别为2．680、1．977、2．539、2．107和2．844，P值均〈0．05）。不同病程分组的强迫症状、恐怖症状得分差异有统计学意义（F值分别为2．379、2．255，P值均〈0．05）。是否合并哮喘和（或）湿疹对强迫症状、人际关系敏感、抑郁、偏执以及精神病性方面得分有影响，两组差异有统计学意义（t值分别为6．835、8．914、7．254、13．358、6．030，P值均〈0．01）。年龄、AR分型、患者受教育程度、变应原种类以及鼻塞、喷嚏、流涕对SCL-90各因子得分没有影响（P值均〉0．05）。鼻痒对抑郁的影响显著（标准化回归系数为0．126，t=2．076，P〈0．05）。结论AR患者的心理健康程度差于常模，掌握AR患者的心理学特点，对提高AR综合治疗效果可能具有意义。

Objective To investigate the psychological characteristics of patients with allergic rhinitis （AR） and its associated factors. Methods Three hundred and seventy-seven patients with AR were evaluated by the Symptom Checklist-90 （SCL-90）. The results were compared with a standard, obtained from healthy Chinese population, including factors of gender, age, educational level, medical history of AR, presence of complications, type of allergenic sensitizations and nasal symptoms （using logistic regression analysis）. Results An abnormal psychological state was found in 10% of AR patients, 13% with deutohealthy, and remaining 77% of AR patients were completely healthy. The SCL-90 scores of the 377 patients were significantly higher than those of the normal standard population, including symptoms of somatization, compulsion, anxiety, rivalry and psychosis （t equals 7. 128, 3. 943, 2. 777, 6.423, 7. 507, respectively, all P 〈 0. 01 ）. Male patients had worse psychological state than femals, especially in the aspects of eompulgion, depression, anxiety, erankiness and psychosis （t equals respectively 2. 680, 1. 977, 2. 539, 2. 107,2.844, all P 〈 0.05 ）. The SCL-90 scores of compulsion and horror were respectively different in different AR case history （ F equals respectively 2.379, 2.255, all P 〈 0. 05 ）. AR complicated with asthma and eczema was the important factors that influenced patient＇s psychological status including compulsion, interpersonal sensitivity, depression, crankiness and psychosis （t equals respectively 6. 835, 8. 914, 7. 254, 13. 358, 6. 030, all P 〈 0.01 ）. There were no statistical differences in different ages, AR types,educational level, allergen types （all P 〉 0.05 ）. Snuffle, sneeze and snivel had no influence on patient＇s SCL-90 scores （all P 〉 0.05 ）. Itchy nose was a major symptom that affect on AR patients＇ SCL-90 scores of depression （ standard regression b = 0. 126,t = 2.076,P 〈 0.05 ）. Conclusions AR patients＇ psychological status was worse than that of the healthy adults.