慢性乙型肝炎患者情绪改变与中医证型相关性初探

Analysis of emotion abnormalcy of hepatitis B virus patients

目的:分析慢性乙型肝炎(CHB)患者的情绪改变,探讨中医肝郁脾虚证、湿热中阻证与情绪变化的相关性。方法:采用Zung焦虑自评表(SAS)和抑郁自评表(SDS)调查133例CHB(肝郁脾虚证或湿热中阻证)患者的焦虑/抑郁状况,并与对照组进行比较。结果:40.60%的CHB患者存在焦虑,49.62%的患者存在抑郁,以轻度和中度居多。两证型比较:轻度焦虑/抑郁以湿热中阻证居多,分别为:39.08%(P<0.05)、44.83%(P<0.01),重度焦虑/抑郁则以肝郁脾虚证为主,分别为:13.04%(P<0.05)、17.39%(P<0.01),均有统计学意义。Logistic回归分析显示SAS/SDS总分与病程、年龄呈正相关(P<0.05),与ALT、AST、HBV DNA载量成负相关(P<0.01)。结论:CHB患者存在明显情绪改变,并与中医证型具有一定的相关性。

Objective： To analyse the emotion abnormalcy of hepatitis B virus patients and to investigate the relationship between two syndrome types of traditional Chinese medicine （TCM） and emotion abnormalcy. Methods： One hundred and thirty three patients with chronic hepatitis B （ DHBS ＆ GSPD） were tested by SAS ＆ SDS, meanwhile it was compared with 30 health adults. Results ： In the group of patients with CHB, the incidence rate of anxiousness was 40. 60% , while the incidence rate of depression was 49.62%, majority of them were longitudinal and midrange. Statistical significance exists among two types of syndrome in TCM. The results indicate that majority of light anxious and depressed patients are composed of type spleen and retention of damp-heat evil patients, rates respectively were 39.08% （P 〈 0. 05）, 44. 83% （P 〈 0. 01 ）, most of serious are type liver- Qi stagnation and type spleen patients, rates respectively were 13.04% （ P 〈 0.05 ）, 17.39% （P 〈 0. 01 ） . Logistic regression showed that SAS ＆ SDS had positive correlation with age and course of disease （ P 〈 0. 05 ） , while negative correlation with ALT/AST, HBV DNA （P 〈0. 01） . Conclusion： Many patients with HBV tend.to have significant emotion abnormalcy, and correlated closely with the types of syndrome in traditional Chinese medicine.