功能性消化不良中医证型与心理因素的相关性研究

Correlation between TCM Pattern of Functional Dyspepsia and Psychological Factors

目的:探讨功能性消化不良中医证型与心理因素的相关性。方法:按照流行病学调查方法,随机抽取297例诊断为功能性消化不良(FD)的患者作为研究对象进行心理测评,并进行中医证型调查,研究各证型分布特点,以及抑郁自评量表(SDS)、焦虑自评量表(SAS)评分差异。结果:1)中医证型分布以脾虚气滞证比例最高(32.3%);2)中医各证型心理异常比例:合并抑郁状态以肝气郁结证比例最高(62.5%),合并焦虑状态以肝气犯胃证比例最高(35.8%),而湿热滞胃证合并抑郁状态及焦虑状态比例均最低,各证型合并抑郁、焦虑状态均占相当比例;3)中医各证型与功能性消化不良症状谱比较:餐后饱胀感以脾胃气虚证及脾虚气滞证多见,早饱在脾胃气虚证最为显著,上腹痛以肝气郁结证、脾胃气虚证多见,上腹烧灼感在湿热滞胃证中最为显著;4)中医各证型SDS、SAS量表评分比较:SDS评分以肝气郁结证最高,SAS评分以肝气犯胃证最高,而湿热滞胃证在两个自评量表中评分均最低。结论:功能性消化不良各中医证型分布及心理测评结果差异明显,病机虚实夹杂,病情与肝、脾两脏关系密切。

Objective：To investigate the correlation between TCM Pattern of functional dyspepsia and psychological factors.Methods：According to epidemiologic investigation method,297 patients were selected randomly,subject to psychological evaluation,TCM pattern identification,scoring using SDS and SAS.Results：1）Pattern of spleen deficiency and qi stagnation was most common（32.3%）;2）depression was often seen with liver qi depression（62.5%）,while anxiety with liver-qi-invading-stomach（35.8%）.Depression and anxiety were comparatively less seen in dampness-heat stagnating-stomach;3）Post-prandial fullness was common with spleen-stomach qi deficiency and spleen-deficiency qi-stagnation,early satiation with spleen-stomach qi deficiency,upper abdominal pain in liver qi depression and spleen-stomach qi deficiency,upper abdominal burning sensation in dampness-heat stagnating-stomach group;4）SDS score was highest with liver qi depression group,while SAS score was highest in liver-qi-invading-stomach group.Lowest scores appeared with dampness-heat-stagnating-stomach group.Conclusion：Patients of functional dyspepsia have varied and significant differences in TCM pattern and psychological status,mechanisms of which are deficiency-excess complicated and closely related to liver and spleen.