慢性乙型肝炎患者中医证型与生存质量及心理障碍相关性分析

Evaluation on Quality of Life and Psychological Obstacle and Analysis on lts Correlation with TCM Syndromes in Patients of Chronic Hepatitis B

目的:探讨慢性乙肝中医证型与患者生存质量及心理障碍的相关性,为慢性乙肝的中医辨证施治和心理干预工作的开展提供科学依据。方法:随机抽取168例诊断为慢性乙肝患者作为研究对象进行中医辨证分型,并采用慢性肝病问卷(CLDQ)进行生存质量测评,研究各证型分布特点,以及与抑郁自评量表(SDS)、焦虑自评量表(SAS)评分差异。结果:(1)中医证型分布以肝郁脾虚证和肝胆湿热证比例最高分别为36.9%和28.6%。(2)CLDQ问卷以肝郁脾虚、肝胆湿热两型评分最低(P<0.05)。(3)中医各证型神经症评分比较,肝胆湿热证总积分最高、肝郁脾虚证次之(P<0.05);且不同证型在症状积分分布上具有明显的差异性(P<0.01或P<0.05)。(4)SDS、SAS量表评分比较:SDS评分以肝郁脾虚最高(P<0.01),SAS评分以肝胆湿热证最高(P<0.01)。结论:慢性乙肝中医证型分布与患者生存质量、心理障碍有一定的相关性,以肝胆湿热和肝郁脾虚型心理障碍最为突出。

Objective：To explore the quality of life（QOL）and psychological obstacle in patients with chronic hepatitis B（CHB）and analyze its correlation with traditional Chinese medicine syndrome type.Methods：168 CHB patients randomly selected were investigated by the chronic liver disease questionnaire（CLDQ）,and their Chinese medicine syndrome type was differentiated.The distribution of Chinese medicine syndrome type in CHB patients was studied and the differences among various types were analyzed using self-rating depression scale（SDS）and self-rating anxiety scale（SAS）.Results：（1）Patients of types of liver depression and spleen deficiency（LDSD）and Liver-Gallbladder Dampness-Heat Syndrome（LGDH）held the dominant shares were 36.9% and 28.6% respectively.（2）The lowest score of CLDQ were the types of LDSD and LGDH（P〈0.05）.（3）The highest integrals of psychoneurosis was the type of LGDH（P〈0.05）,and the second was LDSD（P〈0.05）,also it was different in patients of different TCM syndrome types（P0.01 or P〈0.05）.（4）Comparisons of SDS and SAS scores in patients with different syndrome types showed that the highest SDS score presented in LDSD（P〈0.01）highest SAS score presented in LGDH（P〈0.01）.Conclusions：There is some relationship between the TCM syndrome types of CHB with QOL and psychological obstacle,and among syndromes types LDSD and LDSD were most outstanding in psychological obstacle.