从抑郁症的主要证型探讨“见肝之病,知肝传脾”

Based on the main pattern of depression to explore the meaning of ‘When the liver is affected, a prescription is chosen to replenish the spleen’

目的:探讨抑郁症主要证型间的相关性;为未病先防、已病防传提供客观依据;同时为"异病同治"意义的延伸提供参考依据。方法:制定《抑郁症消化道症状的证候特点研究调查表》,收集完整病例115例,证型的确定采用无监督复杂系统熵聚类对数据进行分析,并结合中医辨证理论对各个证型所占比例进行计算,运用方差分析统计压力与病程对消化道症状分值和脾虚程度的影响。结果:肝郁脾虚证(62例)和肝气郁结证(33例)为抑郁症的主要证型;压力越大消化道症状积分越高;病程越长脾虚分值越高。结论:压力大小对消化道症状影响明显,具有肝郁的患者病程长短对其脾虚症状影响明显,故而调畅情志,舒畅气机,及时疏肝,注重健脾,应当贯穿抑郁症治疗的始终。

Objective： To explore the correlation among the major syndrome types of depression and to provide basis for prevention of depression before its onset and prevention of the complications after the onset and to enrich and expand connotation and denotation of‘same treatment for different diseases’.Methods： Formulate Depression Questionnaire-Investigation on TCM Syndrome Characteristic regarding Gastrointestinal Symptoms,Syndrome type was determined through unsupervised complex system entropy clustering in combination with TCM diagnosis.ANOVA was used to analyze correlation between stress/disease course and score of gastrointestinal symptoms/spleen deficiency.Results： With regard to syndrome distribution,liver depression（62 cases） and spleen deficiency was the syndrome,and the syndrome of liver-qi stagnation in scores increased with pressure.The scores were positively（33 cases） correlated to the course.Conclusion： First,stress may greatly aggravate gastrointestinal symptoms of depression patients.Second,the disease course may adversely affect spleen deficiency in patients with liver-qi stagnation.Thus we assume that soothing the liver and fortifying the spleen will be beneficial for prevention and intervention of depression.It’s advisable to adopt the treatment strategy during the whole treatment course.