产后抑郁症的中医证候分布规律及相关因素分析

Analysis of Distributions of TCM Syndromes and Related Factors of Postpartum Depression

目的:探讨产后抑郁症的中医证候分布规律及其发病相关因素。方法:选择200例产后抑郁症患者,通过调查问卷对其一般资料及中医证候症状进行分析,统计患者产后抑郁症的中医证候分布情况,同时对其发病相关因素进行单因素及多因素分析。结果:200例产妇产后抑郁症中医证候主要分为6种类型:心脾两虚证占13.0%、气虚血瘀证占21.0%、血瘀血虚证占19.0%、肝气郁结证占11.5%、痰热瘀结证占14.5%、脾肾两虚证占21.0%。患者年龄、婚姻状况及文化程度对产妇产后抑郁症的发病无显著影响(P>0.05);孕检次数、分娩方式、母婴同室、母乳喂养及新生儿先天畸形是造成产妇产后抑郁症发病的危险因素(P<0.05)。将经单因素分析具有统计学意义的5项因素进行多因素分析发现,孕检次数、分娩方式、母婴同室、母乳喂养及新生儿先天畸形是造成产妇产后抑郁症的独立相关因素。结论:产后抑郁症与生物、心理社会及产科因素等诸多因素相关,不同患者发病病机不同,中医证候病症亦不同;应严格做好产前检查,提高对抑郁症高危人群的早期筛选,降低产后抑郁症的发生。

Objective： To study the distributions of TCM syndromes and related etiologic factors of postpartum depression. Methods： Two-hundred patients with postpartum depression were selected.The general information and TCM symptoms of the 200 patients were analyzed through questionnaire. Statistics on the distributions of TCM syndromes of postpartum depression were performed, and the univariate and multivariate analysis were carried out on the related etiologic factors. Results： There were six types TCM syndromes among the 200 cases of postpartum depression： dual deficiency of the heart and spleen syndrome（13.0%）, Qi deficiency and blood stasis syndrome（21.0%）, dual blood deficiency and stasis syndrome（19.0%）, liver-qi stagnation syndrome（11.5%）, phlegm heat and blood stasis syndrome（14.5%） and dual deficiency of spleen and kidney syndrome（21.0%）. The age, marital status and educational level of the patients had no significant effect on the incidence of postpartum depression（P〈0.05）;risk factors for postpartum depression of postpartum women were pregnancy examination, delivery mode, rooming-in periods, breast feeding and neonatal congenital malformation（P〈0.05）. Multivariate analysis were carried out on these five factors and statistics showed that pregnancy examination, delivery mode, rooming-in periods, breast feeding and neonatal congenital malformation were the independent related factors caused postpartum depression.Conclusion： Postpartum depression is related to many factors such as biological, psychological and social factors which lead to different patients with different pathogenesis and different TCM syndromes. Prenatal examination should be strictly done to improve the early screening of high-risk groups of depression, and to reduce the incidence of postpartum depression.