慢性阻塞性肺疾病合并抑郁症患者中医体质特点分析

Analysis on characteristics of Chinese medicine constitution in COPD patients with depression

目的对慢性阻塞性肺疾病(COPD)合并抑郁症患者中医体质类型开展研究,探讨体质因素和发病的关系,为中医治未病提供相应的依据。方法收集2014年6月—2016年9月到浙江中医药大学附属第三医院门诊和住院、杭州市周浦社区卫生服务中心门诊就诊诊治为COPD合并抑郁症患者500例,男性260例,女性240例,年龄40~85岁。运用中医体质理论和问卷调查的方法,对500例COPD合并抑郁症患者进行体质调查,进而探讨体质因素和COPD发病的关系。结果在全部500例患者中,中平和质者20例(4.0%);偏颇体质者480例(96.0%),其中气虚质112例(22.4%)、痰湿质97例(19.4%)、阳虚质88例(17.6%)、湿热质73例(14.6%),阴虚质42例(8.4%)、血瘀质33例(6.6%)、气郁质24例(4.8%)和特禀质11例(2.2%)。COPD合并抑郁症患者的9种中医体质类型得分中,相关性最好的体质类型依次是气虚质、痰湿质、阳虚质及湿热质。结论慢性阻塞性肺疾病合并抑郁症患者体质以气虚质、痰湿质、阳虚质及湿热质为主,符合慢性阻塞性肺疾病合并抑郁症本虚标实的病理特征,实践中医"治未病"提供临床依据。

Objective To investigate the distribution of the TCM constitution types in COPD patients with depression and its relationship with COPD exacerbation, providing evidence for the prevention and treatment of COPD and COPD exacer- bation. Methods Five hundred cases COPD with depression patients in outpatient and hospitalization of the Third Affili- ated Hospital of Zhejiang University of Traditional Chinese Medicine and Hangzhou Zhoupu community health service cen- ter from June,2014 to December,2016 were selected. Patients were composed by 260 cases male and 240 cases female with age range from 40 to 85. Based on TCM constitution theory, questionnaire was designed and data were collected from 500 patients of COPD with depression to investigate the relationship with COPD exacerbation. Results In all 500 pa- tients, gentleness type patients were 20 cases（4.0% ） and biased constitution were 480 cases（96.0% ） including 112 ca- ses of Qi asthenia（22.4% ） ,97 cases of phlegm-dampness （ 19.4% ）, 88 cases of Yang asthenia（ 17.6% ）, 73 cases of damp-heat（ 14.6% ） ,42 cases of Yin asthenia,33 cases of blood stasis ,24 cases of Qi Stagnation, and 11 cases of special inherited type. Among the nine types of TCM Constitution in COPD patients with depression, Qi asthenia, phlegm-damp- ness,Yang asthenia and damp-heat were significantly correlated. Conclusion Qi asthenia, phlegm-dampness, Yang as- thenia and damp-heat were the predominant constitution types in COPD patients with depression. It conformed to the path- ological characteristics of deficiency essence with virtual reality and to provide clinical basis for the practice of ＂treating disease＂ in TCM.