口腔扁平苔藓患者C型行为特征分析

Analysis of type C behavior in patients with oral lichen planus

目的:探讨口腔扁平苔藓(oral lichen planus,OLP)与C型行为特征的关系,以期为临床预防、治疗和心理干预提供依据。方法:采用C型行为量表对北京大学口腔医院黏膜科已确诊的符合纳入标准的OLP患者(85例)及非OLP(85例)进行调查,量表包含焦虑(anxiety)、抑郁(depression)、愤怒(anger)、愤怒内向(anger toward inside,anger-in)、愤怒外向(anger toward outside,anger-out)、理智(reasoning)、控制(domination)、乐观(optimism)、社会支持(social support)9个分项,将OLP组与对照组之间的各项得分进行计算并进行统计学分析,并将患者的各项C型行为特征得分按照性别、病损网纹-糜烂-溃疡分型、病程长短等分组,分别进行统计、对比。结果:85例OLP患者中,女性多于男性,OLP最常好发的部位为颊部,非糜烂型患者多于糜烂型患者。C型行为量表中,OLP组与对照组的焦虑、抑郁、愤怒、乐观得分分别为(43.01±7.47)与(37.94±8.70)、(44.02±7.61)与(39.58±7.35)、(21.56±5.26)与(18.12±5.39)、(22.15±4.00)与(24.05±3.23),差异有统计学意义(P<0.05);其中女性患者与对照组女性在焦虑、抑郁、愤怒、理智、控制、乐观得分分别为(43.21±6.97)与(37.20±8.68)、(44.29±7.54)与(39.33±7.33)、(21.64±5.09)与(17.64±5.28)、(39.12±5.66)与(41.23±4.71)、(16.29±3.95)与(17.85±3.69)、(22.05±4.12)与(24.20±3.12),差异有统计学意义(P<0.05);男性患者各项得分与对照组男性差异无统计学意义。糜烂型OLP患者愤怒得分(22.94±5.26)高于非糜烂型OLP患者(20.60±5.03),差异有统计学意义(P<0.05)。病程越长,OLP患者抑郁和愤怒的倾向越明显,乐观得分越低。患病时间3年以上患者的外向愤怒得分(17.36±3.35)高于患病3年以内(包含3年)的患者(15.19±3.99),差异具有统计学意义(P<0.05)。结论:OLP患者的焦虑、抑郁、愤怒、低乐观等C行行为特征明显,在OLP的诊治过程中应关注患者的心理变化,可以此为依据进一步制定相应的干预措施。

Objective： To assess type C behavior in patients with oral lichen planus（ OLP） in order to provide basis for clinical prevention,treatment and psychological intervention of OLP. Methods： Type C behavior scale was used on 85 OLP patients and 85 control patients,who were in accordance with the inclusion criteria,in order to investigate their type C behavior. The scale included 9 items： anxiety,depression,anger,anger toward inside（ anger-in）,anger toward outside（ anger-out）,reasoning,domination,optimism,and social support. Scores of the 9 items between OLP patients and control group were calculated under the instruction of the scale and were statistically analyzed,and OLP group was further stratified statistically by sex,reticulate-erosive-ulcerative（ REU） pathological type and course of diseases,and the scores of each group were analyzed and compared. Results： Among the 85 OLP patients,there were more females,more non-erosive lesion type,and the most common site for OLP was the buccal mucosa. The scores of the type-C behavior questionnaire for anxiety,depression,anger and optimism were respectively 43. 01 ± 7. 47,44. 02 ± 7. 61,21. 56 ± 5. 26,22. 15 ± 4. 00 among the OLP patients and were 37. 94 ± 8. 70,39. 58 ± 7. 35,18. 12 ± 5. 39,24. 05 ± 3. 23 among control group,with significant differences（ P 〈0. 05 for all） between the two groups. The female OLP patients had higher anxiety,depression,anger scores（ 43. 21 ± 6. 97,44. 29 ± 7. 54,21. 64 ± 5. 09） and lower reasoning,domination,optimism scores（ 39. 12 ± 5. 66,16. 29 ± 3. 95,22. 05 ± 4. 12） with significant differences（ P 〈0. 05 for all） compared with those of the female controls. The scores between male patients and male controls showed no significant difference. The patients with erosive lesions had higher anger score（ 22. 94 ±5. 26） than that of the patients without erosive lesions（ 20. 60 ± 5. 03）,with a significant difference（ P 〈0. 05）. With the development of the disease,the tendency of anxiety and depression of the patients were more obvious,while optimism scores remained declining. The patients suffering more than 3 years of OLP had higher anger-toward-outside scores（ 17. 36 ± 3. 35） than the patients suffering less than 3 years of OLP（ 15. 19 ± 3. 99）,with a significant difference（ P 〈0. 05）. Conclusion： OLP patients showed an obvious type C behavior characteristic,especially in anxiety,depression,anger and low optimism. This research provides the C behavior characteristic of OLP for further psychological consultation or intervention during OLP treatment.