不稳定型心绞痛患者中医证型与心理状态的关系

Relation between traditional Chinese medicine syndrome of unstable angina and mental state

目的探讨不稳定型心绞痛患者不同中医证型与心理状态的关系。方法纳入2015年1—12月于广州中医药大学第二附属医院冠状动脉粥样硬化性心脏病(冠心病)不稳定型心绞痛患者86例。由心内科中医专家对患者进行中医辨证评估,分为实证组(46例)和虚证组(40例)。通过调查问卷形式,采用症状自评量表(SCL-90)、焦虑自评量表(SAS)及抑郁自评量表(SDS)对患者进行心理状态调查,比较不同中医证型患者心理状态的差异及与国内常模的差异。结果不稳定型心绞痛患者SCL-90中躯体化、强迫症状、抑郁、焦虑、恐怖、偏执、精神病性7项因子评分明显高于国内常模(P<0.05)。实证组强迫症状、偏执2项因子评分明显高于虚证组,人际关系敏感、抑郁、焦虑、敌对、恐怖、精神病性6项因子评分低于虚证组(均P<0.05)。不稳定型心绞痛患者SAS和SDS评分明显高于国内常模[(56±11)分比(38±12)分、(50±12)分比(42±10)分](P<0.05)。实证组SAS和SDS评分明显低于对照组[(50±9)分比(60±10)分、(48±11)分比(52±12)分](P<0.05)。结论不稳定型心绞痛患者多存在明显的心理问题,且不同证型患者心理问题不一致,护理人员应进行辨证心理干预,提高患者的心理健康。

Objective To explore the relation between traditional Chinese medicine（TCM） syndrome and mental state in patients with unstable angina. Methods Eighty-six patients with unstable angina were enrolled from January to December 2015 in the Second Affiliated Hospital of Guangzhou University of Chinese Medicine. According to TCM syndrome of unstable angina, the patients were divided into sthenia syndrome group（46 cases） and asthenia syndrome group（40 cases）. Mental state of patients was assessed by the Symptom Checklist-90（SCL-90）, the Self-rating Anxiety Scale（SAS） and the Self-rating Depression Scale（SDS）. Relation between TCM syndrome and mental state was analyzed. Results Scores of somatization, obsessive-compulsive disorder, depression, anxiety, phobia anxiety, paranoid ideation and psychoticism in SCL-90 in unstable angina patients were significantly higher than those of the national norm（P 〈 0. 05）. Scores of obsessive-compulsive and paranoid ideation in sthenia syndrome group were significantly higher than those in asthenia syndrome group （P 〈 0. 05 ） ; scores of interpersonal sensitivity, depression, anxiety, hostility, phobia anxiety and psychoticism in sthenia syndrome group were signifi- cantly lower than those in asthenia syndrome group（ P 〈 0. 05 ）. Scores of SAS and SDS in unstable angina patients were significantly higher than those of the national norm[ （56 ± 11 ）points vs（ 38 ± 12）points, （50 ± 12 ）points vs （42 ±10） points] （ P 〈 0. 05 ）. Scores of SAS and sDs in sthenia syndrome group were significantly lower than those in asthenia syndrome group [ （50 ± 9 ）points vs （60 ± 10 ）points, （48 ± 11 ）points vs （52 ± 12 ）points ] （P 〈 0. 05）. Conclusion There are psychological problems in patients with unstable angina, which have a certain relation with the TCM syndrome of unstable angina.