晚期乳腺癌患者心理状态与中医证型的相关性及中药的干预研究

Association of Psychological State of Advanced Breast Cancer Patients with TCM Syndromes and the Effects of TCM on Patients

目的了解晚期乳腺癌(ABC)患者的焦虑和抑郁情况及其和中医证型的相关性,探讨宽郁舒气方对ABC患者心理状态的干预作用。方法采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对138例ABC患者和60例健康对照组进行评价,比较不同证型与SAS和SDS的相关性。采用宽郁舒气方治疗后比较ABC患者用药前后SAS和SDS的评分变化。结果与对照组相比,ABC患者具有明显的焦虑和抑郁症状,SAS和SDS评分均显著高于对照组(P<0.01);气阴两虚型SAS与SDS评分与对照组相比,差异无统计学意义(P>0.05),而肝郁气滞型与冲任失调型SAS及SDS评分均显著高于对照组(P<0.05),肝郁气滞型SAS及SDS评分均明显高于其余两种证型(P<0.05)。ABC患者服用宽郁舒气方2个月后,SAS与SDS评分均比治疗前明显下降(P<0.01);三组证型治疗前后评分分别比较,气阴两虚型SAS与SDS评分与治疗前比较,均无统计学差异(P>0.05),肝郁气滞型与冲任失调型SAS及SDS评分明显低于治疗前(P<0.05)。结论ABC患者存在焦虑和抑郁情况,且与中医证型具有相关性,在治疗时应关注其心理状态;采用宽郁舒气方治疗后,肝郁气滞型与冲任失调型的ABC患者抑郁和焦虑状态明显改善。

Objective To investigate the anxiety and depression of advanced breast cancer(ABC)patients,and explore their correlation with different types of traditional Chinese medicine(TCM)syndromes of breast cancer;To observe the effects of prescriptions specialized in relieving depression and dredging Qi on ABC patients.Methods In the study,a total of 138 ABC patients and 60 healthy controls were evaluated by self-rating anxiety scale(SAS)and self-rating depression scale(SDS).The relationships between SAS,SDS and syndrome patterns were analyzed.ABC patients had prescription in relieving depression and dredging Qi for two months.Then compare the changes of SAS and SDS scores before and after taking the prescription.Results Compared with healthy controls,ABC patients had obvious symptoms of anxiety and depression,and they also had significantly higher SAS and SDS scores than the healthy controls(P<0.01).There was no significant difference in the scores of SAS and SDS between the ABC patients with syndromes of Qi-Yin deficiency and the healthy controls(P>0.05).The scores of SAS and SDS were significantly higher in ABC patients with stagnation of liver and Qi syndrome and those with Chong and Ren disorders than in the healthy controls(P<0.05).ABC patients with stagnation of liver and Qi syndrome scored the highest in SAS and SDS among these three TCM syndromes(P<0.05).The scores of SAS and SDS were reduced in ABC patients after two months of taking prescriptions in relieving depression and dredging Qi(P<0.01).There was no significant difference in SAS and SDS scores before and after treatment in the ABC patients with syndromes of Qi-Yin deficiency(P>0.05).The scores of SAS and SDS were decreased in ABC patients with stagnation of liver and Qi and those with Chong and Ren disorders after two months of treatment(P<0.01).Conclusion The anxiety and depression of ABC patients were associated with their TCM syndromes.Psychological state should be paid attention to.The depression and anxiety are relieved in ABC patients with stagnation of liver and Qi and those with disorders of Chong and Ren after the treatment of prescription specialized in relieving depression and dredging Qi.