肿瘤相关性抑郁中医证型影响因素研究

Study on the Related Factors of TCM Syndromes of Tumor-Related Depression

目的:研究肿瘤相关性抑郁患者中医证型的影响因素。方法:根据中医诊断标准及辨证论治思维确定患者的中医证型,运用统计学方法分析患者的性别、年龄、经济情况、肿瘤分期、化疗周期、抑郁程度等相关因素与中医证型间的相关性。结果:肿瘤相关性抑郁患者主要有肝郁脾虚证、心虚胆怯证、肝肾亏虚证、气滞血瘀证、痰火扰心证5个证型,其中以肝郁脾虚证最为多见。肿瘤相关性抑郁中医证型与患者收入情况及既往化疗史无明显相关性,而在年龄、性别、肿瘤分期及抑郁自评量表(SDS)评分方面存在差异(P<0.01)。在5个证型中除肝郁脾虚证外,男性患者多见于肝肾亏虚证、气滞血瘀证,女性患者以心虚胆怯证较为多见;患者年龄与肝肾亏虚证呈相关性,与其余各证型无明显相关性;肿瘤分期中Ⅰ期患者以痰火扰心证、气滞血瘀证多见,Ⅱ期患者以气滞血瘀证、肝郁脾虚证多见,Ⅲ期患者以肝郁脾虚证、心虚胆怯证多见,Ⅳ期患者多为肝肾亏虚证、心虚胆怯证;轻度抑郁患者主要见于气滞血瘀证、痰火扰心证;中度抑郁患者主要见于肝郁脾虚证、心虚胆怯证;重度抑郁患者主要见于肝肾亏虚证。结论:肿瘤相关性抑郁患者以肝郁脾虚证最为多见;患者的年龄、性别、肿瘤分期及抑郁程度与中医证型具有相关性。

Objective:To study the influencing factors of traditional Chinese medicine(TCM)syndromes of tumor-related depression.Methods:According to diagnostic criteria of TCM and the theory of syndrome differentiation and treatment,the TCM syndromes of patients were determined.Statistical methods were used to analyze the correlation between gender,age,economic status,tumor stage,chemotherapy cycle,depression degree and TCM syndrome types.Results:The main types of tumor-related depression are syndrome of liver qi stagnation and spleen deficiency,syndrome of timidity due to deficiency of heart qi,syndrome of deficiency of liver and kidney,syndrome of qi stagnation and blood stasis,syndrome of phlegm fire disturbing heart.There is no obvious correlation between TCM syndrome type of tumor-related depression and the patient's income and the history of previous chemotherapy.However there is an obvious correlation on age,gender,tumor stage and self-rating depression scale(SDS)score(P<0.01).Except the syndrome of liver qi stagnation and spleen deficiency,for the male patients,the syndromes of deficiency of liver and kidney and qi stagnation and blood stasis were common,but for the female,the syndromes of timidity due to deficiency of heart qi was common.The age of patients age was related to the syndrome of deficiency of liver and kidney,but was not related to other syndromes.In stageⅠ,patients usually showed the syndromes of qi stagnation and blood stasis,and phlegm fire disturbing heart.In stageⅡ,patients usually showed the syndromes of qi stagnation and blood stasis,liver qi stagnation and spleen deficiency.In stageⅢ,patients usually showed syndromes of liver qi stagnation and spleen deficiency,timidity due to deficiency of heart qi.In stageⅣ,syndromes of deficiency of liver and kidneys,timidity due to deficiency of heart qi were common.Syndromes of qi stagnation and blood stasis,phlegm fire disturbing heart were common in patients with mild depression.In patients with moderate depression,syndrome of liver qi stagnation and spleen deficiency,and timidity due to deficiency of heart qi were more common.In patients with severe depression,the syndromes of deficiency of liver and kidneys was common.Conclusion:The major syndrome types of tumor-related depression is liver qi stagnation and spleen deficiency.The age,gender,tumor stage and SDS score are related to the TCM syndrome types.