卒中后抑郁的中医证候及危险因素研究

Study on TCM Syndromes and Risk Factors of Post-stroke Depression

目的:探讨影响卒中后抑郁状态(post-stroke depression,PSD)的中医证候分布及卒中证候与PSD证候的相关性。方法:对2017年7月至2019年5月在神经内科住院的836名卒中患者进行卒中后抑郁筛查、中医辨证分析及危险因素调查,分析评价PSD的中医证候特征及与卒中证候的相关性。结果:453例卒中患者存在抑郁状态,检出率为54.2%(453/836),不同中医证候患者PSD检出率差异不显著;Logistic回归分析显示,卒中证候与PSD证候无关,痰、瘀等因素在PSD每一证候中均有分布,这些病理因素始终贯穿卒中整个病程。卒中后患者的睡眠及生活质量是PSD的发病因素。结论:卒中患者出现抑郁状态的比例较高,睡眠及生活质量差的中风患者易伴发PSD。

Objective:To discuss the distribution of TCM syndrome distribution of PSD,the correlations between the syndromes of stroke and the syndromes of PSD.Methods:The screen of PSD,TCM syndrome differentiation analysis and risk factors survey were performed among 836 stroke patients hospitalized in department of neurology from July,2017 to May,2019,the characteristics of TCM syndrome of PSD and its connections with the syndromes of stroke were analyzed and assessed.Results:All 453 stroke patients suffered depression,the detection rate was 54.2%(453/836),the difference was not significant in the detection rate of PSD among patients with different TCM syndromes;Logistic regression analysis showed that TCM syndrome was not related to the syndromes of PSD,phlegm,stagnation and others were distributed in every syndrome of PSD,these pathological factors ran through the whole course of stroke.The quality of sleep and life are the pathogenic factor of PSD.Conclusion:The proportion of stroke patients suffering depression is high,stroke patients with poor sleep and quality of life are prone to suffer PSD.