不同中医证型的中枢性性早熟女童心理行为差异的对比研究

A Comparative Study on Psychological and Behavioral Differences in Girls of Idiopathic Central Precocious Puberty with Different TCM Syndromes

目的:讨论不同中医证型的中枢性性早熟(ICPP)女童心理行为差异。方法:将246例ICPP女童根据中医分型的不同将其分为肝气郁结证、肝肾阴虚证和痰火郁结证,每种类型均纳入82例,针对所有患儿进行心理评估,评价工具为阿成贝切儿童行为量表(CBCL),观察不同中医证型ICPP女童的心理行为差异。结果:肝肾阴虚证组患儿抑郁、多动评分高于痰火郁结证组,但是违纪评分低于痰火郁结证组(P<0.05);肝气郁结证组患儿违纪、多动、攻击评分低于痰火郁结证组(P<0.05);肝肾阴虚证组患儿社交退缩评分低于肝气郁结证组(P<0.05);痰火郁结证组患儿社交退缩评分低于肝气郁结证组(P<0.05)。肝肾阴虚证组、肝气郁结证组和痰火郁结证组患儿躯体自信量表、自尊量表(SES)评分相当(P>0.05)。结论:中枢性性早熟女童的中医辨证分型与心理行为变化之间存在一定的关系,各个证型体现特点不同,肝气郁结证组患儿在社交退缩方面表现比较明显,痰火郁结证组患儿在违纪、多动方面表现比较明显,且均显示出一定程度的自尊和躯体自信问题,其对于临床诊疗工作具有一定的意义。

Objective:To discuss the psychological and behavioral differences in girls of idiopathic central precocious puberty(ICPP)with different TCM syndrome types.Methods:Totally 246 ICPP girls were divided into liver Qi stagnation syndrome,liver kidney Yin deficiency syndrome and phlegm fire stagnation syndrome according to the syndrome classification of traditional Chinese medicine(TCM).Each type was included in 82 cases.Psychological evaluation was carried out in all children.The evaluation tool was Achengbeche Child behavior Checklist(Achenbach's child behavior checklist,CBCL),to observe the psychological and behavioral differences in ICPP girls with different TCM syndromes.Results:The liver kidney Yin deficiency syndrome group showed higher scores of depression and hyperactivity while lower violation of discipline score than phlegm fire stagnation syndrome group(P<0.05).The liver Qi stagnation syndrome group showed lower scores of discipline violation,hyperactivity and attack than phlegm fire stagnation syndrome group(P<0.05).The liver kidney Yin deficiency syndrome group showed lower score of social withdrawal than liver Qi stagnation syndrome group(P<0.05)and phlegm fire stagnation syndrome group showed lower score of social withdrawal than liver Qi stagnation syndrome group(P<0.05).The liver kidney Yin deficiency syndrome group,liver Qi stagnation syndrome group and phlegm fire stagnation syndrome group showed similar scores of The Body-Esteem Scale and SES(P>0.05).Conclusion:There is a certain relationship between TCM differentiation syndromes and psychological behavior changes,and each syndrome shows different the characteristics.The children with liver Qi stagnation syndrome show obvious social withdrawal and the children with phlegm fire stagnation syndrome show obvious violation of discipline and hyperactivity.All show a certain degree of self-esteem and physical self-confidence.It provides certain significance for clinical diagnosis and treatment.