综合医院就诊患者焦虑症状与中医体质的相关性研究

Study on Correlation Between Anxiety Symptoms and Traditional Chinese Medicine Constitutions of Patients at General Hospital

目的:分析综合医院就诊患者的焦虑症状和中医体质的相关性。方法:对在广州市4家综合医院就诊的患者进行横断面研究,采用广泛性焦虑障碍量表(GAD-7)、抑郁自评量表(PHQ-9)评价患者是否存在焦虑、抑郁症状,采用中医体质分类与判定表辨识体质。结果:在1 595例患者中,442例存在焦虑症状,占27.7%。2组性别、婚姻状况、民族、户籍所在地、居住地、职业、生活状况、收入、付费方式、就诊目的、吸烟、喝酒等分类资料比较,差异均无统计学意义(P>0.05);是否有家人曾患情绪疾病的患者构成比比较,差异有统计学意义(P<0.01)。2组曾患糖尿病、脑血管病、心脏病、肿瘤的数据经统计学分析,差异均无统计学意义(P>0.05),但曾患高血压病、患除外上述5种疾病(高血压病、糖尿病、脑血管病、心脏病、肿瘤)的其他疾病数据比较,差异均有统计学意义(P<0.01)。2组年龄、受教育年限、9种中医体质评分以及PHQ-9总分比较,差异均有统计学意义(P<0.01)。有焦虑症状组的平和质评分低于无焦虑症状组(P<0.01),8种偏颇体质的评分均高于无焦虑症状组(P<0.01)。抑郁情绪、气郁质是焦虑症状的危险因素。焦虑症状与平和质评分呈负相关(P<0.01),与气虚质、气郁质、痰湿质、特禀质、血瘀质、阳虚质、阴虚质以及湿热质评分呈正相关(P<0.01)。结论:在有躯体疾病的患者中,焦虑症状的发生率高于普通人群,提示需要关注综合医院就诊患者的心理健康。从中医体质学的角度分析,气郁质是焦虑症状的主要危险因素,应及早采取针对性措施改善患者的体质,进而预防焦虑症的发生。

Objective: To analyze the correlation between anxiety symptoms and Traditional Chinese Medicine(TCM)constitutions of patients at general hospital. Methods:A cross-sectional study was conducted among patients at four general hospitals in Guangzhou. Generalized Anxiety Disorder-7(GAD-7) and Patient Health Questionnaire-9(PHQ-9) were used to evaluate whether the patients had anxiety and depression symptoms. Classification and Determination of Constitution in TCM was used to identify constitution. Results:Among 1 595 cases of patients,442 patients had anxiety symptoms,accounting for 27.7%. There was no significance in differences being found in the comparison of gender,marital status,nationality,registered residence, present address, occupation, living condition, income, payment method, purposes of medical visit,smoking,and drinking(P>0.05). When compared the constituent ratio of patients with or without family members who had emotional diseases, the difference was significant(P<0.01). According to the analysis and comparison of the medical history data of diabetes,cerebrovascular disease,heart disease and tumor in the two groups,there was no significance in differences(P>0.05);however,there were significant differences being found in the comparison of the medical history date of hypertension and other diseases except the above five diseases(diabetes,cerebrovascular disease,heart disease,and tumor) between the two groups(P<0.01). When compared the age,years of schooling,the scores of nine kinds of TCM constitutions,and the total score of PHQ-9 between the two groups,there was significance in differences(P<0.01). The score of gentler constitution constitution in the anxiety group was lower than that in the non-anxiety group(P<0.01),and the scores of eight kinds of biased constitution were higher than those in the non-anxiety group(P<0.01). Depression and Qistagnation constitution are the risk factors of anxiety. Anxiety symptoms were negatively correlated with the score of gentler constitution(P<0.01).,and positively correlated with the scores of Qi-deficiency constitution,Qi-stagnation constitution,phlegm-dampness constitution,inherited-special constitution,blood-stasis constitution,Yang-deficiency constitution,Yin-deficiency constitution,and damp-heat constitution(P<0.01). Conclusion:Patients with physical diseases have higher incidence of anxiety symptoms than the general population,suggesting that there is a need to pay attention to the mental health of patients at general hospitals. From the perspective of Chinese medicine constitution,Qi-stagnation constitution is the main risk factor of anxiety symptoms;targeted measures should be taken to improve the constitution of patients as soon as possible,so as to prevent the occurrence of anxiety disorders.