关于综合医院中医科抑郁或焦虑倾向患者躯体症状分布特征的研究

A study on the characteristics of somatization symptoms in patients with depression or anxiety in department of traditional Chinese medicine outpatient in general hospital

目的总结综合医院中医科门诊抑郁焦虑患者躯体症状分布特征。方法采用横断面研究方法,对2019年1月至2019年12月在首都医科大学附属北京友谊医院中医科门诊就诊的4900例患者进行SCL-90心理量表及躯体症状观察表的填写,筛选出具有抑郁或焦虑倾向的患者。选取SCL-90量表抑郁因子分>2分或者焦虑因子分>2分患者共390例作为抑郁焦虑组,根据其性别、年龄分布匹配相应的抑郁、焦虑因子分均<2分患者390例作为对照组。观察其症状分布特征,并分析其特征症状与抑郁焦虑的相关性。结果综合医院中医科门诊患者抑郁或焦虑筛查阳性率为7.36%,其症状主要分布于神经系统、心血管系统、消化系统、耳鼻喉器官等,其中心悸、失眠、咽部不适为抑郁或焦虑倾向患者最常出现的临床症状。抑郁焦虑组失眠、乏力、耳鸣、心悸、咽部不适的发生率为29.23%、28.46%、27.95%、27.18%、26.67%,显著高于对照组(17.44%、21.54%、20.51%、14.62%、16.67%),差异均有统计学意义(P<0.05)。结论综合医院中医科就诊患者中合并抑郁或焦虑者较多,主诉心悸、失眠、咽部不适的患者更可能出现抑郁焦虑倾向,为中医科医师识别患者的抑郁或焦虑状态提供参考和提示。

Objective To summarize the symptom characteristics of depression and anxiety patients in department of traditional Chinese medicine outpatient in Beijing general hospital.Methods In a cross-sectional study,SCL-90 psychological scale and physical symptom Observation form were filled out for 4900 patients who visited the Department of traditional Chinese medicine outpatient,Beijing Friendship Hospital,Capital Medical University from January 2019 to December 2019.A total of 390 patients with depression factor score of SCL-90 scale>2 points or anxiety factor score>2 points were selected as the depression and anxiety group,and 390 patients with corresponding depression and anxiety factor scores<2 points were matched according to their gender and age distribution.Cases were used as the control group.Patients with depression and anxiety were screened out,and their symptom characteristics were observed,and the correlation between characteristic symptoms and depression and anxiety was analyzed.Results The positive rate of depression and anxiety screening in outpatients department of traditional Chinese medicine general hospital was 7.36%,and the symptoms were mainly distributed in nervous system,cardiovascular system,digestive system,ear,nose and throat organs.Among them,palpitation,insomnia and pharyngeal discomfort are the most common clinical symptoms in patients with depression or anxiety.The incidence rates of insomnia,fatigue,tinnitus,palpitations,and throat discomfort in the depression and anxiety group were 29.23%,28.46%,27.95%,27.18%,26.67%,which were significantly higher than those in the control group(17.44%,21.54%,20.51%,14.62%,16.67%),the differences were statistically significant(P<0.05).Conclusion There are more patients with depression or anxiety in department of traditional Chinese medicine in general hospital,and patients complaining of palpitation,insomnia and pharyngeal discomfort are more likely to have depression and anxiety tendency,which provides reference for traditional Chinese medicine doctors to identify depression or anxiety state of patients.