肺癌患者焦虑、抑郁状态的影响因素及中医证型分析

Influencing factors of anxiety and depression in lung cancer patients and analysis in Chinese traditional medicine syndromes

目的探讨肺癌患者焦虑、抑郁状态的影响因素和肺癌抑郁患者的中医证型。方法选取肿瘤科肺癌患者、其他科室普通慢性疾病患者和健康体检者各50例作为研究对象,分别纳入肺癌组、慢性疾病组和健康对照组。比较3组研究对象的汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分,探讨肺癌患者焦虑、抑郁状态的影响因素,并分析肺癌抑郁患者的中医证型特点。结果肺癌组、慢性疾病组的HAMA评分、HAMD评分均高于健康对照组,且肺癌组HAMA评分、HAMD评分均高于慢性疾病组,差异有统计学意义(P<0.05)。50例肺癌患者中,焦虑者31例(焦虑组)、非焦虑者19例(非焦虑组),抑郁者34例(抑郁组)、非抑郁者16例(非抑郁组);焦虑组与非焦虑组间、抑郁组与非抑郁组间在年龄、性别、受教育程度和疾病类型方面比较,差异无统计学意义(P>0.05);焦虑组与非焦虑组间、抑郁组与非抑郁组间在远处转移、肺癌分期、患病时间和体力活动状态(PS)评分方面比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,肺癌分期、患病时间和PS评分是肺癌患者焦虑、抑郁的独立影响因素(P<0.05)。中医证型分析结果显示,肺癌抑郁患者以肝气郁结型(35.29%)最多见,其后是心脾两虚型(29.41%)和心肾阴虚型(23.53%),其他3种证型则较少。结论肺癌患者普遍处于焦虑、抑郁状态,其中抑郁患者的中医证型以肝气郁结型和心脾两虚型居多,肺癌分期、患病时间和PS评分均为肺癌患者焦虑、抑郁状态的独立影响因素。

Objective To explore influencing factors of anxiety and depression in lung cancer patients and traditional Chinese medicine(TCM)syndromes of lung cancer patients with depression.Methods Fifty patients with lung cancer in the department of oncology,50 patients with common chronic diseases in other departments and 50 healthy people were selected as research objects,and were included in lung cancer group,chronic disease group and healthy control group,respectively.The Hamilton Anxiety Scale(HAMA)score and Hamilton Depression Scale(HAMD)score of subjects in three groups were compared,and influencing factors of anxiety and depression in lung cancer patients were explored,and the TCM syndromes characteristics of lung cancer patients with depression were analyzed.Results The scores of HAMA and HAMD in the lung cancer group and the chronic disease group were significantly higher than those in the healthy control group,and the above scores in the lung cancer group were higher than those of the chronic disease group(P<0.05).Among 50 lung cancer patients,31 had anxiety(anxiety group),19 had no anxiety(non-anxiety group),34 were depressed(depression group)and 16 were non-depressed(non-depression group).There were no significant differences in age,sex,education level and disease types between anxiety group and non-anxiety group,between depression group and non-depression group(P>0.05).There were significant differences in distant metastasis,cancer stage,onset time and physical activity state(PS)score between anxiety group and non-anxiety group and between depression group and non-depression group(P<0.05).Multiple Logistic regression analysis showed that lung cancer stage,disease duration and PS score were independent influencing factors for anxiety and depression(P<0.05).TCM syndrome analysis showed patients with liver qi stagnation accounted for the most(35.29%),followed by deficiency of heart and spleen(29.41%)and yin deficiency of heart and kidney(23.53%),while the other three TCM syndromes were rarely seen.Conclusion Lung cancer patients are generally in a state of anxiety and depression.Among depressed patients,majority of them are liver qi stagnation syndrome and heart and spleen deficiency syndrome.Lung cancer stage,disease duration and PS score are independent influencing factors for depression or anxiety in lung cancer patients.