肺癌相关性抑郁的影响因素及中医证候分析

Factors and TCM pattern analysis of lung cancer-related depression

目的 分析肺癌相关性抑郁的影响因素及中医证候情况。方法 收集160例原发性肺癌患者性别、年龄、民族、职业、文化程度、家庭年收入、医疗费用来源等基本信息;患病时间、临床分期、既往治疗方式、治疗时间、是否有不良反应、是否疼痛、是否知情、中医证候等肿瘤相关信息,以及患者抑郁状况。采用χ~2检验进行单因素分析,筛选出P<0.05的影响因素,采用Logistic回归模型进行多因素回归分析,确定独立影响因素。采用χ^(2)检验分析中医证候与抑郁轻重程度两者间的关系。结果 160例患者中,68例抑郁自评量表标准分≥50分,抑郁发生率42.5%。年龄、性别、文化程度、临床分期、既往治疗、治疗不良反应、癌痛、知情、中医证候等9个因素与肺癌相关性抑郁有相关性(P<0.05)。其中,文化程度、临床分期、既往治疗、治疗不良反应、癌痛、知情、中医证候对肺癌相关性抑郁的影响具有统计学意义(P<0.05),是肺癌相关性抑郁的独立影响因素。中医证候、临床分期和知情3个因素与肺癌相关性抑郁的发生关系密切,文化程度对肺癌相关性抑郁的影响相对较小。相关性抑郁轻重程度与中医证候分布有相关性(P<0.05)。轻度抑郁患者以肝气郁结证、痰湿阻滞证为主,中度抑郁患者以肝郁脾虚证、气滞血瘀证为主,重度抑郁患者以肝肾亏虚证多见。结论 文化程度、临床分期、既往治疗、治疗不良反应、癌痛、知情、中医证候是肺癌相关性抑郁的独立影响因素。

Objective To analyze the factors and TCM patterns of lung cancer-related depression.Methods We collected basic information, which included gender, age, ethnicity, occupation, education, annual household income, source of medical expenses, and tumor-related information, including disease duration, clinical stages, previous treatment, treatment duration, adverse reactions, cancer pain, to what extent are they informed of their conditions, TCM patterns, and depression status, of 160 patients with primary lung cancer. A univariate analysis was conducted through a χ~2 test, which screened out the factors with P<0.05, and the logistic regression model was adopted in the multivariate regression analysis to determine the independent factors. Then the relationship between their TCM patterns and severity of depression was analyzed in a χ^(2)test.Results Among the 160 patients, 68 had a standard score of ≥50 on the Self-Rating Depression Scale, and the incidence of depression was 42.5%. Nine factors, including age, gender, education, clinical stages, previous treatment, adverse reactions to treatment, cancer pain, informedness, and TCM patterns, are associated with lung cancer-related depression(P<0.05). Seven of the nine factor, which are education, clinical stages, previous treatment, adverse reactions to treatment, cancer pain, informedness, and TCM patterns, have statistically significant effects on lung cancer-related depression(P<0.05), and these are independent factors of lung cancer-related depression. Three factors, including TCM patterns, clinical stages and informedness, are closely related to the occurrence of lung cancer-related depression, and education has relatively little effect on lung cancer-related depression. There is a correlation between the severity of depression and the distribution of TCM patterns(P<0.05). Patients with mild depression are mainly characterized by binding constraint of liver qi and phlegm-dampness forming obstructions. Those with moderate depression reported liver constraint and spleen deficiency, and qi stagnation and blood stasis. Patients suffer from severe depression tend to have the pattern of liver-kidney depletion.Conclusions Education, clinical stages, previous treatment, adverse reactions to treatment, cancer pain, informedness, and TCM patterns were independent factors of lung cancer-related depression.