抑郁障碍中医证素分布特点分析

Traditional Chinese medical Distribution characteristics in depressive disorder

目的分析不同人群、不同病情、不同病程的抑郁障碍患者中医证素分布特点。方法纳入抑郁障碍患者127例,记录患者的一般人口学资料,包括年龄、性别等;记录患者的病情资料,包括病情程度、病程。采用汉密尔顿抑郁量表(HAMD)评估患者抑郁症状,中医症状调查表评估中医症状,分析不同人群、不同病情、不同病程的抑郁障碍患者中医证素分布特点。结果127例抑郁障碍患者中医证素主要有14个,其中病位类证素7个,病性类证素7个,病位类证素出现频次由高到低为心、脾、肾、胃、肝、胆、营卫,病性类证素出现频次由高到低为火旺、气虚、阴虚、气郁、血虚、气逆、痰湿。男性心、肾、火旺证素出现频次最多,女性心、脾、气虚证素出现频次最多;青少年组病位类证素心、病性类证素气虚出现频率低于成年组,病位类证素肝、病性类证素气郁出现频率高于成年组;病程≥10年病位类证素脾出现频次较高,不同抑郁程度的病位类证素均以心、脾出现频次较多。结论抑郁障碍中医证素在不同年龄、性别、病程、病情患者中的分布频次存在差异,中医治疗抑郁障碍时应考虑年龄、性别、病情及病程等因素影响。

Objective To analyze traditional Chinese medical(TCM)distribution characteristics in depressive disorder(DD)of different populations,conditions,and disease courses.Methods Totally 127 DD patients were included to record the socio-demographic characteristics(age,sex,etc.)and patient’s medical data(the severity and course of disease).The Hamilton Depression Rating Scale(HAMD)and the TCM Pattern Questionnaire were respectively used to assess depressive symptoms and TCM symptoms.The TCM distribution characteristics in DD of different populations,conditions,and disease courses was analyzed.Results There were 14 TCM syndrome elements among 127 DD patients,inclding 7 disease location and 7 disease nature.In turn,the frequency of disease location was heart,spleen,kidney,stomach,liver and gallbladder,yingqi and weiqi,the frequency of disease nature was hyperactivity of fire,Qi deficiency,Yin deficiency,stagnation of Qi,blood deficiency,adverse rising of qi,phlegm damp.Among male,the most common syndrome elements were heart,kidney,and hyperactivity of fire,and while heart,spleen,and Qi deficiency in female.Compared with the adult group,the adolescent group had lower the frequency of heart and Qi deficiency and higher the frequency of liver and stagnation of Qi.The frequency of spleen was higher in patients with the course of disease>10 years.The frequency of blood deficiency was lower in patients with the course of disease≤1 year.The frequency of heart was higher in severe DD patients.Conclusion There are differences in TCM distribution frequency among DD patients of different populations,conditions and disease courses.These influencing factors should be considered in TCM treatment.