2561例青少年抑郁症患者出生时间运气规律的多中心回顾性研究

Characteristics of Yun-Qi(运气)of Birth Date of 2561 Adolescents with Depression:A Multicenter Retrospective Study

目的从出生时间的运气规律及特征角度探讨影响青少年抑郁症患者发病的影响因素。方法采用回顾性研究方法收集2019年12月至2021年11月浙江省11个医疗中心医院信息系统诊断为青少年抑郁症的患者病历资料。采集患者性别、出生日期、首诊日期、每次复诊日期、用药情况、病程信息,并将复诊时西药用药与前一次就诊不一致记为一次病情波动。根据患者出生日期推算岁运、主运、客运、主气、客气、司天和在泉,统计分析出生时间的运气规律。结果最终共纳入青少年抑郁症患者2561例,其中出生时间岁运属水患者最多,其次为木、金、土、火,且属水不及、土太过的患者显著多于其他属性者,差异具有统计学意义(P<0.01);性别方面,火不及和土太过患者中男性例数较火太过患者高,水太过患者中男性例数较火不及患者低(P<0.05);病情波动次数方面,火不及、土太过、金不及、水太过患者较水不及患者更多,水太过患者较金太过患者更多(P<0.05);病程方面,木太过、火不及、土太过、金不及、水太过患者较水不及患者更长(P<0.05)。出生时间主运属金患者最多,其次依次为土、水、木、火,差异有统计学意义(P<0.05);客运属火患者最多,其次依次为土、木、水、金,差异无统计学意义(P>0.05),且客运属木、火者年龄比属金者大(P<0.05);主气属阳明燥金患者最多,其次依次为太阴湿土、太阳寒水、少阳相火、厥阴风木、少阴君火,差异有统计学意义(P<0.01);司天属厥阴风木患者最多,其次依次为太阳寒水、少阴君火、少阳相火、阳明燥金、太阴湿土,差异有统计学意义(P<0.01),且少阴君火、太阴湿土、阳明燥金患者较厥阴风木患者的病情波动次数更多、病程更长(P<0.05);客气属少阴君火患者最多,其次依次为阳明燥金、厥阴风木、太阳寒水、少阳相火、太阴湿土,差异无统计学意义(P>0.05)。结论青少年抑郁症的发病病机主要与素体脾虚湿盛、肾气不足或肝气郁结导致阳气郁遏有关,其发生与出生时间相关,出生岁运属水不及和土太过者、司天属厥阴风木者更易罹患抑郁症。

Objective To explore the factors influencing the onset of depression in adolescents from the perspec-tive of the characteristics of yun-qi of birth date of patients.Methods Medical records were retrospectively collected from adolescents who were diagnosed with depression in 11 medical centers in Zhejiang Province from 2019 December to 2021 November.The data on gender,date of birth,date of first visit,date of each follow-up visit,medications,and disease course were collected,and the inconsistency between the follow-up visit and the previous visit on western medicines was recorded as a fluctuation of the disease.With the birth date of patients,we calculated the year of yun(岁运),host yun(主运),guest yun(客运),hostqi(主气),guestqi(客气),sitian(司天)and zaiquan(在泉),and analyzed the yun-qi characteristics of the birth date.Results A total of 2,561 DA cases were included.We found that the number of patients whose birth date was in the year of water yun was highest,followed by wood,metal,earth,fire,in particular,the year of deficient water and excessive earth was among the top two with significantly difference(P<0.01).In terms of gender,there were more males in the patients with deficient fire and excessive earth than those with excessive fire,and less males were found in excessive water patients than deficient fire ones(P<0.05).For the condition fluctuations of the patients,there was a less frequent condition fluctuation of patients in the year of deficient water compared to the ones in the year of deficient fire,excessive earth,deficient metal,excessive fire,and excessive water patients had more frequent fluctuations than those in the year of excessive metal(P<0.05).The patients in the year of excessive wood,deficient fire,excessive earth,deficient metal and excessive water had longer disease course than those in the year of deficient water(P<0.05).As to the host yun,the number of patients of the metal yun was highest,followed by earth,water,wood,and fire,with significantly statistical difference(P<0.05).As to the guest yun,the number of patients of the fire yun was highest,followed by earth,wood,water,and metal,with no statistical difference(P>0.05),and the mean age of patients with wood and fire guest yun was larger than those with metal yun(P<0.05).As to the host qi,the number of patients of Yangming(阳明)was highest,followed by Taiyin(太阴),Taiyang(太阳),Shaoyang(少阳),Jueyin(厥阴),and Shaoyin(少阴),having statistically significant difference(P<0.01).As to the sitian,the number of patients of Jueyin was highest,followed by Taiyang,Shaoyin,Shaoyang,Yangming,Taiyin,having statistically significant difference(P<0.01),and patients in the Jueyin had a less frequency of condition fluctuation and shorter course of disease than those in the Shaoyin,Taiyin and Yangming(P<0.05).Regarding the guest qi,the number of patients of Shaoyin was highest,followed by those in the Yangming,Jueyin,Taiyang,Shaoyang,Taiyin,with no statistically significant difference(P>O.05).Conclusion The pathogenesis of adolescent depression is mainly related to yang qi constraint caused by spleen deficiency,kidney qi insufficiency or stagnation of liver qi,which is closely correlated to the birth date.The patients with birth date in the year of deficient water and excessive earth yun,and of sitian ascribed to Jueyin are most prone to suffer from depression.