中医体质和心理状态对溃疡性结肠炎临床疗效的影响及相关性分析

Exploration of the effect of Chinese medicine constitution and psychological state on the clinical efficacy of ulcerative colitis and its correlation analysis

目的:探讨中医体质和心理状态对溃疡性结肠炎(UC)临床疗效的影响及相关性。方法:采用便利抽样法选择2022年1月—2022年12月永州职业技术学院附属医院消化内科UC住院患者和门诊患者98例作为本研究的研究对象。采用调查问卷的形式对患者的一般资料、中医体质、心理状态进行调查,常规治疗3个月后评价患者的临床疗效,分析患者的一般情况、中医体质、心理状态对临床疗效的影响及相关性。结果:98名患者中缓解27例,有效42例,无效29例,治疗总有效率为70.41%,治疗有效率较低;不同性别、年龄、学历、收入、居住地、婚姻状况、医疗费用支付方式的UC患者,其临床疗效比较,差异无统计学意义(P>0.05)。98例患者中平和质、气郁质、气虚质、痰湿质、湿热质、阴虚质、阳虚质、血瘀质、特禀质分别为23例、8例、9例、10例、12例、6例、14例、7例、9例,治疗有效率分别为95.65%、62.50%、88.88%、40.00%、33.33%、66.67%、85.71%、71.42%、55.56%,不同中医体质UC患者临床疗效比较,差异有统计学意义(P<0.05),其中平和质UC患者临床疗效最好,痰湿质和湿热质临床疗效最差。98例患者中无抑郁、轻度抑郁、中度抑郁、重度抑郁分别为22例、33例、25例、18例,治疗有效率分别为77.27%、81.82%、64.28%、38.89%;无焦虑、轻度焦虑、中度焦虑、重度焦虑分别为27例、34例、28例、9例,治疗有效率分别为96.30%、73.52%、53.57%、33.33%。不同心理状态患者临床疗效比较,差异有统计学意义(P<0.05),其中重度抑郁和重度焦虑UC患者治疗有效率最低。经Spearman秩相关性分析显示,中医体质、抑郁程度与患者的临床疗效呈弱相关性,焦虑程度与患者的临床疗效呈中等强度相关。多重线性回归分析显示中医体质、抑郁程度、焦虑程度解释了患者临床疗效存在31.7%的变异量。结论:中医体质和心理状态对UC患者的治疗效果起着至关重要的作用,在疾病的治疗过程中,应更加重视偏颇体质患者,尤其是痰湿质和湿热质,通过调整患者的偏颇体质向平和体质转变,提高患者治疗效果;其次对负面情绪重的患者要通过心理健康宣讲等手段调节其负面情绪,从而加速患者康复。

Objective:To explore the effect of Chinese medicine constitution and psychological state on the clinical efficacy of ulcerative colitis(UC)and its correlation.Methods:A total of 98 inpatients and outpatients with UC in the gastroenterology department of the affiliated hospital of Yongzhou vocational and technical college from January 2022 to December 2022 were selected by convenience sampling method as the research objects of this study.The general information,Chinese medicine constitution and psychological state of patients were investigated by questionnaire.The clinical efficacy of patients was evaluated after 3 months of routine treatment,and the effect and correlation of patients′general condition,Chinese medicine constitution and psychological state on clinical efficacy were analyzed.Results:Among the 98 patients,27 were relieved,42 were effective,and 29 were ineffective.The total effective rate was 70.41%,indicating a low effective rate.There was no statistically significant difference in clinical efficacy among UC patients with different genders,ages,education,income,residence,marital status and payment methods of medical expenses(P>0.05).Among the 98 patients,there were 23 cases of mild constitution,8 cases of Qi depression constitution,9 cases of Qi deficiency constitution,10 cases of phlegm-dampness constitution,12 cases of damp-heat constitution,6 cases of Yin deficiency constitution,14 cases of Yang deficiency constitution,7 cases of blood stasis constitution,and 9 cases of special constitution,respectively.The effective rates were 95.65%,62.5%,88.88%,40.00%,33.33%,66.67%,85.71%,71.42%and 55.56%,respectively.There were statistically significant differences in the clinical efficacy of UC patients with different Chinese medicine constitutions(P<0.05).The clinical efficacy of UC patients with mild constitution was the best,and the clinical efficacy of phlegm-dampness constitution and damp-heat constitution were the worst.Among the 98 patients,there were 22 cases without depression,33 cases with mild depression,25 cases with moderate depression and 18 cases with severe depression.The effective rate of treatment was 77.27%,81.82%,64.28%and 38.89%,respectively.There were 27 cases without anxiety,34 cases with mild anxiety,28 cases with moderate anxiety and 9 cases with severe anxiety.The effective rate of treatment was 96.30%,73.52%,53.57%and 33.33%,respectively.The clinical efficacy of patients with different psychological states was compared,and the difference was statistically significant(P<0.05),among which the effective rates of treatment of UC patients with severe depression and severe anxiety were the lowest.Spearman rank correlation analysis showed that Chinese medicine constitution and depression degree were weakly correlated with the clinical efficacy of patients,and anxiety degree was moderately correlated with the clinical efficacy of patients.Multiple linear regression analysis showed that Chinese medicine constitution,depression degree and anxiety degree explained 31.7%of the variation of clinical efficacy.Conclusion:Chinese medicine constitution and psychological state play a crucial role in the therapeutic effect of UC patients.In the treatment process of the disease,more attention should be paid to patients with biased constitution,especially phlegm-dampness and damp-heat constitution.The therapeutic effect of patients can be improved by adjusting their biased constitution turning to the mild constitution.Secondly,patients with heavy negative emotions should regulate their negative emotions through mental health propaganda and other means,so as to accelerate the recovery of disease.