从SAS、SDS量表评分推测甲状腺结节中医证型的研究

A study on the Inference of Traditional Chinese Medical Syndromes of Thyroid Nodules from SAS and SDS Scale Scores

目的:依据焦虑自评量表(SAS)、抑郁自评量表(SDS)评分推测甲状腺结节可能的中医证型,为甲状腺结节的辨证从新的途径提供部分新数据。方法:收集120例甲状腺结节患者的资料,将SAS、SDS量表评分与中医证型进行相关性分析,进一步采用决策树探讨其中医证型与SAS、SDS量表评分之间的对应性关系。结果:通过决策树得出:SAS<48且SDS≥46为气郁痰阻;SAS<48且SDS<46为痰结血瘀;SAS≥48且SDS<46为肝火旺盛;SAS≥48且SDS≥61为气郁痰阻;SAS≥48且46≤SDS<61为气阴两虚。结论:甲状腺结节患者中气郁痰阻证、肝火旺盛证的轻重程度分别与抑郁、焦虑程度关系最密切。采用基于决策树的算法可以筛选出甲状腺结节患者各中医证型对应的焦虑、抑郁量表的具体得分,并建立根据SAS、SDS量表评分推测相应中医证型的模式。

Objective:To speculate on possible TCM syndrome types of thyroid nodules based on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores,and to provide some new data for a new approach to syndrome differentiation of thyroid nodules.Methods:Data on 120 patients with thyroid nodules were collected,correlation analysis was conducted between SAS and SDS scale scores and TCM syndrome types,and decision trees were further used to explore the correspondence between TCM syndrome types and SAS and SDS scale scores.Results:Through the decision tree:SAS<48 and SDS≥46 means Qi stagnation and phlegm obstruction;SAS<48 and SDS<46 means phlegm and blood stasis;SAS≥48 and SDS<46 means strong liver fire;SAS≥48 and SDS≥61 indicates qi stagnation and phlegm obstruction;SAS≥48 and 46≤SDS<61 indicates deficiency of both qi and yin.Conclusion:The severity of Qi stagnation,phlegm obstruction and excessive liver fire in patients with thyroid nodules are most closely related to the degree of depression and anxiety respectively.An algorithm based on decision trees can be used to screen out the specific scores of anxiety and depression scales corresponding to each TCM syndrome type in patients with thyroid nodules,and establish a model for inferring the corresponding TCM syndrome type based on SAS and SDS scale scores.