抑郁症患者1063例的中医证候要素、伴随症状及其相关性分析

TCM syndrome elements,accompanying symptoms and correlation analysis of 1063 patients with depression

目的观察抑郁症患者的中医证候要素及临床症状分布特征,探索其相关性,分析抑郁症的危险因素。方法回顾2022年4月至2023年12月就诊于北京中医药大学东方医院门诊的抑郁症患者病历资料,比较患者的抑郁症筛查量表、抑郁症中医证候要素辨证量表、广泛性焦虑量表、阿森斯失眠自评量表、疲劳量表-14,观察不同抑郁程度抑郁症患者的中医证候要素及临床伴随症状的分布特征,并通过Pearson相关性分析探索中医证候要素与临床症状之间的相关性,采用有序logistic回归分析探索抑郁症的危险因素。结果(1)中医证候要素以气虚占比最多,其次是气滞、血虚、阳虚、阴虚等;(2)80.06%的抑郁症患者伴有焦虑症状,66.60%伴有失眠,70.56%伴有疲劳;(3)中医证候要素与临床伴随症状整体呈现随着抑郁程度加重,在人群中占比增多,且量化评分亦随之增高的趋势;(4)相关性分析结果表明,抑郁症的抑郁、焦虑、失眠、疲劳程度与中医证候要素均存在显著正相关(P<0.01);(5)有序logistic回归分析结果显示,焦虑、失眠、疲劳、气虚、痰湿为抑郁症的独立危险因素(P<0.05)。结论气血阴阳亏虚可能是抑郁症发病的基础,七情应激导致的气滞可能是抑郁症发病的重要诱因,治疗上在解郁的同时应当重视补虚。

Objective To observe the distribution characteristics of TCM syndromes and clinical symptoms in patients with depression,explore their correlation,and analyze the risk factors of depression.Methods To review the medical records of patients with depression who were admitted to the outpatient department of Beijing University of Chinese Medicine Oriental Hospital from April 2022 to December 2023,and compare the PHQ-9,TCM syndrome factor Differentiation Scale for depression,GAD-7,AIS and FS-14 of patients with different degrees of depression,and observe the clinical characteristics of TCM.Pearson correlation analysis and ordered logistic regression analysis were used to explore the risk factors of depression.Results(1)In terms of TCM syndrome elements,qi deficiency accounted for the most,followed by qi stagnation,blood deficiency,yang deficiency,yin deficiency,etc.;(2)In terms of clinical symptoms,80.06%patients were associated with anxiety,66.60%with insomnia,70.56%with fatigue;(3)With the aggravation of depression,the proportion of TCM syndromes and clinical symptoms in the population were increased,and the quantitative score were also increased;(4)Correlation analysis results showed that depression,anxiety,insomnia and fatigue of depression were significantly positively correlated with TCM syndrome elements(P<0.01);(5)Ordered logistic regression analysis showed that anxiety,insomnia,fatigue,qi deficiency and phlegm dampness were independent risk factors for depression(P<0.05).Conclusion Deficiency of qi-blood yin-yang may be the basis of depression,and qi-stagnation caused by seven emotions stress may be an important reason of depression,treatment should pay attention to relieving depression at the same time.