摘要
目的:调查沈阳地区不同中医分型抑郁症患者常见情志症状表现,论证其与精神心理学症状量表的相关性。方法:选择2000-05/2006-05入住中国医科大学附属第四医院精神科的抑郁症患者149例,入选对象均在治疗前由两名资深中医师进行辨证诊断,并获得一致结论后入选,辨证诊断时间在开始治疗前1周内。抑郁症患者中医辨证标准:参照1991年中国中西医结合学会精神疾病委员会昆明座谈会修订的《情感性(心境)障碍中西医结合辨证分型标准》,结合临床实际,拟设肝郁气滞型(证见多愁善感、悲观厌世、失眠多梦、嗳气叹息、身倦纳呆、便结不畅,舌质淡红,脉弦);肝郁脾虚证(证见胸胁胀痛、咽部有梗塞感,四肢倦怠、乏力,情绪抑郁、委靡不振或急躁易怒、善太息,食欲减退、纳呆腹胀、便溏不爽、肠鸣矢气、便溏,舌苔白,脉弦或缓弱);肝郁痰阻证(证见情绪抑郁、表情沮丧,神思迟钝、嗜卧少动、妄见妄闻,善太息,眩晕、胸胁胀闷、恶心欲呕、泛吐痰涎,苔白腻,脉弦滑);心脾两虚证(证见忧心忡忡、寡言少语,纳呆消瘦、心慌气短、神疲乏力、行动迟缓,健忘失眠,舌质淡,脉沉细无力);共计4个证型。同时接受汉密顿抑郁量表(24项版本)评估,该量表共分7类因子结构和24项症状表现,7类因子包括:躯体化、体质量变化、认知障碍、昼夜变化、迟缓、睡眠、绝望感。上述测试项目大部分分为5级(无、轻、中、重和极重度),评分为0～4分,少部分为无、轻、中度和重度3级,评分0～2分。量表评定时间相同于中医辨证诊断时间。结果:抑郁症患者149例,均进入结果分析。①中医证型分布如下:肝郁气滞型53例(35.6%)、肝郁脾虚型45例(30.2%)、肝郁痰阻型27例(18.1%)、心脾两虚型24例(16.1%)。②心脾两虚型组的平均年龄明显高于其他证型患者,而肝郁脾虚型和心脾两虚型患者的平均病程明显大
AIM： To investigate common affective symptoms of patients with depression of different TCM patterns in Shenyang, and demonstrate the correlation with neuropsychological symptom rating scale. METHODS： 149 depressive inpatients were selected from the Department of Psychiatry, Forth Hospital Affiliated to China Medical University between May 2000 and May 2006, and all subjects were identified by two senior traditional Chinese physicians before treatment. Patients with coincident conclusion were included, and the syndrome differentiation diagnosis began from one week before the treatment. Syndrome differentiation criteria of TCM for depression referred to CCMD-2-R Criteria for Affective Disorder revised in Kunming discussion meeting by Committee on Mental Disorder of China Association of Integrative Medicine in 1991, based on which four patterns were set according to the clinical situation： Stagnation of qi due to depression of the liver （representing as sentimental, pessimistic, insomnia and dreaminess, belching and sighing, tired and anorexia, coprostasis, texture of tongue in light red as well as wiry pulse）; stagnation of liverqi with deficiency of the spleen （representing as gas pains in chest and hypochondrium, block-feeling in pharyngeal portion, tired limbs, emotional depression, unable to pick oneself up, irritable and tantrum, sighing, decreased food appetite, anorexia and abdominal distension, uncomfortable loose stool, rugitus, white coated tongue, wiry pulse or slow）; stagnation of liver-qi and phlegm （representing as emotional depression, depressive expression, dull mind, addicting to lying and disliking motion, false seeing and hearing, sighing, dizzy, expanding in chest and hypochondrium, nauseated with the desire of vomit, phlegm retention, white coated tongue as well as smooth pulse）; deficiency of both heart and spleen （representing as anxiety, reticent, anorexia and tabid, panicky with short breath, mindtiredness without power, slow in action, forgetful and insomnia, light text
出处
《中国临床康复》
CSCD
北大核心
2006年第47期42-45,共4页
Chinese Journal of Clinical Rehabilitation
