摘要
目的:探讨青少年混合性焦虑和抑郁障碍(MADD)的中医证候分布规律以及抑郁、焦虑情绪与早期应激因素之间的关系。方法:纳入2021年10月至2022年1月就诊于广东省中医院心理睡眠科并确诊MADD的青少年患者155例,对患者的四诊信息进行描述性统计和聚类分析,总结其中医证候分布规律。采用多元回归分析探究影响青少年焦虑、抑郁情绪的早期应激因素。结果:MADD青少年患者舌象最常见舌质红、苔腻、舌胖大、舌边缘齿痕,脉象最常见细脉、弦脉、滑脉,常见辨证分型为肝郁脾虚证、脾胃伏热证、脾虚湿盛证、肾阳亏虚证及阴虚火旺证。部分生活事件及睡眠维度与焦虑抑郁情绪具有显著相关性(P<0.01,P<0.05),回归分析发现,白天功能紊乱、睡眠紊乱等睡眠维度分别对焦虑、抑郁情绪有一定的预测作用(P<0.01),生活习惯变化、不喜欢上学等生活事件分别对焦虑、抑郁情绪有一定预测作用(P<0.01)。结论:青少年MADD的中医证候以肝郁脾虚最常见,核心病机以肝失疏泄为主,常波及脾、胃。睡眠问题、生活事件中部分因素会导致青少年焦虑、抑郁情绪。
Objective:To explore the distribution patterns of traditional Chinese medicine(TCM)syndromes,and the relationship between early-life stress factors,depression and anxiety among adolescent patients with mixed anxiety-depressive disorder(MADD).Methods:A total of 155 adolescent patients who attended at the Psychology and Sleep Clinic of Guangdong Provincial Hospital of Chinese Medicine from October 2021 to January 2022 who were diagnosed with MADD.Descriptive statistics and cluster analysis was performed on the four diagnostic information of the patients,and the distribution patterns of TCM syndromes were summarized.Multiple regression analysis was used to investigate the early-life stress factors affecting adolescents'anxiety and depression.Results:Commonly observed tongue signs include red tongues,tongues with greasy coatings,enlarged tongues with teeth marks,while the pulses mostly manifested as thready pulses,wiry pulses and slippery pulses.TCM syndromes related to MADD included liver qi stagnation with spleen deficiency,heat stagnation in the spleen and stomach,spleen deficiency with dampness,kidney yang deficiency and hyperactivity of fire due to yin deficiency.It was also found that symptoms of MADD were correlated with most of the items on the life events scale and sleep(P<0.01,P<0.05).Regression analyses showed that daytime dysfunction,sleep disturbances and other sleep dimensions were significant predictors of depression and anxiety(P<0.01).Evident alteration in habits,dislike of school and other life events were significant predictors of depression and anxiety(P<0.01).Conclusion:Liver qi stagnation and spleen deficiency is the mostly observed TCM syndromes among adolescent patients with MADD.The core pathogenesis lie in liver dysfunction,which is often related to the spleen and stomach.Factors like sleep disorder and life events can lead to depression and anxiety in adolescents.
作者
松泉午
周鑫
杨玲玲
郑莉明
周流畅
史亚飞
张荣
李艳
SONG Quanwu;ZHOU Xin;YANG Lingling;ZHENG Liming;ZHOU Liuchang;SHI Yafei;ZHANG Rong;LI Yan(School of Basic Medical Sciences,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;The Second Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510006,China;School of Pharmaceutical Sciences,Guangzhou University of Chinese Medicine,Guangzhou 510006,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2023年第9期4431-4437,共7页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金面上项目(No.81873271,No.82074219)
广州中医药大学“双一流”与高水平大学学科协同创新团队项目(No.2021xk29)。
关键词
混合性焦虑和抑郁障碍
中医证候
早期应激
青少年
相关性
Mixed anxiety and depressive disorder(MADD)
Traditional Chinese medicine syndromes
Early-life stress
Adolescent
Relationship
