50例重症肌无力患者焦虑抑郁心理与中医证型相关性的研究

发布时间：2018-01-17 14:34

本文关键词：50例重症肌无力患者焦虑抑郁心理与中医证型相关性的研究　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的：1.调查重症肌无力患者合并焦虑抑郁的发生率和中医证型的分布情况；2.探讨重症肌无力患者焦虑抑郁与中医证型之间的相关性。研究方法：通过发放焦虑自评量表(SAS)和抑郁自评量表(SDS),收集重症肌无力病例相关得分、一般人口学资料和临床资料。采用经转换后的量表标准分是否50分作为判断焦虑抑郁的依据。根据《中医内科学常见病诊疗指南.中医病证部分.痿病》中的证型划分,确定研究对象中医证型分布特征。综合运用线性相关检验、秩和检验以及描述性统计方法的频数法合和卡方检验法等统计方法,分析考察相关数据,得出结论。研究结论：本研究共收集了2015年11月至2016年1月在我院就诊的50例重症肌无力患者。SAS得分50有19例,焦虑发生率为38%,SDS得分50有24例,抑郁发生率为48%。其中,单纯焦虑4例,发生率8%；单纯抑郁9例,发生率18%；焦虑合并抑郁15例,发生率30%；无焦虑抑郁22例,占44%。SAS得分50的19例患者中,门诊14例,门诊病例焦虑发生率为35%,住院病例5例,住院病例焦虑发生率为50%；SDS得分50的24例患者中,门诊有17例,门诊病例抑郁发生率为42.5%；住院病例5例,住院例抑郁发生率为70%。焦虑和抑郁的住院发生率都高于对应的门诊发生率。表明在重症肌无力患者中存在较高的焦虑／抑郁发生率,值得临床医师重视。患者SAS、SDS得分与国内正常数据比较有显著差异。SAS、SDS得分之间存在正相关关系,相关系数为r=0.695,在临床上以焦虑抑郁共病形式出现的不少见。在相关因素分析中,患者是否发生焦虑或抑郁与对自身疾病了解程度密切相关,而与性别、受教育程度和经济情况未见明显相关。在临床资料上,住院次数多的患者,容易发生焦虑；抑郁的发生率则与病程和住院次数显著相关。根据辨证分型标准,50例重症肌无力病例中,脾胃气虚证27例,占54%；脾肾阳虚15例,占30%；肝肾不足为8例,占16%。其中,肝肾不足证与焦虑发生率之间、脾肾阳虚证与抑郁发生率之间都存在显著相关(P0.0166)。本次研究通过分析中医证型与焦虑／抑郁的相关规律,给临床中医药治疗重症肌无力合并焦虑抑郁提供相关指导依据。
[Abstract]:Objective 1. To investigate the incidence of anxiety and depression in patients with myasthenia gravis and the distribution of TCM syndromes. 2. To explore the relationship between anxiety and depression and TCM syndrome types in patients with myasthenia gravis. Methods: Self-Rating anxiety scale (SAS) and Self-Rating Depression scale (SDS) were issued. The related scores of myasthenia gravis cases were collected. General demographic data and clinical data. Whether the standard score of the converted scale is 50 or not is used as the basis for judging anxiety and depression. According to the guidelines for diagnosis and treatment of common diseases in traditional Chinese medicine. Part of TCM diseases and syndromes. Impotence. Classification of syndromes. To determine the distribution characteristics of TCM syndromes of the study object. Comprehensive use of linear correlation test, rank sum test and descriptive statistical methods of frequency and chi-square test statistical methods, analysis and inspection of relevant data. Conclusion: this study collected 50 patients with myasthenia gravis from November 2015 to January 2016. There were 19 patients with 50 patients with myasthenia gravis. There were 24 cases of anxiety and 48 cases of depression in 50 cases of SDS score of 38 cases, of which 4 cases were simple anxiety and 8 cases were depression. There were 9 cases of simple depression, the incidence rate was 18%. There were 15 cases of anxiety and depression, the incidence was 30%. There were 22 cases of non-anxiety and depression, accounting for 44.5% of the 19 patients with SAS score 50, out of which 14 cases were outpatient, the incidence rate of outpatient anxiety was 35%, the incidence of inpatients was 5 cases, the incidence rate of anxiety was 50%. Of the 24 patients with SDS score 50, 17 were outpatients, and the incidence of depression was 42.5%. The incidence of depression in 5 inpatients was 70. The incidence of anxiety and depression was higher than that of outpatients. It indicated that there was a higher incidence of anxiety / depression in patients with myasthenia gravis. It is worthy of attention by clinicians. There is a significant difference between the scores of SASN SDS and normal data in China. There is a positive correlation between the scores of SASN SDS and normal data in China, and the correlation coefficient is 0.695. In the related factor analysis, the occurrence of anxiety or depression is closely related to the degree of understanding of their own disease, but with gender. There was no significant correlation between education level and economic situation. In clinical data, patients with more frequent hospitalization were prone to anxiety. The incidence of depression was significantly related to the course of disease and the number of hospitalizations. According to the criteria of syndrome differentiation, 27 cases (54%) had deficiency of spleen and stomach qi in 50 cases of myasthenia gravis. There were 15 cases with deficiency of spleen and kidney yang, accounting for 30 cases. There were 8 cases of liver and kidney deficiency, accounting for 16 cases, among which, the incidence of liver and kidney deficiency and anxiety. There is a significant correlation between spleen and kidney yang deficiency syndrome and the incidence of depression. This study analyzed the correlation between TCM syndromes and anxiety / depression. To provide guidance for clinical treatment of myasthenia gravis with anxiety and depression.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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