支气管哮喘合并抑郁情况及其中医分型研究

发布时间：2018-05-25 07:05

本文选题：支气管哮喘 + 支气管哮喘合并抑郁　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:研究支气管哮喘合并抑郁情况及其中医分型,为临床进一步认识及治疗支气管哮喘合并抑郁提供理论依据。方法:收集2016年1月至2016年12月在新疆医科大学第一附属医院、新疆医科大学第四附属医院就诊的支气管哮喘患者409例,在经过患者同意后,对患者进行支气管哮喘合并抑郁调查表、SDS抑郁自评量表及汉密尔顿抑郁量表调查,经副高级及以上中医医师诊断后进行中医辨证分型,利用统计软件分析支气管哮喘患者合并抑郁情况及其中医证型特点。结果:1)409例支气管哮喘患者中共有282例患者合并抑郁占68.9%,其中轻度抑郁患者195例占69.1%,中度抑郁患者53例占18.8%,重度抑郁患者34例占12.1%;2)对支气管哮喘患者进行辨证论治后得出409例患者中肾虚痰瘀型患者145例占35.5%,风痰哮型患者137例占33.5%,冷哮型患者85例占20.8%,热哮型患者42例占10.3%;3)支气管哮喘合并抑郁患者282例,其中肾虚痰瘀型患者124例占44.0%,风痰哮型患者82例占29.1%,冷哮型患者57例占20.2%,热哮型患者19例占6.7%;4)利用统计学软件分析282例支气管哮喘合并抑郁患者的中医证型在一般资料(性别、年龄、民族、生活习惯)、临床表现(发病季节、主要症状)以及抑郁程度、哮喘控制程度中的差异性,结果发现中医证型在患者性别中的比较无差异,结果无统计学意义(P0.05),中医证型在患者民族、生活习惯等因素中的比较均没有明显的差异,结果无统计学意义(P0.05),中医证型在患者年龄分布中的对比有明显差异,结果有统计学意义(X~2=27.724,P0.05);中医证型在发病季节中的比较有明显的差异,结果有统计学意义(X~2=25.744,P0.05);分别比较中医证型在患者的临床症状(咳嗽、气喘、胸痛、夜间气憋,失眠情况)中的差异,结果没有明显差异,无统计学意义(P0.05);中医证型在患者的抑郁程度中的对比无差异,结果无统计学意义(P0.05);中医证型在哮喘的控制程度中的对比有明显差异,结果有统计学意义(X~2=8.426,P0.05)。结论:1)支气管哮喘患者常伴有抑郁;2)对支气管哮喘患者进行中医分型后发现患者所有证型中都伴有“肝郁”的情况,而肝郁的程度与患者的病程长短以及病情的严重程度密切相关,故在支气管哮喘的治疗过程中除了予以解痉平喘、宣肺化痰等治疗外应予以疏肝解郁结合干预治疗;3)支气管哮喘合并抑郁患者的所有中医分型中也常伴有“肝郁”,肝郁程度以及辨证分型结果与患者的病情严重程度、年龄及发病季节关系密切。
[Abstract]:Objective: to study the status of asthma combined with depression and its TCM classification, and to provide theoretical basis for further understanding and treatment of asthma with depression. Methods: from January 2016 to December 2016, 409 patients with bronchial asthma were collected from the first affiliated Hospital of Xinjiang Medical University and the fourth affiliated Hospital of Xinjiang Medical University. Self-rating SDS Depression scale and Hamilton Depression scale were used to investigate the patients with bronchial asthma and depression. Statistical software was used to analyze the depression in bronchial asthma patients and the characteristics of TCM syndromes. Results out of 409 cases of bronchial asthma, 282 cases were complicated with depression, including 195 cases of mild depression (69.1%), 53 cases of moderate depression (18.8%) and 34 cases of severe depression (12.1g / 2). The results showed that 145 of 409 patients had kidney deficiency and phlegm stasis, 137 were wind and phlegm asthma, 85 were cold asthma, 42 were heat asthma, and 282 were bronchial asthma complicated with depression. 124 patients with kidney deficiency and phlegm stasis, 82 with wind and phlegm asthma, 57 with cold asthma and 19 with heat asthma were analyzed by statistical software. Age, nationality, living habits, clinical manifestations (onset season, main symptoms), depression and asthma control degree were different. The results showed that there was no difference in TCM syndromes in patients' sex. Results there was no significant difference in the difference of TCM syndromes in the factors of patients' nationality and living habits, but there was no significant difference in the difference of TCM syndromes in the distribution of patients' age, the results showed that there was no significant difference in the distribution of TCM syndromes in the age distribution of the patients, and there was no significant difference in the differences between the TCM syndromes and other factors. Results there were significant differences in the clinical symptoms (cough, asthma, chest pain, nocturnal choke) of the TCM syndromes in the patients, and there were significant differences in the types of TCM syndromes in the onset season, the results were statistically significant, the clinical symptoms of TCM syndromes in the patients were compared. There was no significant difference in the results between the two groups. There was no significant difference in the degree of depression in the patients with TCM, but there was no significant difference in the degree of depression of the patients, and there was no significant difference in the control degree of asthma between TCM syndromes and TCM syndromes. The results showed that there was statistical significance (P 0.05). Conclusion (1) Asthma patients are often accompanied by depression. After classifying bronchial asthma patients with traditional Chinese medicine, it is found that all syndrome types of bronchial asthma patients are accompanied by "liver depression". The degree of liver depression is closely related to the duration of the disease and the severity of the patient's condition, so in the treatment of bronchial asthma, in addition to the treatment of spasmolysis and asthma, All TCM types of bronchial asthma complicated with depression should also be accompanied by "liver depression", the degree of liver depression, the result of syndrome differentiation and the severity of the patient's condition. Age and onset season are closely related.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R256.12;R277.7

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