面部糖皮质激素依赖性皮炎危险因素及发病与情绪变化的相互关系研究

发布时间：2018-04-16 19:43

  本文选题：激素依赖性皮炎 + 危险因素　； 参考：《成都中医药大学》2010年硕士论文

【摘要】：目的： 探讨面部糖皮质激素依赖性皮炎与患者情绪之间的相互影响关系,并分析该病发生、加重、迁延不愈的相关因素；寻找传统中医情志理论与现代心理学的共通处,运用中医辨证论治,将心理疏导与中医药物治疗结合起来,让患者接受治疗,自信治疗,坚持治疗,从而真正达到治愈该病的最终目的。 方法： 采用成组病例-对照设计,回顾性调查方式,对50例依赖性皮炎患者和50例未患依赖性皮炎者进行相关病史问卷调查以及SCL-90症状自评。用Excel2003建立数据库,采用SPSS 13.0完成统计分析。 结果： 1.发病危险因素统计结果： 用药时间(Wald值=9.427,P=0.024,＜0.05)、重叠用药(B=5.547,OR=256.371,P=0.000)是GDD的危险因素。 2.病例组与对照组之间Scl-90评分差异： (1)总分及9项情绪因子均比对照组高,其中强迫症状(Z=-1.953,P=-0.051,)可能与样本量小有关,但该项病例组中位数大于对照组,提示病例组强迫症状略明显于对照组；其他各项情绪因子比较(均P＜0.05)。 (2)扣除年龄影响后,病例组阳性项目数确实高于对照组(P＜0.05) (3)病例组SCL-90情绪症状阳性率高于对照组(x2=14.924,P=O.000)。 (4)病例组躯体化、强迫症状、抑郁、焦虑、敌对、恐怖、精神病性的程度重于对照组(P均＜0.05)。 3.各证型与对照组比较： 气血两燔组人际关系敏感、抑郁、焦虑、敌对、恐怖、精神病性严重于对照组(均P＜0.0125)；血分证焦虑、恐怖症状比对照组较重(均P＜0.0125)。 4网络组SCL-90各情绪因子分明均显高于对照组(均P＜0.025)。 5不同病程与对照组比较： (1)病程T≤1年者比对照组不良情绪躯体化、焦虑、敌对、恐怖重(均P＜0.0167)。 (2)病程T2年者比对照组强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、精神病性重(P值均＜0.0167)。 6.病例组内比较： (1)不同来源病例中医证型分布相同(P均＞0.05)。 (2)各证型之间情绪症状相同(P均＞0.0083)。 (3)网络患者比门诊患者的9项情绪因子分均高(P＜0.05)。 (4)病程与SCL-90各项评分无线性相关(P＞0.05)。T≤1年、T2分别与1年＜T≤2年比较,差异均反映在焦虑情况上,均比1年＜T≤2年者明显(均P＜0.0167)。 结论： 1用药时间和重叠用药是GDD发病危险因素。 2 GDD患者在情绪变化上比非GDD人群更显著。 3中医辨证体系对情绪异常的认识与患者临床上所表现出的相符合。 4网络患者的情绪变化更重。 5病程与情绪无直线相关关系,但急性发病、久病者的不良情绪明显严重。
[Abstract]:Objective:To explore the relationship between facial glucocorticoid dependent dermatitis and patients' emotions, and to analyze the related factors of occurrence, aggravation and immortality of the disease, and to find common ground between traditional Chinese medicine emotional theory and modern psychology.Using TCM syndrome differentiation and treatment, the psychological dredging and traditional Chinese medicine treatment are combined to make patients accept treatment, self-confident treatment, insist treatment, so as to truly achieve the ultimate goal of curing the disease.Methods:A case-control design was used to investigate 50 patients with dependent dermatitis and 50 patients with non-dependent dermatitis by questionnaire survey and self-evaluation of SCL-90 symptoms.Excel2003 was used to establish database and SPSS 13.0 was used to complete statistical analysis.Results:1.Statistical results of risk factors:The time of drug use was 9.427m, 0.024, < 0.05U, and the superimposed drug was 5.547 (256.371P0.000), which was the risk factor of GDD.2.The difference of Scl-90 score between the case group and the control group:(1) the total score and 9 emotion factors were higher than those in the control group. The obsessive-compulsive symptoms were probably related to the sample size, but the median of the case group was higher than that of the control group, suggesting that the obsessive-compulsive symptom in the case group was slightly more than that in the control group.Other emotional factors were compared (all P < 0.05).(2) after deducting the influence of age, the number of positive items in the case group was indeed higher than that in the control group (P < 0.05).3) the positive rate of SCL-90 emotional symptoms in the case group was higher than that in the control group.4) somatization, obsessive-compulsive symptoms, depression, anxiety, hostility, phobia and psychosis in the case group were more severe than those in the control group (P < 0.05).3.Compared with the control group, each syndrome type:The sensitivity of interpersonal relationship, depression, anxiety, hostility, phobia and psychosis in Qi-blood two burnt group were more serious than those in control group (all P < 0.0125, P < 0.0125), and the anxiety and phobic symptoms in blood differentiation syndrome were more serious than those in control group (all P < 0.0125).4 SCL-90 emotional factors in the network group were significantly higher than those in the control group (P < 0.025).5Compared with control group in different course of disease.The course of disease T 鈮，

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