肺癌患者的躯体化症状及与焦虑抑郁的相关性研究

发布时间：2019-04-20 15:51

【摘要】：背景与目的肺癌是一种严重威胁人类健康的恶性肿瘤,其发病率及死亡率近年始终排在全国首位。肺癌患者常伴发焦虑、抑郁等情绪问题,而焦虑抑郁等情绪问题会进一步引发一系列躯体症状。目前,临床上对于肺癌患者的躯体化症状认识不足,相关的临床研究较少,本研究以肿瘤内科患者为研究对象,探究肺癌患者的躯体化症状及其与焦虑、抑郁的相关性分析。方法对符合躯体化症状诊断标准的肺癌患者,用患者健康问卷躯体症状群量表(Patient Health Questionnaire-15,PHQ-15)中文版进行躯体症状统计,用汉密尔顿焦虑他评量表(Hamilton Anxiety Scale,HAMA)和汉密尔顿抑郁他评量表(Hamilton Depression Scale,HAMD)评定焦虑和抑郁状态。计算焦虑或抑郁检出率及不同程度躯体化症状人数,分析躯体化症状与焦虑、抑郁的相关性,统计不同躯体化症状发生频率的分布情况。结果 50例具有躯体化症状的肺癌患者中,存在焦虑抑郁情绪的患者有43例,仅焦虑、仅抑郁及焦虑合并抑郁的患病率分别为10%、10%、66%,其中躯体化症状程度越高,焦虑合并抑郁的检出率越高。躯体化症状与焦虑、抑郁的相关分析显示,PHQ-15总分、PHQ-15阳性症状数目与HAMA得分(r=0.752,P0.001;r=0.710,P0.001)、HAMD得分(r=0.648,P0.001;r=0.618,P0.001)呈显著正相关。具有躯体化症状的肺癌患者临床症状出现频率由高到低依次是疲劳(96%)、虚弱感(88%)、睡眠障碍(84%)、头晕(82%)、肢体或关节疼痛(80%)等;不同性别肺癌患者之间的躯体化症状比较差异无统计学意义(P0.05)。结论具有躯体化症状的肺癌患者焦虑、抑郁常见,躯体化症状与焦虑、抑郁密切相关,此类患者最常见的临床症状为非特异性全身不适症状。
[Abstract]:Background & objective Lung cancer is a kind of malignant tumor which threatens human health seriously. Its morbidity and mortality have been ranked the first in China in recent years. Lung cancer patients often associated with anxiety, depression and other emotional problems, and anxiety and depression and other emotional problems will lead to a series of somatic symptoms. At present, there are few clinical studies on somatization symptoms in patients with lung cancer. In this study, patients with lung cancer were selected as subjects to explore the correlation between somatization symptoms and anxiety and depression in patients with lung cancer. Methods the patients with lung cancer who met the criteria of somatization symptom diagnosis were counted with the Chinese version of the somatosomatic symptom group scale (Patient Health Questionnaire-15,PHQ-15) of the patient health questionnaire, and the Hamilton anxiety Checklist (Hamilton Anxiety Scale,) was used to evaluate the physical symptoms. HAMA) and Hamilton Depression Checklist (Hamilton Depression Scale,HAMD) were used to assess anxiety and depression. The detection rate of anxiety or depression and the number of somatization symptoms in different degrees were calculated. The correlation between somatization symptoms and anxiety and depression was analyzed. The distribution of occurrence frequency of different somatization symptoms was counted. Results among the 50 lung cancer patients with somatization symptoms, 43 patients had anxiety and depression. The prevalence rates of depression and anxiety combined with depression were 10%, 10%, 66% respectively. The higher the degree of somatization symptoms, the higher the degree of somatization symptoms. The higher the prevalence rate of anxiety with depression. The correlation analysis of somatization symptoms with anxiety and depression showed that the total score of PHQ-15, the number of positive symptoms of PHQ-15 and the scores of HAMA (r = 0.752, P0.001) and P0.001), HAMD (r = 0.648, P0.001) were correlated with the scores of HAMA (r = 0.752, P0.001 r = 0.710, P = 0.001, P < 0.01). R = 0. 618, P 0. 001 (P < 0. 001). The frequency of clinical symptoms of lung cancer patients with somatization was fatigue (96%), asthenia (88%), sleep disorders (84%), dizziness (82%), pain of limbs or joints (80%), etc. The frequency of clinical symptoms in patients with somatization was 96%, 88%, 84%, 82% and 80%, respectively. There was no significant difference in somatization symptoms among patients with lung cancer between different sexes (P0.05). Conclusion anxiety and depression are common in lung cancer patients with somatization symptoms. Somatization symptoms are closely related to anxiety and depression. The most common clinical symptoms in these patients are non-specific general discomfort symptoms.
【作者单位】：中国医科大学附属盛京医院第四肿瘤科;
【分类号】：R734.2

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