2型糖尿病肝经郁热证与焦虑抑郁情绪评分的相关性研究

发布时间：2018-01-26 23:22

本文关键词： 2型糖尿病肝经郁热证焦虑抑郁　出处：《北京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：背景：2型糖尿病(type 2 diabetes mellitus, T2DM)是因为胰岛素分泌的绝对或相对不足而导致的代谢性疾病,同时又是一种身心疾病。国内外诸多研究发现2型糖尿病与焦虑抑郁不良情绪之间关系密切。中医认为“肝主疏泄,调畅情志”,情志不遂易引起肝气郁滞,肝气不舒会导致情志失调。糖尿病的基本病机是内热伤阴、壮火食气、瘀血阻络。肝郁化火而耗气伤阴,加速糖尿病进程。临床上2型糖尿病多见肝经郁热证,而对于2型糖尿病中肝经郁热证与焦虑抑郁情绪的具体关系却缺乏相关研究。研究目的：通过2型糖尿病肝经郁热证与气阴两虚证的对比研究,以期能够找到2型糖尿病肝经郁热证与焦虑抑郁情绪的相关性,肝经郁热证与糖尿病并发症及伴发疾病的关系。从而为肝经郁热证的临床辩证和糖尿病情绪障碍的临床治疗提供科学依据。研究方法：选取2015年至2016年东直门医院门诊及病房的2型糖尿病肝经郁热证、气阴两虚证患者,分为两组进行对比研究。收集一般资料、证候积分资料,填写Zung氏焦虑抑郁自评量表,用SPSS 17.0统计软件进行数据分析。计量资料先进行正态检验：其中符合正态分布的数据采用独立样本t检验比较两组间的差异；不符合正态分布的数据采用Mann-Whitney U检验比较两组间的差异。计数资料采用卡方检验比较两组间差异。两组病例的年龄、BMI分层比较以及焦虑抑郁分级比较,均采用Kruskal-Wallis H检验。并采用Spearman相关分析证候积分与情绪评分之间的关系。所有数据均采用双侧检验,α取0.05,P0.05为差异有统计学意义。研究结果：①肝经郁热组抑郁评分(46±6)高于气阴两虚组(33±9),t=6.732,P=0.000。分层比较,肝经郁热组轻度、中度、重度抑郁患者的比例都高于气阴两虚组,X2=25.812,P=0.000。肝经郁热的证候积分与Zung氏抑郁自评量表的评分呈正向直线关系,Spearman相关系数r=0.591,P=0.000。②肝经郁热组焦虑评分(37±6)高于气阴两虚组(31±7),t=3.653,P=0.001。肝经郁热证的证候积分与Zung氏焦虑自评量表的评分呈正向直线关系,Spearman相关系数r=0.458,P=0.000。③肝经郁热组并发糖尿病视网膜病变的比例明显高于气阴两虚组,X2=8.576,P=0.003。④肝经郁热证组伴发高血压的比例明显高于气阴两虚组,X2=4.993,P=0.025。⑤肝经郁热证组伴发高脂血症的比例明显高于气阴两虚组,X2=6.385,P=0.012。结论：①2型糖尿病肝经郁热证患者容易出现焦虑抑郁不良情绪,并且与气阴两虚证的患者相比,其焦虑抑郁的程度较重。②2型糖尿病肝经郁热证的严重程度与焦虑抑郁负性情绪的严重程度呈正向直线相关。③2型糖尿病肝经郁热证患者与气阴两虚证患者相比,更容易并发糖尿病视网膜病变。④2型糖尿病肝经郁热证患者与气阴两虚证患者相比,更容易伴发高血压、高脂血症等疾病。
[Abstract]:Background Type 2 diabetes mellitus type 2 diabetes mellitus (T2DM) is a metabolic disease caused by absolute or relative insufficiency of insulin secretion. At the same time, it is also a physical and mental disease. Many studies at home and abroad found that type 2 diabetes mellitus and anxiety and depression are closely related to bad mood. The basic pathogenesis of diabetes mellitus is internal heat injury of yin, strong fire and food qi, blood stasis blocking collaterals. Liver stagnation and fire dissipate Yin, accelerate the progress of diabetes mellitus. Type 2 diabetes mellitus is more common in liver meridian stagnation and heat syndrome. But for type 2 diabetes mellitus, the specific relationship between liver meridian stagnation heat syndrome and anxiety and depression is lack. Objective: through the type 2 diabetes mellitus liver meridian stagnation heat syndrome and qi and yin deficiency syndrome comparative study. In order to find out the relationship between type 2 diabetes mellitus liver meridian stagnation heat syndrome and anxiety and depression. The relationship between the syndrome of liver meridian and heat stagnation and the complications of diabetes mellitus and the associated diseases, thus providing the scientific basis for the clinical dialectical of liver meridian and heat stagnation syndrome and the clinical treatment of diabetic emotional disorder. The research methods are as follows:. From 2015 to 2016 in Dongzhimen Hospital, type 2 diabetes mellitus with liver stagnation and heat syndrome was selected from outpatient and ward of Dongzhimen Hospital. The patients with deficiency of qi and yin were divided into two groups for comparative study. The general data and syndromes integral data were collected and Zung's anxiety and depression self-rating scale was filled out. The statistical software SPSS 17.0 was used to analyze the data. The measurement data were tested by normal test. The difference between the two groups was compared by independent sample t test for the data in accordance with normal distribution. Mann-Whitney U test was used to compare the difference between the two groups. The counting data were compared by chi-square test. The age of the two groups was compared. BMI stratification and anxiety and depression grades were compared. Kruskal-Wallis H test was used, and Spearman correlation analysis was used to analyze the relationship between syndrome score and emotion score. All data were tested by bilateral test. Results the depression score of 1% 1 liver meridian and heat stagnation group (46 卤6) was higher than that of Qi and Yin deficiency group (33 卤9). The proportion of mild, moderate and severe depression in liver meridian stagnation group was higher than that in Qi Yin deficiency group. There was a positive linear relationship between the syndrome score of liver meridian stagnation and the score of Zung's self rating Depression scale. The Spearman correlation coefficient was 0. 591. The anxiety score was 37 卤6 in liver meridian stagnation group (P 0.000.2) and 3.653 in Qi and Yin deficiency group (31 卤7). P0. 001.The syndromes score of liver meridian stagnation heat syndrome and the score of Zung's self rating anxiety scale were positively correlated with the Spearman correlation coefficient r0. 458. The rate of diabetic retinopathy in liver meridian stagnation group was significantly higher than that in Qi Yin deficiency group (8.576). The incidence of hypertension in the group of liver meridian stagnation and heat stagnation was significantly higher than that in the group of deficiency of qi and yin. The proportion of hyperlipidemia in liver meridian stagnation syndrome group was significantly higher than that in Qi and Yin deficiency group. Conclusion the patients with liver meridian and heat stagnation syndrome of type 12 diabetes are prone to anxiety and depression, and compared with the patients with deficiency of qi and yin. The degree of anxiety and depression in type 22 diabetes mellitus is more serious. The severity of liver meridian and heat stagnation syndrome is positively related to the severity of negative emotion of anxiety and depression. There is a positive linear correlation between type 32 diabetes mellitus patients with liver meridian heat stagnation syndrome and patients with deficiency of qi and yin. Compared to. The patients with type 42 diabetic liver meridian and heat stagnation syndrome were more easily complicated with hypertension and hyperlipidemia than those with deficiency of qi and yin.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259;R277.7

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