抑郁、焦虑与精神分裂症患者共情能力及中医证候的差异性研究

发布时间：2018-04-22 09:25

本文选题：共情 + 焦虑症　；参考：《北京中医药大学》2017年硕士论文

【摘要】：研究目的:选取抑郁、焦虑症各30名患者,分别对两类患者各自进行证候及共情评估,探析两种疾病的中医证候与共情的关联性,并与前期精神分裂症患者进行共情及中医证型的差异性研究。研究方法:1.本研究以中医症状入手,依据《中医诊断学》相关内容,制定了中医证候观察评分表,同时运用国内与国外合作翻译的八种共情量表,分别对抑郁、焦虑症患者进行共情能力及中医证候评估。2.以纸质版量表为病例收集工具,病例所有资料来源于2016年01月至2017年01月,安定医院及北京中医药大学第三附属医院脑病科的门诊病人。3.运用SPSS软件,采用相关统计学方法,分别对抑郁、焦虑症患者的中医证候观察表及共情指数量表(EQ Empathy Quotient)、过度竞争性态度量表(HCA Hypercompetitive Attitude Scale)、自闭症谱系量表(AQ The Autism-spectrum Quotient)、自我建构量表(SCS Self-Construction Scale)、人际反应指数量表(IRI Interpersonal Reactivity Index)、伯克利情绪表达量表(BEQ Berkeley Expressivity Questionnaire)、情绪调节量表(ERQ Emotion Regulation Questionnaire)及多伦多述情障碍量表(TAS Toronto AlexithymiaScale)八种量表进行评估,并探讨共情能力与中医证候的内在相关性。并依据两类患者的研究结果分别与前期业已得出的精神分裂症的成果,三者之间进行证候及共情能力的差异性对比。研究结果:1.抑郁症组共纳入30例,男性为17例,女性13例,男女比例约为1.3:1,年龄平均为35.4±9.48,最小为22岁,最大为54岁;焦虑症组共纳入30例患者中,男性为17例,女性13例,男女比例约为1.3:1,年龄平均为33.93± 10.70,最小为18岁,最大为64岁;正常组共纳入34例,男性为30例,女性4例,男女比例约为7.5:1,年龄平均为33.91±9.52,最小为18岁,最大为56岁。2.通过对抑郁、焦虑患者各自中医证候观察表评分发现:抑郁症组主要证型为肝气郁结,心(阴)血虚,肝火炽盛,心(阳)气虚;焦虑症患者主要证型为肝气郁结,心(阴)血虚,胆郁痰扰,肝火炽盛。3.抑郁、焦虑症患者与正常组之间的共情量表分值研究结果如下:两组患者F1(难以识别自己的情感)因子分数高于正常组,差异具有统计学意义(P0.05),提示两类患者对自己的情感难以识别,且两组患者F2(难以描述自己的情感)因子分数低于正常组,差异具有统计学意义(P0.05),说明两类患者描述自身情感方面存在缺陷;两组患者表达抑制因子分数低于正常组,差异均具有统计学意义(P0.05),说明两类患者较正常人更易因难以表达情绪,而产生较强的主观情绪体验;两组患者注意力因子(AS)评分低于正常组,差异具有统计学意义(P0.05),说明两类患者在注意力集中及转换能力方面较差。此外,焦虑症组患者个体忧伤(PD)及量表中负向因子(PD+FS)总分,均高于正常组,差异具有统计学意义(P0.05),说明焦虑症患者,面对他人所处困境或压力情景时,不能准确地的产生自我内心反应。4.中医证候与共情之间的相关性:抑郁症组:肝火炽盛、胆郁痰扰与PD因子存在相关性;痰证与STR因子存在相关性,脾胃气虚与Interdependent-self因子存在相关性。焦虑症组:血瘀及肝气郁结证型与PD因子及FS+PD负向因子均存在明显相关性;血瘀型与F1、AD因子与亦存在明显的相关性;肝气郁结与STR存在较强的相关性;肾阴虚与Interdependent-self因子存在相关性;脾气虚、肾阳虚证型与表达抑制因子存在相关性。5.3组患者证型对比结果发现:三种疾病中肝火炽盛、心(阴)血虚型多见;焦虑及精神分裂症中胆郁痰扰型多见;抑郁症心阳气虚型多见,精神分裂症痰证多见。6.3组患者共情量表的差异性结果发现:TAS量表在三种疾病均可见评分异常;ERQ、AQ量表在抑郁、焦虑症均见评分异常;IRI量表在精神分裂、焦虑症中可见评分异常;BEQ量表仅在精神分裂症见评分异常。结论:1.抑郁、焦虑症患者各自存在一定的共情缺陷,两者均涉及难以识别自己的情感、难以描述自己的情感、表达抑制及注意力转换等方面;此外,焦虑患者在个体忧伤及个体忧伤与幻想因子两方面存在共情缺陷。2.抑郁症主要证型为肝气郁结,心(阴)血虚,肝火炽盛,心(阳)气虚;焦虑症为肝气郁结,心(阴)血虚,胆郁痰扰,肝火炽盛。3.抑郁症患者:偏于扩大自身痛苦的患者,可尝试从清肝利胆,泻火化痰法治疗;情绪表达强度较强的患者,可尝试从痰论治;对他人及朋友依赖较强的患者,可尝试从补益脾胃治疗。焦虑症患者:易于扩大自身痛苦患者,可尝试用疏肝解郁,活血化瘀治疗;难于识别自身情感及细节注意力较差的患者,可尝试从活血化瘀论治;易产生主观情绪体验的患者,可尝试从补脾益肾治疗;对外界环境依赖性较强的患者,可尝试从补肾育阴治疗。4.抑郁、焦虑与精神分裂症患者肝火炽盛、心(阴)血虚型多见;焦虑及精神分裂症胆郁痰扰型多见;抑郁症心阳气虚型多见,精神分裂症痰证多见。5.TAS可用于抑郁、焦虑及精神分裂症的量表评定;ERQ、AQ量表可用于抑郁、焦虑症的评判;IRI量表适用于精神分裂、焦虑症的评估;BEQ量表仅用于精神分裂症的量表测评。
[Abstract]:Objective: to select 30 patients with depression and anxiety, each of the two types of patients, respectively, to carry out their respective syndromes and empathy, to explore the correlation between the TCM syndromes and empathy of the two diseases, and to study the difference between the empathy and the TCM syndrome type in the early schizophrenic patients. The research methods: 1. studies are based on the TCM symptoms and according to the TCM syndrome. Diagnostics > related contents, formulating the scale of TCM syndrome observation, at the same time using eight empathy scales translated by domestic and foreign cooperation, the empathy and TCM syndrome assessment of patients with depression, anxiety, and TCM syndrome.2. are used as a case collection tool. The data from 01 months to 01 months of 2017 from 2016 to 01 months in 2017 .3., the Third Affiliated Hospital of Beijing University of Chinese Medicine, used SPSS software in the outpatient department of the Department of encephalopathy in the Third Affiliated Hospital of the hospital. The related statistical methods were used to observe the TCM syndromes and the empathy index scale (EQ Empathy Quotient), the excessive competitive attitude scale (HCA Hypercompetitive Attitude Scale), and the autism spectrum of the patients with depression and anxiety. The AQ The Autism-spectrum Quotient, the self construction scale (SCS Self-Construction Scale), the interpersonal response index scale (IRI Interpersonal Reactivity Index), the Berkeley emotional expression scale, the emotion regulation scale and the Toronto alexithymia The eight scales of TAS Toronto AlexithymiaScale were evaluated, and the intrinsic correlation between the empathy ability and TCM syndromes was discussed. The results of the schizophrenia in the two types of patients were compared with the previous results of schizophrenia, and the differences in the syndrome and empathy between the three were compared. The results of the study were included in the 1. depression group, 3 In 0 cases, there were 17 males and 13 females, the average age of men and women was about 1.3:1, the average age was 35.4 + 9.48, the minimum was 22, and the maximum was 54 years old. Among the 30 patients, the anxiety group had 17 men and 13 women, the male and female ratio was about 1.3:1, the average age was 33.93 + 10.70, the smallest was 18 years and the largest was 64. In 4 women, the proportion of men and women was about 7.5:1, the average age was 33.91 + 9.52, the youngest was 18 years old and the maximum was 56 years old.2.. The main syndrome types of depression group were liver qi stagnation, heart (Yin) blood deficiency, liver fire flaming, heart (Yang) Qi deficiency, and the main syndromes of anxiety patients were liver qi depression, heart (Yin) blood. Deficiency, cholera phlegm disturbance, liver fire and.3. depression, the results of the empathy scale between the patients with anxiety and the normal group are as follows: two groups of patients F1 (difficult to identify their own emotion) scores are higher than the normal group, the difference is statistically significant (P0.05), suggesting that the two types of patients are difficult to identify their own emotions, and the two groups of patients F2 (difficult to describe) The factor scores of their own emotions were lower than those of the normal group, the difference was statistically significant (P0.05), indicating that the two types of patients described their own emotional defects, and the two groups were lower than the normal group, and the difference was statistically significant (P0.05), indicating that the two types of patients were more likely to be more difficult to express their emotions than the normal ones. The two groups of patients' attention factor (AS) score was lower than the normal group, the difference was statistically significant (P0.05), indicating that the concentration and conversion ability of the two types of patients were poor. In addition, the individual sadness (PD) and the total score of negative factor (PD+FS) in the scale of the anxiety group were higher than those in the normal group, and the difference was statistically significant. (P0.05), indicating that patients with anxiety disorders, in the face of the predicament or stress situation of others, can not accurately produce the correlation between.4. syndrome and empathy: depression group: liver fire, cholera phlegm disturbance and PD factor correlation; phlegm syndrome and STR factor correlation, spleen and stomach qi deficiency and Interdependent-self factor There was a significant correlation between the syndrome of blood stasis and the syndrome of liver Qi Stagnation with PD factor and FS+PD negative factor; blood stasis type and F1, AD factor also have obvious correlation; liver qi stagnation and STR have strong correlation; kidney yin deficiency and Interdependent-self cause the correlation; spleen qi deficiency, kidney yang deficiency syndrome type and expression inhibition The result of the correlation of the.5.3 group with the related factors found that the liver fire was flourishing and the heart (Yin) blood deficiency was more common in the three diseases; the anxiety and schizophrenia were most common in the cholera phlegm disturbance type; the depression of the heart yang deficiency type was more common, the schizophrenia phlegm syndrome was found in the.6.3 group and the difference results of the empathy scale of the group were found: the TAS scale was all in the three diseases. The score abnormality was seen in the ERQ and AQ scales in the depression and anxiety disorder; the IRI scale in schizophrenia and anxiety showed a score abnormality; the BEQ scale was only in the schizophrenia score abnormality. Conclusion: 1. the patients with depression and anxiety have some empathy, both of which are difficult to identify their own emotions and are difficult to describe themselves. In addition, the main syndromes of.2. depression in anxiety patients and individual melancholy and individual melancholy and fantasy factor two were liver qi stagnation, heart (Yin) blood deficiency, liver fire blaming, heart (Yang) Qi deficiency, anxiety disorder for liver qi stagnation, heart (Yin) blood deficiency, cholera phlegm disturbance and liver fire blowing.3. depression. Patients who are inclined to enlarge their own pain can try to treat them from liver clearing and diarrhea and cremation and phlegm therapy; the patients with strong emotional expression can try to treat them from phlegm, and can try to treat the patients who have strong dependence on others and their friends. The patients who are difficult to identify their own feelings and the poor attention in detail can try to treat the patients from activating blood and removing blood stasis. The patients who are prone to subjective emotional experience can try to treat the spleen and kidney and benefit the kidney. The patients with strong external environment dependence can try to treat.4. depression, anxiety and schizophrenia patients' liver fire, heart (Yin) and heart (Yin). Blood deficiency type is common; anxiety and schizophrenia cholera phlegm type is common; depression heart yang deficiency syndrome is more common, schizophrenia phlegm syndrome can be used to evaluate depression, anxiety and schizophrenia; ERQ, AQ scale can be used for the evaluation of depression and anxiety; IRI scale is suitable for schizophrenia, anxiety assessment; BEQ scale is only used in the BEQ scale. A scale assessment of schizophrenia.

【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】：2017
【分类号】：R277.7

【参考文献】