319例肺癌患者合并抑郁情况分析及中医辨证分型特点研究

发布时间：2018-05-21 17:14

本文选题：肺癌 + 抑郁　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨肺癌患者临床合并抑郁的情况及影响因素,分析肺癌相关性抑郁的中医辨证分型特点,为临床更好的认识、治疗肺癌相关性抑郁提供参考及依据。方法:收集2016年1月-2016年7月来自新疆医科大学附属肿瘤医院、新疆医科大学附属中医医院住院的肺癌患者319例,进行一般状况评价表、自制中医症候表、24项汉密尔顿抑郁量表(Hamilton)、抑郁自评量表(SDS)评分,将采集后信息输入数据库,利用统计分析软件对合并抑郁情况、中医辨证分型特点进行分析研究。结果:1.319例肺癌患者中,262例患者合并抑郁,抑郁发生率为82.0%;2.262例抑郁患者中,轻度、中度、重度抑郁患者分别为126例、114例、22例,分别占百分比为39%、36%、7%;3.病程、病理分期、是否转移、文化程度与抑郁无明显统计学意义(P0.05),疼痛与抑郁有统计学意义(P0.05),且随着抑郁程度的加重,疼痛比例明显上升,差异具有统计学意义(P0.05);4.肺癌合并抑郁中医证素有14种,病性证素以痰(23.0%)、阴虚(22.3%)、气虚(16.0%)、瘀(15.0%)为主,病位证素以肺(47.0%)、脾(20%)、肾(16%)、肝(15.5%)为主,轻中度抑郁患者中,气阴两虚证为67例,占34.1%,痰瘀互阻证40例,占20.4%,痰湿蕴肺34证例,占17.3%;重度抑郁中,痰瘀互阻12例,占54.5%;84例合并疼痛的抑郁患者中,痰瘀互阻证31例,占36.9%,气阴两虚22例,占26.2%。结论:1.肺癌患者临床多伴有抑郁;2.不同程度的抑郁可贯穿肺癌发生、发展的全过程,与病程的长短、病理类型的不同、文化程度的差异、是否转移无明显关系,伴有疼痛的肺癌患者更易合并抑郁,且重度抑郁中,合并疼痛的患者多见;3.肺癌合并抑郁患者中以气阴两虚证、痰瘀互阻证多见,重度抑郁、合并有疼痛的抑郁患者以痰瘀互阻证多见,痰、瘀、虚、郁、痛在肺癌的发生、发展过程中多同时存在,且常互为因果,并易相互转化、相互影响;4.临床要多关注肺癌患者合并的抑郁情况,不仅要从传统的角度治痰、治瘀、治虚,同时要以治郁、治痛并重,不仅要以补虚化痰去瘀为法,还要以解郁舒络止痛为要,进行综合干预。
[Abstract]:Objective: to explore the clinical status and influencing factors of lung cancer patients with depression, analyze the characteristics of TCM syndrome differentiation of lung cancer associated depression, and provide reference and basis for clinical better understanding and treatment of lung cancer associated depression. Methods: from January 2016 to July 2016, 319 lung cancer patients from the affiliated Cancer Hospital of Xinjiang Medical University and the affiliated TCM Hospital of Xinjiang Medical University were collected and evaluated. Twenty-four items of Hamilton Depression scale (Hamilton Depression scale) and self-rating depression scale (SDS) score were made by ourselves. The collected information was input into the database, and the characteristics of syndromes and syndrome differentiation were analyzed and studied by statistical analysis software. Results among 319 lung cancer patients, 262 cases were complicated with depression. The incidence of depression was 82. 0% and 2. 262 cases. There were 126 cases of mild, moderate and severe depressive patients. There were 114 cases (22 cases) of mild, moderate and severe depressive patients, respectively. The percentage of them was 39 36 36 7%. The disease course, pathological stage, metastasis, education level and depression had no significant difference (P 0.05), but pain and depression had statistical significance (P 0.05), and with the severity of depression, the proportion of pain increased significantly, the difference was statistically significant (P 0.05). There are 14 kinds of TCM syndromes of lung cancer combined with depression, there are 14 kinds of TCM syndromes of lung cancer complicated with depression, 23% of them are phlegm, 22.3% of Yin deficiency, 16.0% of Qi deficiency, 15.0% of blood stasis, and 47.0% of lung syndrome. The main symptoms of disease are lung syndrome 47.0%, spleen 20%, kidney 20%, kidney 15. 5). In mild and moderate depression, there are 67 cases with deficiency of qi and yin, accounting for 34 1 points, and 40 cases with phlegm and stasis blocking syndrome. In severe depression, there were 12 cases of phlegm and blood stasis mutual obstruction, accounting for 54.5N 84 cases of depression with pain, 31 cases (36.9%) of phlegm and stasis mutual obstruction syndrome, 22 cases of deficiency of Qi and Yin, 22 cases of deficiency of Qi and Yin, and 26.2B. Conclusion 1. Most patients with lung cancer are associated with depression. Depression of different degrees can run through the whole process of the occurrence and development of lung cancer, and it is not related to the length of the course of disease, the difference of pathological type, the difference of education level, the metastasis of lung cancer, and the patients with pain are more likely to be complicated with depression. Among the patients with severe depression, the patients with pain were more than 3%. In patients with lung cancer combined with depression, qi and yin deficiency syndrome, phlegm and blood stasis mutual obstruction syndrome are more common, severe depression patients with pain and phlegm stasis mutual obstruction syndrome, phlegm, blood stasis, deficiency, depression, pain in the occurrence and development of lung cancer more than at the same time, And often cause and effect each other, and easy to transform each other, influence each other. Clinical attention should be paid to the depression of lung cancer patients, not only from the traditional point of view to treat phlegm, blood stasis, and deficiency, but also to treat depression and pain, not only by reinforcing deficiency and removing phlegm and removing blood stasis, but also by relieving depression and soothing collaterals to relieve pain. Comprehensive intervention.
【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】：R273

【参考文献】