糖尿病足合并抑郁状态影响因素的分析及中医证型分布规律的研究

发布时间：2018-05-25 08:48

  本文选题：糖尿病足 + 抑郁　； 参考：《大连医科大学》2016年硕士论文

【摘要】：目的:对比糖尿病足(Diabetic foot,DF)患者与2型糖尿病(Type 2 diabetic mellitus,T2DM)患者的心理状况,调查DF患者抑郁患病率,探究DF合并抑郁患者的影响因素及中医证型的分布规律,为临床论治糖尿病足合并抑郁状态患者提供客观依据。方法:本研究经北京空军总医院伦理委员会审核与批准,根据纳入标准选取2015年3月至2015年11月就诊于空军总医院内分泌科、中医科病区、糖尿病足门诊换药室的DF患者171例,及同期就诊于内分泌科、中医科病区的T2DM患者120例,分别填写症状自评量表(symptom check list-90,SCL-90),根据DF及T2DM患者的心理因子得分情况进行心理状况对比。制定调查表记录171例DF患者的性别、年龄、个人史、家族史及血糖、血脂等指标,运用SPSS l7.0软件对以上数据行因素相关性的统计分析。对其中抑郁单因子得分≥2分的71例DF患者,进行整体和局部(足)中医辨证,根据频数统计结果,探讨DF抑郁患者的整体及局部中医证型分布规律。结果:1.DF患者与T2DM患者相比,躯体化、抑郁、恐怖、精神病性四个因子具有统计学差异(P0.05),DF患者抑郁的患病率为41.52%,T2DM患者抑郁的患病率为27.50%。2.性别、年龄、病程、脂肪肝病史、吸烟史、治疗方式、血糖水平、CRP等指标与DF患者抑郁的发生具有统计学差异(P0.05)。3.DF合并抑郁患者中医辨证以肝气郁结型最多,抑郁因子得分最高,局部(足)中医证型以热盛肉腐型最多,抑郁因子得分最高。肝气郁结证型的DF抑郁患者的局部中医证型中以热盛肉腐型最多。结论:1.DF患者以明显的躯体化障碍为主,易产生抑郁、恐怖、精神病性等消极情绪,且DF患者抑郁的患病率显著高于T2DM患者。2.中老年、女性、糖尿病(Diabetic mellitus,DM)及DF病程长、脂肪肝病史、吸烟史、血糖控制差、联合多种方式控制血糖、局部感染严重、炎症因子较高的DF患者,为抑郁的高发人群。3.肝气郁结证是DF抑郁患者的主要证型,热盛肉腐型是DF抑郁患者局部(足)辨证的主要证型。局部热盛肉腐与肝郁气结有相互的影响关系。
[Abstract]:Objective: to compare the psychological status of type 2 diabetic foot with type 2 diabetes mellitus type 2 diabetic mellitus T2DM, investigate the prevalence of depression in DF patients, explore the influencing factors of DF patients with depression and the distribution of TCM syndromes. To provide objective basis for clinical treatment of diabetic foot patients with depression. Methods: this study was examined and approved by the Ethics Committee of Beijing Air Force General Hospital. According to the inclusion criteria, 171 cases of DF patients were selected from March 2015 to November 2015 in the Department of Endocrinology, the Department of traditional Chinese Medicine, and the Department of Diabetes foot. 120 cases of T2DM in endocrine department and traditional Chinese medicine department were treated at the same time. The symptom checklist (SCL-90) was filled out respectively. The psychological status was compared according to the scores of psychological factors of DF and T2DM patients. Sex, age, personal history, family history, blood sugar and blood lipid were recorded in 171 DF patients. The correlation of the above data was analyzed by SPSS L7.0 software. The integral and local TCM syndrome differentiation was performed in 71 cases of DF patients with depression score 鈮，

本文编号：1932822