紧张型头痛中医证型与述情障碍的相关性研究

发布时间：2018-07-24 13:37

【摘要】：目的:通过了解紧张型头痛与述情障碍的关系,在此基础上进一步探讨紧张型头痛中医证型与述情障碍的相关性,为临床上中医药治疗紧张型头痛提供一定的辨证客观依据,开拓中医药在紧张型头痛防治中的新思路。方法:依据2004年《国际头痛分类(第二版)》(ICHD-Ⅱ)的诊断标准,纳入2016例紧张型头痛患者进行本课题研究,并参照《中医内科学》中头痛证候诊断标准进行辨证分型,主要辨证为肝阳头痛、痰浊头痛、肾虚头痛、瘀血头痛、血虚头痛及导师的辨证经验辨证为肝郁痰凝头痛六种头痛证型。入组的每例紧张型头痛患者均给予多伦多述情障碍量表评分、汉密顿焦虑量表以及汉密顿抑郁量表评分。将患者的基本信息及量表评分等数据收集后选用spss18.0软件进行统计分析,计量资料选用x±s表示,计数资料选用百分数表示,论文中出现的全部检验为双侧检验,认为p0.05有统计学意义。本文采用的统计方法有描述性统计、卡方检验、Spearman相关分析(数据不服从正态分布)或皮尔森相关分析(数据服从正态分布)。结果:1一般人口学资料,患者平均病程为4.01年,紧张型头痛患者性别分布在各年龄段无明显的差异(p=0.1990.05),均以女性为多;脑力劳动者发生述情障碍的比率较体力劳动及混合型劳动者高;文化程度越高,发生述情障碍的比率越高。2述情障碍的总发生率为64.8%,焦虑的总发生率为40.3%,抑郁的总发生率为70.4%。每种中医证型中述情障碍的发生率如下:肝郁痰凝头痛85.3%,血瘀头痛74.3%,痰浊头痛70%,肾虚头痛40%,血虚头46.3%,肝阳头痛36.8%,不同证型之间述情障碍的发生率,差异有统计学意义(p=0.0010.05)。3紧张型头痛患者中医证型与述情障碍总分之间存在相关性,r=-0.436,p=0.0010.05,有统计学意义。4紧张型头痛患者述情障碍总分与焦虑总分之间无相关性,r=-0.026,p=0.7010.05,无统计学意义;紧张型头痛患者述情障碍评分与抑郁评分之间存在正相关性,r=0.950,p=0.0010.05,有统计学意义。5头痛各中医证型述情障碍得分与焦虑得分经相关性分析,其相关系数及p值分别如下:肝郁痰凝头痛r=0.08,p=0.493;痰浊头痛r=-0.233,p=0.274;血瘀头痛r=-0.057,p=0.744;肾虚头痛r=-0.254,p=0.280;血虚头痛r=-0.007,p=0.953;肝阳头痛r=0.137,p=0.575;p值均大于0.05,表明各证型中述情障碍得分与焦虑得分之间无相关性;头痛各中医证型述情障碍得分与抑郁得分经相关性分析,其相关系数及p值分别如下:肝郁痰凝头痛r=0.906,p=0.001;痰浊头痛r=0.986,p=0.001;血瘀头痛r=0.973,p=0.001;肾虚头痛r=0.962,p=0.0001;血虚头痛r=0.917,p=0.001;肝阳头痛r=0.881,p=0.001;p值均小于0.05,相关性系数为正值,表明各证型中述情障碍得分与抑郁得分之间存在正相关性。结论:1紧张型头痛的中医证型与述情障碍总分之间存在相关性,证型按照肝阳头痛、肾虚头痛、血虚头痛、痰浊头痛、血瘀头痛、肝郁痰凝型头痛的顺序,述情障碍总分呈逐渐增高的趋势。2述情障碍在紧张型头痛各种中医证型中的发生率存在显著差异,其中以肝郁痰凝型头痛述情障碍的发生率最高,其他证型的发生率依次为血瘀头痛、痰浊头痛、肾虚头痛、血虚头痛、肝阳头痛。因而可知,从病机方面可以得出郁与痰的相互交结、痰浊、瘀血在紧张型头痛患者述情障碍发生的过程中起着重要的作用,在治疗中可注重解郁化痰、化痰降浊、活血化瘀等治法的应用。3紧张型头痛患者述情障碍总分与抑郁量表总分存在正相关性,即紧张型头痛患者随着述情障碍量表总分的增高,其抑郁量表总分也随之升高;而其与焦虑量表总分无相关性。在紧张型头痛的中医各种辨证分型中,患者述情障碍量表总分与焦虑量表总分仍无相关性。述情障碍量表总分与抑郁量表总分仍存在正相关性,即紧张型头痛患者随着述情障碍量表总分的增高,其抑郁量表总分也随之增高。因此可知,心理精神因素,尤其是抑郁在述情障碍产生过程中起着重要的作用。4述情障碍在紧张性头痛各种证型中的发生率及总分存在显著差异,因此可将述情障碍作为紧张型头痛中医辨证的客观指标,尤其为紧张型头痛的中医辨证分型提供了理论基础。
[Abstract]:Objective: To explore the relationship between tension type headache and alexithymia, and to further explore the correlation between TCM syndrome type and alexithymia of tension type headache, to provide a certain objective basis for clinical traditional Chinese medicine to treat tension type headache, and to explore new ideas of TCM in the prevention and control of tension type headache. Method: according to 2004 < country. The diagnostic criteria for the classification of headaches (Second Edition) (ICHD- II) were included in the study of 2016 patients with tension type headache, and according to the diagnosis standard of the headache syndrome in the medicine of traditional Chinese medicine, the main syndrome differentiation was liver Yang headache, phlegm headache, kidney deficiency headache, blood stasis headache, blood asthenia headache and syndrome differentiation of tutor's syndrome differentiation for liver depression Six kinds of headache syndrome types of phlegm, headache and headache were given in each group. The Toronto Alexithymia Scale score, Hamilton Anxiety Scale and Hamilton Depression Scale score were given. The data of basic information and scale score of patients were collected and analyzed with SPSS18.0 software, and the measurement data were x + s and counted. The total test in this paper was a bilateral test. The statistical methods used in this paper were statistically significant. The statistical methods used in this paper were descriptive statistics, chi square test, Spearman correlation analysis (data disobeying normal distribution) or Pearson correlation analysis (the data were subject to normal distribution). Results: 1 General demographic data, patients were flat. The duration of the disease was 4.01 years. There was no significant difference in gender distribution in all age groups (p=0.1990.05). All of them were more women. The rate of alexithymia in mental workers was higher than that of manual labor and mixed type workers. The higher the cultural degree, the higher the rate of alexithymia, the total incidence of.2 alexithymia was 64.8%. The total incidence rate was 40.3%, the total incidence of depression was 70.4%., the incidence of alexithymia in each type of TCM syndrome was as follows: Liver Depression phlegm coagulating headache 85.3%, blood stasis headache 74.3%, phlegm headache 70%, kidney asthenia headache 40%, blood asthenia head 46.3%, liver Yang headache 36.8%, different syndrome types between different syndromes, the difference was statistically significant (p=0.0010.05).3 tight There was a correlation between the TCM syndrome type and the total score of alexithymia, r=-0.436, p=0.0010.05. There was no correlation between the total score of alexithymia and the total score of anxiety in.4 patients with tension type headache, r=-0.026, p=0.7010.05, no statistical significance; there was a positive correlation between the alexithymia score and the depression score of the patients with tension type head pain. The correlation coefficient and P value of the TCM syndrome type alexithymia score and anxiety score of different TCM Syndrome Types in.5 were statistically significant as follows: Liver Depression phlegm coagulation headache r=0.08, p=0.493, phlegm headache r=-0.233, p=0.274, blood stasis headache r=-0.057, p=0.744, kidney asthenia headache r=-0.254, p=0.280; blood asthenia headache, headache, respectively,.5 .953, liver Yang headache r=0.137, p=0.575 and P value were more than 0.05, indicating that there was no correlation between the scores of alexithymia and anxiety scores in each type of syndrome; the correlation coefficient and P value of the scores of the TCM syndrome type alexithymia and the depression score were as follows: Liver Depression phlegm coagulating headache r=0.906, p=0.001; phlegm headache r=0.986, p=0.001; blood stasis Headache r=0.973, p=0.001; kidney deficiency headache r=0.962, p=0.0001; blood asthenia headache r=0.917, p=0.001; Liver Yang headache r=0.881, p=0.001; P values are less than 0.05, correlation coefficient is positive value, indicating that there is a positive correlation between the scores of alexithymia and depression scores in each syndrome. Conclusion: there exists between the TCM syndrome type of 1 tension type headache and the total score of alexithymia. Correlation, in accordance with the liver Yang headache, kidney deficiency headache, blood asthenia headache, phlegm headache, blood stasis headache, liver depression and phlegm coagulating type headache, the total score of alexithymia is increasing gradually. The incidence of.2 alexithymia in various TCM syndrome types of tension type headache is significantly different, among which the incidence of headache and alexithymia of liver depression and phlegm type is the incidence of headache and alexithymia The occurrence rate of other syndrome types is blood stasis headache, phlegm headache, kidney deficiency headache, blood deficiency headache, liver Yang headache. Therefore, it can be found that the mutual connection between depression and phlegm, phlegm and blood stasis play an important role in the process of alexithymia in patients with tension type headache from the pathogenesis of the disease, and the treatment may pay attention to the solution of phlegm and phlegm in the treatment. The general score of alexithymia in patients with tension type headache was positively correlated with the total score of the depression scale, that is, with the increase of the total score of the alexithymia, the total score of the depression scale also increased with the increase of the total score of the depression scale in the patients with tension type headache, and there was no correlation between the total score of the depression scale and the total score of the anxiety scale. Various syndromes in the Chinese medicine of tension type headache were found in.3. There was no correlation between the total score of the patient's Alexithymia Scale and the total score of the anxiety scale. The total score of the alexithymia and the total score of the depression scale remained positive, that is, the total score of the tension type headache patients with the total score of the alexithymia was increased, and the total score of the depression scale was also increased. The incidence and total score of.4 alexithymia in the various syndromes of tension headache are significant differences. Therefore, alexithymia can be used as an objective index of TCM Syndrome Differentiation for tension type headache, especially for the TCM syndrome differentiation of tension type headache.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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