摘要
目的探讨冠心病伴发焦虑、抑郁患者的中医证型分布特点,分析各影响因素与中医证型之间的关系,为此类疾病的规范化诊断和准确辨证用药提供依据。方法收集2018年1月—2019年1月期间在新疆医科大学附属中医医院住院明确诊断为冠心病伴发焦虑、抑郁的患者445例,对其进行临床资料和中医证型信息收集,分析中医证型分布特点与各影响因素的相关性。结果冠心病伴发焦虑、抑郁中医证型的分布由高到低依次为:气滞血瘀(32.1%)>气阴两虚(21.6%)>痰瘀互结(15.3%)>气虚血瘀(12.4%)>痰浊内蕴(7.2%)>心肾阴虚(6.1%)>心肾阳虚(5.4%),不同中医证型的分布在年龄、民族中差异具有统计学意义(P<0.05)。Logistic回归分析显示,气阴两虚证与肥胖、高血压病史、脑血管病史呈正相关,与患者焦虑程度、抑郁程度呈负相关。气滞血瘀证与年龄呈正相关,与患者焦虑程度、抑郁程度呈负相关。痰浊壅阻证与脑血管病史呈正相关,与患者回族和哈族、肥胖、焦虑程度呈负相关。心肾阳虚证与焦虑程度、抑郁程度呈负相关。结论不同中医证型的冠心病伴发焦虑、抑郁患者具有不同的临床分布特点,且各中医证型与影响因素之间具有一定的相关性。
Objective To discuss the distribution characteristics of TCM syndrome in patients with coronary heart disease(CHD) accompanied by anxiety and depression,andanalyze the relationship between various influence factors and TCM syndrome,so as to provide basis for standardized diagnosis and accurate syndrome differentiation and medication. Methods A total of 445 patients with CHD complicated with anxiety and depression were collected from January 2018 to January 2019 in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University. Clinical data and TCM syndrome information were collected,and the correlation between the distribution characteristics of TCM syndrome and various influence factors was analyzed. Results The distribution of TCM syndromes of CHD with anxiety and depression from high to low was as the following: Qi-stagnation and blood stasis( 32. 1%) > Qi and Yin deficiency( 21. 6%) > intermingled phlegm and blood stasis( 15. 3%) > Qi deficiency and blood stasis( 12. 4%) > phlegm accumulation( 7. 2%) > heart and kidney Yin deficiency( 6. 1%)> heart and kidney Yang deficiency( 5. 4%). The distribution of different TCM syndromes was statistically significant in age and nationality( P < 0. 05). Logistic regression analysis showed that Qi and Yin deficiency syndrome was positively correlated with obesity,hypertension history and cerebrovascular disease history,and negatively correlated with anxiety and depression degree of patients. Qi stagnation and blood stasis syndrome was positively correlated with age and negatively correlated with anxiety and depression of patients. Phlegm obstruction syndrome was positively correlated with the history of cerebrovascular diseases,and negatively correlated with the degree of obesity and anxiety of Hui and Kazak patients. Heart and kidney Yang deficiency syndrome was negatively correlated with anxiety and depression. Conclusion Patients with CHD accompanied by anxiety and depression with different TCM syndromes have different clinical distribution characteristics,and there is a certain correlation between each TCM syndrome and influence factors.
作者
苏翔
赵明芬
SU Xiang;ZHAO Mingfen(Traditional Chinese Medicine Department,Xinjiang Bayin Guoyu Mongolian Autonomous Prefecture People's Hospital,Korla 841000,Xinjiang,China;The Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University,Urumqi 830000,Xinjiang,China)
出处
《辽宁中医杂志》
CAS
2021年第5期14-18,共5页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81760883)。
关键词
冠心病
焦虑抑郁
中医证型
影响因素
coronary heart disease
anxiety and depression
syndrome types
influential factors
