社区老年抑郁症患者中医体质与辨证分型临床特征研究  

Clinical Characteristics of Senile Depression in Elderly Patients with Different Traditional Chinese Medicine Constitution and Syndrome Types in Communities

作　　者：陈定华[1] 张明[1] 瞿正万[1] 江琦[1] 付伟忠[1] 孙喜蓉[1] 

机构地区：[1]上海市浦东新区精神卫生中心,上海200124

出　　处：《安徽中医学院学报》2013年第2期38-41,共4页Journal of Anhui Traditional Chinese Medical College

基　　金：浦东新区卫生系统重点学科建设项目(PWZxk2010-06)

摘　　要：目的研究社区老年抑郁症患者的中医证候学特征临床,为抑郁症的临床治疗和健康保健提供依据。方法采用多阶段随机抽样方法,抽样调查上海市浦东新区5个街镇25个村居委会55岁以上常住人口,筛查老年抑郁症,再对抑郁症患者进行中医体质辨识和辨证分型,考察其中医体质类型、证型、临床分型的关系。结果抽样4 600例,回收有效问卷4 047份,筛查出抑郁症患者519例,其体质类型以气郁质、阳虚质、气虚质最多,分别是122、99、99例,此3类体质占抑郁症总数的61.66%,其次是平和质、阴虚质、血瘀质、痰湿质、湿热质、特禀质,分别为94、37、26、18、17、7例。中医证型以肝郁气滞型最多,为141例,其次是肝郁脾虚型、心脾两虚型、肝肾阴虚型,分别是132、77、59例。结论老年抑郁症多为"情志之郁,因郁而病",初起以气滞气郁为主,多为实证,久则由实转虚,导致脏腑气血阴阳亏虚。Objective To study the clinical characteristics of senile depression in elderly patients with dif ferent traditional Chinese medicine （TCM） constitution and syndrome types in communities and to provide a basis for clinical treatment and health care for these patients. Methods A questionnaire survey was con- ducted in permanent residents over 55 years old,who were selected by multi stage random sampling from 25 communities in 5 towns in Shanghai Pudong New Area, to screen out the patients with senile depres sion. TCM constitution identification and syndrome differentiation were performed in the patients to inves tigate the relationship of TCM constitution and syndrome types with clinical types. Results A total of 4 600 residents were selected in the survey, and 4 047 completed questionnaires were returned. A total of 519 patients with senile depression were screened out. As for TCM constitution types, qi-stagnation con- stitution （122 cases）, yang-deficiency constitution （99 cases）, and qi-deficiency constitution （99 cases） were the most common ones, accounting for 61.66~//oo of all types; other types included balanced constitu- tion （94 cases）, yin deficiency constitution （37 cases）, blood stasis constitution （26 cases）, phlegm-damp- ness constitution （18 cases）, damp-heat constitution （17 cases）, and inherited special constitution （7 ca- ses）. As for TCM syndrome types, liver-qi stagnation syndrome was the most common one （141 cases）, followed by liver-stagnation and spleen-deficiency syndrome （132 cases）, heart-spleen deficiency syndrome （77 cases）, and liver kidney ying-deficiency syndrome （59 cases）. Conclusion The patients with senile de- pression usually have depressive emotion which results in the disease. The TCM constitution and syndrome types are mostly qi stagnation and excess syndrome in the early stage,but the patients will have deficiency transformed from excess if left untreated,finally leading to interior deficiency.

关 键 词：社区 老年人 抑郁症 中医体质 辨证分型 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R25[医药卫生—临床医学]