抑郁症的中医证候特征研究  

Study of the TCM Syndromes Characteristics of Depression

作　　者：徐春燕[1] 田金洲[1] 时晶[1] 苗迎春[1] 冯秀杰[2] 贾竑晓[2] 马辛[2] 尹冬青[1] 李那永[1] 

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]首都医科大学附属安定医院,北京100088

出　　处：《中华中医药学刊》2013年第4期810-813,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家科技支撑计划资助项目(2009BA177B);北京市科技计划资助项目(D101107047810003);中药新药临床评价研究技术平台资助项目(2011X09302-006-01)

摘　　要：目的:探讨抑郁症中医证候特征。方法:在病证结合的指导思想下,采用临床流行病学调查方法,以证候要素为基本研究单位,以ICD-10版(F32)《抑郁发作诊断标准》为抑郁症的诊断标准,应用数理统计方法对317例抑郁症患者的证候要素分布特点及组合规律、中医证侯分型分布情况进行分析研究。结果:抑郁症常见证候要素为肝、脾、气虚、气郁、痰浊、阴虚、肾、内火。中医证候分型出现频次前六位的依次为肝郁脾虚、肝肾阴虚、肝郁痰阻、心脾两虚、肝郁气滞、气滞血瘀,覆盖全部病例的88.3%。抑郁症证素组合形式8种,单证形式前三位的为肝、脾、气虚,两证组合形态前三位的为肝、脾和气虚、脾和气郁、肝;三证组合形态前三位的为气郁、脾、肝和气虚、脾、肝和气郁、气虚、肝;而四证组合以气郁、气虚、肝、脾最多见。结论:抑郁症的核心病位为肝,与脾、肾、心密切相关,而气郁、气虚是抑郁症的基本病机,肝郁脾虚为抑郁症的主要证候,抑郁症以虚实夹杂证多见,虚性病理因素不容忽视。Objective：To explore the characteristics of TCM syndromes of depression. Methods：Based on the guiding ide- ology of combination of disease and syndrome, clinical epidemiology survey methodology, ICD - 10 （ F32）, and Depressive Episode Diagnostic Criteria were used as diagnostic criteria of depression and the syndrome element as the basic study units, using mathematical statistical method to analyze distribution characteristics and combination law of syndrome element, distri- bution of TCM syndrome types of 317 cases of depression patients. Results：The common syndrome elements of depression were liver, spleen, qi deficiency, qi depression, phlegm turbidity, yin deficiency, kidney, endogenous fire. The top six syn- drome types were depression of the liver - qi with spleen deficiency, yin deficiency of liver and kidney, depression of the liv- er - qi with phlegm choke, deficiency of both the heart and spleen, stagnation of the liver - qi, qi stagnation and blood stasis, covering 88.5% of all cases. There were a total of 8 combination patterns of syndrome elements of depression. The top three single syndrome element patterns were liver, spleen ,qi deficiency. The top three two syndrome element patterns were liver, spleen and qi deficiency, spleen and qi depression,liver;the top three syndrome element patterns were qi depression, spleen,liver and qi deficiency, spleen,liver and qi depression, qi deficiency, liver; but the most common four syndrome ele- ment patterns were qi depression, qi deficiency,liver, spleen. Conclusion： The core of disease location of depression is liver, and is closely related with spleen,kidney and heart. Qi depression and qi deficiency are the essential pathogenesis of de- pression, depression of the liver - qi with spleen deficiency is the main syndrome type. Deficiency syndrome mixed excess syndrome is more common in depression, and deficiency pathological factors can not be ignored.

关 键 词：抑郁症 中医证候特征 证候要素 组合规律 证候分型 

分 类 号：R749.41[医药卫生—神经病学与精神病学]