肝豆状核变性患者生命质量与中医证型的相关性研究  

Correlation between Quality of Life and Traditional Chinese Medicine Syndrome Types in Patients with Wilson's Disease

作　　者：吴鹏[1] 鲍远程[2] 汪鸿浩[3] 

机构地区：[1]安徽中医药大学中西医结合临床学院,安徽合肥230038 [2]安徽中医药大学第一附属医院神经内科,安徽合肥230031 [3]安徽医科大学第一附属医院神经内科,安徽合肥230022

出　　处：《安徽中医药大学学报》2014年第2期16-20,共5页Journal of Anhui University of Chinese Medicine

基　　金：安徽中医学院青年科学研究基金(2012qn007)

摘　　要：目的探究肝豆状核变性(Wilsons disease,WD)患者生命质量的主要影响因素及其与中医证型的关系。方法运用SF-36量表、抑郁自评量表(self-rating depression scale,SDS)调查186例WD患者的生命质量和情绪状况,并比较不同证型WD患者及参照人群SF-36量表各维度评分的差异;运用Pearson和Spearman相关分析及多元线性逐步回归研究SF-36量表各维度评分与各影响因素(包括患者性别、文化程度、居住地、病程等)的关系。结果除精神健康维度外,男性WD患者其余7个维度评分显著低于男性参照人群(P<0.01);女性WD患者所有维度评分均显著低于女性参照人群(P<0.01)。影响患者生命质量的因素较多,其中病程、费用支出方式、SDS评分对患者SF-36量表多个维度评分都呈负面影响。不同中医证型WD患者的生理功能、生理职能、社会功能、情感职能评分均显著低于参照人群(P<0.05,或P<0.01);痰瘀互结型和肝肾阴虚型患者躯体疼痛评分显著低于痰湿中阻型(P<0.01),脾肾阳虚型患者的活力评分显著低于肝气郁结型(P<0.05),肝气郁结型患者的情感职能评分显著低于痰瘀互结型(P<0.05)。结论 WD患者生命质量较正常人明显降低,不同证型患者的生命质量存在差异,对WD患者应早诊断、早治疗,加强农村患者的医疗保障。Objective To investigate the main influential factors for quality of Wilson＇s disease （WD） and the correlation between QOL and traditional Chi life nese （QOL） in patients with medicine （TCM） syn- drome types. Methods A total of 186 WD patients were included in the study. The QOL and emotion of patients were evaluated using the 36-Item Short Form Health Survey （SF-36） and Self-Rating Depression Scale （SDS）, and the scores on 8 SF-36 subscales were compared between patients with different TCM syndrome types and controls. Pearson correlation analysis, Spearman correlation analysis, and multivariate linear stepwise regression analysis were used to determine the relationship between SF 36 scores and potential influential factors （including sex, educational level, place of residence, and course of disease）. Results Among male subjects, WD patients had significantly lower scores on all SF36 subscales except the mental health subscale than controls （P〈0.01） ; among female subjects, WD patients had significantly lower scores on all SF-36 subscales than controls （P〈0.01）. There were many influential factors for the QOL in patients, including course of disease, way of expenditure, and SDS scores, which had negative im pacts on scores on several SF-36 subscales. The WD patients with different TCM syndrome types had significantly lower scores on physical functioning, role physical, social functioning, and role emotional subscales of SF-36 than controls （P〈0.05 or P〈0.01）. The patients with syndrome of intermingled phlegm and blood stasis and syndrome of liver-kidney yin-deficiency had a significantly lower SF-36 bodily pain score than those with interior retention of phlegm dampness （P〈0.01） ; the patients with spleen-kidney yang deficiency had a significantly lower SF-36 vitality score than those with stagnation of liver qi （P〈 0.05）; the patients with stagnation of liver qi had a significantly lower SF-36 role emotional score than those with intermingled phlegm and

关 键 词：肝豆状核变性 SF-36 抑郁自评量表 中医证型 

分 类 号：R742.4[医药卫生—神经病学与精神病学]