CKD1～4期患者抑郁症状发生情况及中医证候研究  

The Research Situation and the TCM Syndromes of CKD 1～4 Depression

作　　者：周倩[1] 孙鲁英[2] 刘玉宁[2] 金化男 张雯[1] 郑启艳 王娅辉 ZHOU Qian;SUN Luying;LIU Yuning(Belling University of Chinese Medicine, Beijing（ 100029)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东直门医院,北京100700

出　　处：《中国中西医结合肾病杂志》2018年第1期15-19,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家科技支撑计划项目(No.2011BAI10B00)

摘　　要：目的:了解1~4期慢性肾脏病患者抑郁症状的发生情况,探讨慢性肾脏病伴抑郁症状患者的中医证候。方法:采用横断面研究方法,选取北京中医药大学东直门医院肾病科18岁~70岁的慢性肾脏病患者,调查一般资料、抑郁自评量表(SDS)、中医证候量表,使用SPSS 21.0软件统计分析。结果:(1)262例CKD1~4期患者中伴抑郁症状者82例,文化程度较高的、不抽烟的CKD患者更易伴发抑郁症状。抑郁症状轻度组与重度组、中度组与重度组两组中病程短的患者抑郁症状程度更重。(2)CKD1期患者抑郁症状发生情况37.5%,CKD 2期患者抑郁症状发生情况28.30%,CKD 3期患者抑郁症状发生情况28.21%,CKD 4期患者抑郁症状发生情况29.41%。(3)CKD伴抑郁症状患者中医证候以脾肾阳虚证为主,其次是肝肾阴虚证、肺脾肾气虚证、阴阳两虚证、湿热证等。结论:与内科疾病伴抑郁症状相比,CKD患者伴抑郁症状发生率较高;CKD1~4期各期患者抑郁症状发生情况无明显统计学差异;伴抑郁症状CKD患者中医证候以本虚为主,兼有标实。Objective： To investigate the prevalence of depression in patients with chronic kidney disease from stage 1 to stage 4,to delve the TCM syndromes of chronic kidney disease with depressive symptoms. Methods： Relying on a transversal research approach,we selected 262 cases of CKD patients（aged 18-70） from the Department of Nephrology,Beijing university of Chinese Medicine Dongzhimen hospital,whose diagnostic criteria was in line with diagnostic criteria,with the blood biochemical examination results of Beijing University of the Dongzhimen hospital. Then we carried out an clinical observation on their gender,age,marriage state,and their Zung Self-rating Depression Seale（SDS）,TCM Syndrome Scale,Statistical data with the research software SPSS 21. 0.Results：（1） the total 262 cases of patients with chronic kidney disease from stage 1 to stage 4 were included in this study. Among these subjects,there were 82 cases diagnosed depression. The statistical analysis shows that high education level and non-smoking were more susceptible to depression. By comparing mild depression patients with severe depression patients,and moderate ones with severe ones,the statistical analysis shows that patients with a shorter disease duration are more susceptible to depression of degree.（2） Prevalence of depression in patients with CKD in four clinical stages： stage 1,the rate accounts for 37. 5%; stage 2,the rate accounts for 28. 3%; stage 3,the rates accounts for 28. 21%; stage 4,the rate accounts for 29. 41%.（3） The occurrence rate of spleen-kidney yang deficiency was the highest,followed by liver-kidney yin deficiency,lung-spleen-kidney qi deficiency,yin-yang deficiency,heat-dampness syndrome,ect. Conclusion： The prevalence of depression in patients with chronic kidney disease was significantly higher than that of Internal medicine diseases associated with depression. There was no obvious statistical difference in the incidence of depressive symptoms for patients among CKD 1 ~ 4 stage. The common TCM syndro

关 键 词：慢性肾脏病患者 抑郁症状 CKD分期 中医证候 

分 类 号：R277.5[医药卫生—中医学]