不同证型功能性消化不良与焦虑抑郁状态的相关性  

Correlation between different syndromes of functional dyspepsia and anxiety and depression

作　　者：付丽鹤 时昭红[2] 黄亮亮 FU Lihe;SHI Zhaohong;HUANG Liangliang(Pediatric Medicine Department,Hubei Maternal and Child Health Institute,Wuhan,Hubei 430070,China;Department of Digestion,Wuhan Hospital of Integrated Traditional Chinese and WesternMedicine,Wuhan,Hubei 430022,China;Clinical College of TCM,Hubei University of ChineseMedicine,Wuhan,Hubei 430070,China)

机构地区：[1]湖北省妇幼保健院儿内科,湖北武汉430070 [2]武汉市中西医结合医院消化内科,湖北武汉430022 [3]湖北中医药大学中医临床学院,湖北武汉430070

出　　处：《安徽医药》2019年第8期1529-1532,共4页Anhui Medical and Pharmaceutical Journal

基　　金：国家重点基础研究发展计划(“973”计划)(2013CB531703)

摘　　要：目的探讨不同证型功能性消化不良(FD)与焦虑、抑郁状态的相关性。方法采用随机数字表法,选取2015年1~12月就诊于武汉市中西医结合医院消化内科,经罗马Ⅲ标准确诊的FD病人60例(FD组),招募同期健康志愿者22例(HS组)。将FD组中医辨证分型,脾虚气滞型28例,脾虚湿阻型17例,脾阳虚型15例,并对受试者进行症状量表评分及医院焦虑抑郁量表(HAD量表)积分评定。结果(1) FD组焦虑、抑郁状态评分[(9.31±2.23)分、(10.17±2.30)分)]均高于HS组[(8.22±2.07)分、(8.63±1.81)分],差异有统计学意义(P=0.049,0.015)。(2)辨证为脾虚气滞型FD病人焦虑状态评分(10.59±2.01)分高于脾虚湿阻型(9.40±1.72)分(P=0.048)及脾阳虚型(9.27±1.23)分(P=0.033);抑郁状态评分(10.75±2.65)分高于脾虚湿阻型(9.24±1.75)分(P=0.014)。(3)辨证为脾虚气滞型及脾阳虚型FD病人症状积分与焦虑、抑郁状态呈显著性正相关(rs=0.61、0.53、0.63、0.57,P<0.05)。结论功能性消化不良病人大多伴有焦虑、抑郁状态,脾失健运是其致病关键,临证中辨证基础上应注重健脾理气、养心安神之法的应用。Objective To investigate the correlation between functional dyspepsia and anxiety and depression.Methods Sixty patients who were diagnosed by Rome III standard in Department of Digestion,Wuhan Hospital of Integrated Traditional Chinese and Western Medicine from January to December 2015 were selected as FD group(FD) by random number table method.At the same time,22 healthy volunteers were recruited as HS group(HS).FD group was differentiated by TCM syndrome,there were 28 cases of spleen deficiency qi stagnation,17 cases of spleen deficiency and dampness,15 cases of spleen Yang deficiency type.All subjects were evaluated with symptom scale and Hospital anxiety and depression scale(HAD).Results(1) The anxiety(9.31±2.23 vs.8.22±2.07) and depression(10.17±2.30 vs.8.63±1.81) scores of FD group were higher than those in the HS group,and the differences were statistically significant(P=0.049,0.015).(2) The syndrome differentiation of FD patients with spleen deficiency and qi stagnation(10.59±2.01 vs.9.40±1.72) was higher than that in the spleen deficiency and dampness obstruction(P=0.048) and spleen yang deficiency(9.27±1.23)(P=0.033).The depression score with spleen deficiency and qi stagnation(10.75±2.65) was significantly higher than that of the spleen deficiency and dampness obstruction(9.24±1.75)(P=0.014).(3) The syndrome differentiation was positively correlated with anxiety and depression in FD patients with spleen deficiency and spleen deficiency type FD(rs=0.61,0.53,0.63,0.57,P<0.05).Conclusion Most of the patients with functional dyspepsia are accompanied by anxiety and depression,and the loss of spleen and health is the key to the disease.The syndrome differentiation should be based on the application of invigorating spleen and nourishing the spirit of god.

关 键 词：消化不良 脾气虚 脾阳虚 脾阴虚 寒湿困脾 肺脾两虚 焦虑 抑郁 安神 益气健脾 医院焦虑抑郁量表 

分 类 号：R259[医药卫生—中西医结合]