381例卒中恢复期抑郁障碍患者的中医证候特征分析  

Analysis of TCM Syndrome Characteristics of 381 Patients with Depressive Disorder in the Convalescent Stage of Stroke

作　　者：曾玉筱 陈枫[1] 蔡向红[2] 陈江华[1] 杜鹃 ZENG Yu-xiao;CHEN Feng;CAI Xiang-hong;CHEN Jiang-hua;DU Juan(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]北京中医药大学,北京100029

出　　处：《中国中医基础医学杂志》2021年第9期1420-1425,共6页JOURNAL OF BASIC CHINESE MEDICINE

摘　　要：目的:探讨卒中恢复期抑郁障碍患者的中医证候分布特征,为临床辨证论治提供参考,也为卒中后抑郁障碍的预防、早期干预及卒中患者整体康复方案的完善提供依据。方法:采用横断面研究,收集2018年至2020年中国中医科学院望京医院收治的381例卒中恢复期抑郁障碍患者的病历资料,使用SPSS 26.0软件对收集病例的症状、体征、舌象、脉象等中医四诊信息进行频数和频率等描述性统计分析及按变量进行聚类分析,总结出中医常见证候及辨证分型。结果:381例卒中恢复期抑郁障碍患者的中医证候集中分布为脾肾亏虚证(47.77%)、气虚痰瘀证(17.06%)、肝郁脾虚证(15.75%)、气滞血瘀证(11.81%)和心脾两虚证(7.61%)5个证候类型。结论:卒中恢复期抑郁障碍患者的证候分布特征为虚实夹杂而以虚证表现为主,治疗应当侧重扶正补虚,同时在卒中恢复期对具有虚性中医证候特征表现的患者应当高度警惕和及时干预,预防卒中后抑郁的发生。并运用聚类分析的统计学方法,对卒中后抑郁障碍进行证候分布研究具有一定的临床意义。Objective:To explore the distribution characteristics of TCM syndromes of depression in stroke recovery period and provide an objective reference for clinical diagnosis and treatment of symptoms and signs by using the statistical method of systematic cluster analysis.And to provide a basis for the prevention of post-stroke depression,early intervention and improvement of the overall rehabilitation program for stroke patients.Methods:A cross-sectional study was conducted to collect the medical records of 381 patients with post-stroke depression in Wangjing hospital,Chinese Academy of traditional Chinese medicine from 2018 to 2020.SPSS 26.0 software was used to conduct descriptive statistical analysis on the frequency of symptoms,signs,tongue,pulse and other TCM diagnostic information and cluster analysis by variables,and summarize the common TCM syndromes and syndrome differentiation.Results:The TCM Syndromes of 381 patients with depressive disorder in convalescent stage of stroke were mainly distributed as spleen and kidney deficiency(47.77%),Qi deficiency and phlegm stasis(17.06%),liver depression and spleen deficiency(15.75%),qi stagnation and blood stasis(11.81%)and deficiency of both heart and spleen(7.61%).Conclusion:The distribution of syndromes in patients with depression in the convalescent stage of stroke is a mixture of deficiency and excess,while the main manifestation is deficiency syndrome.The treatment should be based on the method of strengthening the body and supplementing deficiency.At the same time,we should be highly vigilant and intervene in time to prevent the occurrence of post-stroke depression during the stroke recovery period for patients with symptoms of deficiency in TCM.It has certain clinical significance to use the statistical method of cluster analysis to study the syndrome classification of post-stroke depression.

关 键 词：卒中恢复期 卒中后抑郁 聚类分析 证候特征 

分 类 号：R749.4[医药卫生—神经病学与精神病学]