癫痫患者功能性肠病与焦虑、抑郁状态的关系及中医证候分布规律研究  

Study on the relationship between functional bowel disorders and anxiety and depressive states in epileptic patients and the distribution of traditional Chinese medicine syndromes

作　　者：余阳洋[1] 顾超[1] 王春旭 袁灿兴[1] YU Yangyang;GU Chao;WANG Chunxu;YUAN Canxing(Department of Neurology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院脑病科,上海200032

出　　处：《上海中医药杂志》2021年第11期23-26,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科委科技创新行动计划国内科技合作领域项目(19695840100);上海中医药大学附属龙华医院爱建捐赠基金项目(AJ048)。

摘　　要：目的探讨癫痫患者功能性肠病(FBD)与焦虑、抑郁状态的关系及中医证型分布规律。方法将306例癫痫患者根据FBD的患病情况分为伴FBD组(172例)、不伴FBD组(134例),收集病例资料,分析比较两组一般情况(性别、年龄、病程、脑电图、认知功能)、焦虑状态自评量表(SAS)评分、抑郁状态自评量表(SDS)评分及中医证候分布情况,采用logistic回归分析癫痫FBD的影响因素。结果①伴FBD组年龄大于不伴FBD组,病程长于不伴FBD组,脑电图异常率高于不伴FBD组(P<0.001,P<0.05)。②伴FBD组SAS、SDS评分高于不伴FBD组(P<0.001),SAS、SDS评分异常率高于不伴FBD组(P<0.001)。③logistic回归分析结果显示,癫痫患者的病程、年龄、SAS评分为癫痫伴发FBD的影响因素(P<0.05),其中SAS评分异常的癫痫患者伴发FBD的可能性是SAS评分正常者的6.104倍[OR=6.104,95%CI(3.416~10.906),P<0.001]。④伴FBD组患者心脾两虚证最多见(27.91%),不伴FBD组患者瘀阻脑络证最多见(41.79%);痰、虚、瘀三大中医证型分布显示,伴FBD组患者虚证最多见(44.19%),不伴FBD组患者痰证最多见(52.24%)。结论与不伴FBD比较,伴FBD的癫痫患者焦虑、抑郁情绪更加严重,癫痫病程、患者年龄、焦虑状态均为癫痫患者发生FBD的影响因素;癫痫伴FBD患者以虚证多见,其中占比最高的为心脾两虚证。Objective To explore the relationship between functional bowel disorder(FBD)and anxiety and depressive states in patients with epilepsy and the distribution of traditional Chinese medicine(TCM)syndromes.Methods A total of 306 patients with epilepsy were divided into the group with FBD(n=172)and the group without FBD(n=134)according to the disease status of FBD.The case data were collected and analyzed to compare the general conditions(gender,age,disease duration,EEG,cognitive function),Self-rating Anxiety Scale(SAS)scores,Self-rating Depression Scale(SDS)scores and the distribution of TCM symptoms between the two groups.Logistic regression was used to analyze the factors influencing FBD in epileptic patients.Results①Compared with the conditions in the group without FBD,the age was higher,the disease duration was longer and the EEG abnormality rate was higher in the group with FBD(P<0.001,P<0.05).②SAS and SDS scores were higher in the group with FBD than the scores in the group without FBD(P<0.001),and the abnormal rates of SAS and SDS scores were higher than those in the group without FBD(P<0.001).③According to the results of logistic regression analysis,the disease duration,age,and SAS scores were influencing factors of FBD in epileptic patients(P<0.05),and epileptic patients with abnormal SAS scores were 6.104 times more likely to have FBD than those with normal SAS scores[OR=6.104,95%CI(3.416-10.906),P<0.001].④The heart and spleen dual deficiency syndrome was the most common syndrome in the group with FBD(27.91%),and the stasis blocking brain collaterals syndrome was most common syndrome in the group without FBD(41.79%).The distribution of TCM syndromes of phlegm,deficiency and stasis showed that most cases in the group with FBD had deficiency syndomes(44.19%)and most cases in the group without FBD had phlegm syndromes(52.24%).Conclusion Compared with conditions in the group without FBD,epileptic patients with FBD had more severe anxiety and depression.The disease duration,age,and anxiety and depressiv

关 键 词：癫痫 功能性肠病 焦虑状态 抑郁状态 中医证型 

分 类 号：R277.7[医药卫生—中医学] R259