慢性心力衰竭伴焦虑患者中医体质分布规律及危险因素相关性分析  

Correlation Analysis of TCM Constitution Distribution and Risk Factors in Patients with CHF and Anxiety

作　　者：张娜 冷建春[1] ZHANG Na;LENG Jianchun(Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610032,China)

机构地区：[1]成都中医药大学附属医院,四川成都610032

出　　处：《中医药信息》2023年第7期71-76,共6页Information on Traditional Chinese Medicine

摘　　要：目的:分析慢性心力衰竭伴焦虑状态患者中医体质分布规律及中医体质与危险因素的相关性。方法:纳入159例慢性心力衰竭患者,根据汉密尔顿焦虑量表(HAMA)对患者进行焦虑状态评估,根据评估结果分为焦虑组(55例,HAMA≥7分)和无焦虑组(104例,HAMA<7分)。分析两组患者的中医体质,收集患者年龄、性别、体质量、学历、婚姻状况、心功能等相关因素,并分析两者的关系。结果:单因素Logistic回归分析显示,与无焦虑组比较,焦虑组性别、年龄、心功能分级(Ⅱ、Ⅲ、Ⅳ)、吸烟史、饮酒史、高血压病史、糖尿病史、房颤史、住院天数>2周、1年住院次数>2次、医疗负担、LVEF比例具有统计学意义(P<0.01,P<0.05)。多因素Logistic回归分析显示,性别、心功能分级、1年住院次数>2次、房颤史、糖尿病史是慢性心力衰竭患者产生焦虑的独立危险因素(P<0.05,P<0.01)。焦虑组的中医体质按由高到低的频率分布为气虚质(23.6%)、阳虚质(18.2%)、痰湿质(16.4%)、血瘀质(14.5%)、湿热质(9.1%)、阴虚质(7.3%)、气郁质(5.5%)、平和质(3.6%)和特禀质(1.8%);偏颇质是焦虑组主要的体质类型;焦虑组气虚质、阳虚质、痰湿质和血瘀质比例明显高于无焦虑组(P<0.05);焦虑组气虚质与性别、一年住院次数>2次、房颤史危险因素相关(P<0.05),阳虚质与心功能分级、1年住院次数>2次相关(P<0.05),痰湿质与糖尿病史相关(P<0.05),血瘀质与房颤史相关(P<0.05)。结论:慢性心力衰竭伴焦虑患者的体质类型以气虚质、阳虚质、痰湿质、血瘀质常见,上述体质与性别、一年住院次数>2次、房颤史、心功能分级、糖尿病史等危险因素呈正相关。Objective:To analyze the distribution law of TCM body constitution and risk factors in patients with chronic heart failure(CHF)and anxiety.Methods:159 patients with CHF were assigned into the anxiety group(n=55,HAMA≥7 points)and the non-anxiety group(n=104,HAMA<7 points)according to the Hamilton Anxiety Scale(HAMA).TCM body constitution,the related factors,including age,gender,body mass,educational background,marital status and cardiac function were collected and analyzed in the two groups.Results:Univariate Logistic regression analysis showed that there were significant differences in the gender,age,NYHA classification(Ⅱ,Ⅲ,Ⅳ),histories of smoking,drinking,hypertension,diabetes and atrial fibrillation,more than two days of hospitalization days in 2 weeks,more than two times of hospitalization times in 1 year,medical burden and LVEF ratio between the anxiety group and the non-anxiety group(P<0.01,P<0.05).Multivariable Logistic regression analysis showed that gender,cardiac function grade,more than two times of hospitalization in a year,histories of atrial fibrillation and diabetes were independent risk factors for anxiety in patients with CHF(P<0.05,P<0.01).The body constitutions of the anxiety group included Qi deficiency(23.6%),Yang deficiency(18.2%),phlegm dampness(16.4%),blood stasis(14.5%),damp heat(9.1%),Yin deficiency(7.3%),Qi stagnation(5.5%),peace quality(3.6%)and intrinsic quality(1.8%)in the order from high to low.Biased quality was the main constitution type in anxiety group.The proportion of Qi deficiency,Yang deficiency and phlegm dampness was significantly higher in the anxiety group than that in the non-anxiety group(P<0.05).In the anxiety group,Qi deficiency was related to gender,more than two times of hospitalizations in one year,and risk factors of atrial fibrillation(P<0.05);Yang deficiency was related to cardiac function grade,more than two times of hospitalizations in one year(P<0.05);phlegm dampness was related to diabetes(P<0.05);blood stasis was related to atrial fibrillation(P<0.0

关 键 词：慢性心力衰竭 焦虑状态 中医体质 危险因素 

分 类 号：R259[医药卫生—中西医结合]