围绝经期及绝经后女性中医证型与焦虑、抑郁情绪的相关性  

Correlation between traditional Chinese medicine syndromes and anxiety and depression in perimenopausal and postmenopausal women

作　　者：郭志玲 左圣兰 宋梦帆[1,2] 顾晓青 徐凤英 蔡美玲 金富锐 GUO Zhiling;ZUO Shenglan;SONG Mengfan;GU Xiaoqing;XU Fengying;CAI Meiling;JIN Furui(International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Shanghai Key Laboratory of Embryo Original Diseases,Shanghai 200030,China;Xidu Community Health Service Center,Fengxian District,Shanghai 201401,China;Shanghai Jinshan Tinglin Hospital,Shanghai 201505,China;Qingpu Branch of Shanghai Zhongshan Hospital,Shanghai 201799,China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院,上海200030 [2]上海市胚胎源性疾病重点实验室,上海200030 [3]上海市奉贤区西渡社区卫生服务中心,上海201401 [4]上海市金山区亭林医院,上海201505 [5]上海市中山医院青浦分院,上海201799

出　　处：《上海中医药杂志》2024年第8期45-48,61,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市卫健委名老中医学术经验研究工作室建设项目(SHGZS-202214)。

摘　　要：目的探讨围绝经期及绝经后女性中医证型与焦虑、抑郁情绪的相关性。方法借助自主研发的更年期应用程序收集围绝经期及绝经后女性的资料,同时采用广泛焦虑障碍量表(GAD-7)、抑郁筛查量表(PHQ-9)进行焦虑、抑郁情绪评估,分析围绝经期及绝经后女性焦虑、抑郁情绪发生情况以及中医证型与焦虑、抑郁情绪的相关性。结果①共收集有效病例2379例,其中伴有焦虑情绪者737例、伴有抑郁情绪者826例,同时伴有焦虑、抑郁情绪者537例。月经情况、流产史、生育史对焦虑情绪的发生有影响(P<0.05),而年龄、月经情况、流产史、生育史对抑郁情绪的发生有影响(P<0.05)。②不同程度(轻度、中度、中重度/重度)焦虑、抑郁情绪的人数分布比较,差异无统计学意义(P>0.05)。③不同中医证型在焦虑、抑郁情绪中的分布,差异具有统计学意义(P<0.05)。④肾虚肝郁证与轻度、中度、重度焦虑情绪有较强关联性,尤其与轻度焦虑情绪关联性最强;肾阴阳两虚证、肝肾阴虚证、心肾不交证与无焦虑情绪关联性较强。肾虚肝郁证与轻度、中度、中重度/重度抑郁情绪有较强关联性,尤其与轻度、中度抑郁情绪关联性最强;肝肾阴虚证、心肾不交证、肾阴阳两虚证与无抑郁情绪有较强关联性。结论围绝经期及绝经后女性焦虑、抑郁情绪的发生与肾虚肝郁证的关联性最强,因此在临床工作中更应关注肾虚肝郁证围绝经期及绝经后女性的情绪状态,在早期采用补肾疏肝法进行治疗,改善患者的症状,提高围绝经期及绝经后女性的生活质量。Objective To explore the correlation between traditional Chinese medicine(TCM)syndromes and anxiety and depression in perimenopausal and postmenopausal women.Methods Data from perimenopausal and postmenopausal women were collected using a self-developed menopause management application.Anxiety and depression were assessed using the Generalized Anxiety Disorder 7-item scale(GAD-7)and the Patient Health Questionnaire-9(PHQ-9),respectively.The incidence of anxiety and depression in perimenopausal and postmenopausal women and their correlation with TCM syndromes were analyzed.Results①A total of 2,379 valid cases were collected,including 737 with anxiety,826 with depression,and 537 with both conditions.Factors such as menstrual status,history of miscarriage or abortion,and childbirth history influenced the occurrence of anxiety(P<0.05),while age,menstrual status,history of miscarriage or abortion,and childbirth history influenced the occurrence of depression(P<0.05).②The distribution of anxiety and depression across different severity levels(mild,moderate,moderate-severe/severe)showed no statistically significant differences(P>0.05).③Significant differences were found in the distribution of TCM syndromes in anxiety and depression cases(P<0.05).④Kidney deficiency and liver stagnation syndrome was strongly associated with all levels of anxiety(mild,moderate and severe),particularly mild anxiety.Kidney yin-yang deficiency syndrome,liver-kidney yin deficiency syndrome,and heart-kidney disharmony syndrome were strongly associated with the absence of anxiety.Similarly,kidney deficiency and liver stagnation syndrome was strongly associated with all levels of depression(mild,moderate,and moderate-severe/severe),especially mild and moderate depression.Liver-kidney yin deficiency syndrome,heart-kidney disharmony syndrome,and kidney yin-yang deficiency syndrome were strongly associated with the absence of depression.Conclusions The incidence of anxiety and depression in perimenopausal and postmenopausal women is most str

关 键 词：围绝经期 绝经后期 中医证型 焦虑 抑郁 

分 类 号：R271.116[医药卫生—中医妇科学]