功能性消化不良中医证型与心理因素的相关性研究

作者	单位
黄铭涵	福建中医药大学附属第二人民医院
黄健	福建省妇幼保健院
陈琴	福建医科大学附属协和医院
林平	福建中医药大学附属第二人民医院

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中文摘要:

目的探讨功能性消化不良中医证型与心理因素的相关性。方法按照流行病学调查方法,随机抽取297例诊断为功能性消化不良(FD)的患者作为研究对象进行心理测评,并进行中医证型调查,研究各证型分布特点,以及抑郁自评量表(SDS)、焦虑自评量表(SAS)评分差异。结果 (1)中医证型分布以脾虚气滞证比例最高[96例(32.3%)];(2)中医各证型心理异常比例:合并抑郁状态以肝气郁结证比例最高[30例(62.5%)],合并焦虑状态以肝气犯胃证比例最高[19例(35.8%)],而湿热滞胃证合并抑郁状态及焦虑状态比例均最低,各证型合并抑郁、焦虑状态均占相当比例;(3)中医各证型与功能性消化不良症状谱比较:餐后饱胀感以脾胃气虚证及脾虚气滞证多见,早饱在脾胃气虚证最为显著,上腹痛以肝气郁结证、脾胃气虚证多见,上腹烧灼感在湿热滞胃证中最为显著;(4)中医各证型SDS、SAS量表评分比较:SDS评分以肝气郁结证最高,SAS评分以肝气犯胃证最高,而湿热滞胃证在两个自评量表中评分均最低。结论功能性消化不良各中医证型分布及心理测评结果差异明显,病机虚实夹杂,病情与肝、脾两脏关系密切。

英文摘要:

Objective To explore the relationship between Chinese medicine syndrome type and psychological factor in patients with functional dyspepsia(FD).Methods With an epidemiologic method adopted,297 FD patients received psychologic mensuration and their Chinese medicine syndrome type was differentiated.The distribution of Chinese medicine syndrome type in FD patients was studied and the differences among various types were analyzed using self-rating depression scale(SDS)and self-rating anxiety scale(SAS).Results(1)Patients’ Chinese medicine syndrome could be differentiated into 5 types:the Pi-deficiency qi-stagnancy type(Ⅰ),the Gan-qi accumulation type(Ⅱ),the Gan-qi invading Wei type(Ⅲ),the dampness-heat stagnating in Wei type(Ⅳ)and the Pi-Wei qi-deficiency type(Ⅴ).Patients of type Ⅰ(96 cases,32.3%)held the dominant share.(2)Depressive and anxiety states presented in patients with various syndrome types,among them,patients of type Ⅱ held the highest percentage of depressive status(30 cases,62.5%),type Ⅲ held the highest percentage of anxiety state(19 cases,35.8%),while type Ⅳ possessed the lowest percentages of both.(3)Analysis between symptoms and syndrome types showed that post-prandial fullness presented in most patients of types Ⅴ and Ⅰ;early satiation presented more prominently in patients of type Ⅴ;upper abdominal pain presented frequently in patients of types Ⅱ and Ⅴ,and upper abdominal burning sensation presented more evidently in patients of type Ⅳ.(4)Comparisons of SDS and SAS scores in patients with different syndrome types showed that the highest SDS score presented in type Ⅱ,highest SAS score presented in type Ⅲ;and the lowest scores of SDS and SAS all presented in type Ⅳ.Conclusions Psychological states are different in FD patients with various syndrome types.The Chinese medicine pathogenetic mechanisms of FD is complex in deficiency/excessive nature,and the condition of disease is closely related with organs Gan and Pi.

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