不明原因复发性流产患者的D型人格与中医证候分布研究

目的　探讨不明原因复发性流产患者的D型人格及中医证候分布情况。方法　选取2013年1月—2014年2月黑龙江中医药大学附属第一医院妇科门诊和病房收治的不明原因复发性流产患者200例（研究组）,选取同期就诊的有≥1次生育史的其他患者200例（对照组）。采用D型人格量表（DS14）评价两组的D型人格情况;查阅相关文献并咨询专家后,制定“不明原因复发性流产中医证候诊断标准”,以判断研究组的中医证候。结果　研究组的D型人格阳性率高于对照组〔59.0%（118/200）比15.5%（31/200）,P<0.05〕;且研究组DS14中消极情感、社会压抑2个人格维度得分及量表总得分高于对照组（P<0.05）。200例不明原因复发性流产患者的中医证候排在前2位的分别为单纯肾虚证101例（50.5%）、肾虚夹肝郁证39例（19.5%）;118例D型人格阳性的不明原因复发性流产患者的中医证候分别为单纯肾虚证85例（72.0%）、肾虚夹肝郁证29例（24.6）、血瘀证4例（3.4%）。结论　D型人格在不明原因复发性流产中的分布具有倾向性,且D型人格的不明原因复发性流产者中医证候以单纯肾虚证为主。

Prevalence of Type D Personality and Distribution of TCM Syndromes in Unexplained Recurrent Spontaneous Abortion Patients

Objective　To investigate the prevalence of type D personality and distribution of TCM syndromes in patients with unexplained recurrent spontaneous abortion（URSA）.Methods From First Affiliated Hospital,Heilongjiang University of Chinese Medicine,we enrolled 200 outpatients and inpatients with URSA（study group）,and 200 patients with childbearing history（≥1 time） and other diseases（control group） during January 2013 to February 2014.Type D Scale-14（DS14） was used to assess the prevalence of type D personality in both groups.On the basis of literature review and expert consultation,we developed the "Diagnostic Criteria of TCM Syndromes for Unexplained Recurrent Spontaneous Abortion" and used it to assess the TCM syndromes in the study group.Results　Compared with the control group,the study group demonstrated higher prevalence of type D personality〔59.0%（118/200） vs 15.5%（31/200）,P<0.05〕,and higher mean scores of DS14 and its two dimensions（negative affectivity and social inhibition）（P<0.05）.The top common TCM syndromes in the study group were simple kidney deficiency（101 cases,50.5%） and kidney deficiency and liver stagnation（39 cases,19.5%）.In the 118 URSA patients with type D personality,the TCM syndromes found were simple kidney deficiency（85 cases,72.0%）,kidney deficiency and liver stagnation（29 cases,24.6%） and blood stasis（4 cases,3.4%）.Conclusion　URSA patients are prone to have type D personality.In URSA patients with type D personality,simple kidney deficiency is the main TCM syndrome.