抑郁症中医证候学临床流行病学调查*

【目的】是为获得抑郁症的常见中医证候特征，以为中医辨证治疗抑郁症提供依据。【方法】采用自拟抑郁症中医证候学调查表，在5个临床点同时以同样方式对487例抑郁症患者进行调查，调查人员依据调查表充分收集辨证信息，进行临床初步辨证，最后由专人对调查表集中进行流调后辨证。【结果】抑郁症的常见中医证候位于前10位的是：肝郁脾虚证（25．7％），肝郁气滞证（22．8％），心脾两虚证（12、5％），肾阳不足证（9．1％），肝肾阴虚证（5、5％），心胆气虚证（5．1％），气滞血瘀证（4．7％），心肾不交证（3、5％），胆郁痰扰证（3．3％）和阴阳两虚证（2．9％）；以前10位证型为基准气机失调出现的频率为56．5％。【结论】从脏腑辨证而言抑郁症病位涉及心、肝、脾、肾，病性可见实证、虚证或虚实并见；其基本病机特点为气机失调表现充分。

Clinical Epidemiological Investigation of TCM Syndrome in Depression Patients

Objective] To explore main TCM syndromes in depression in order to provide the foundation for syndrome differentiation treatment.Methods] The 487 patients were interviewed with the Self-designed questionnalre Of TCM Syndromes. All of the lnterviews were carried out in five different clinical places with same method at the same time. During each interview, the investigators collected sufficient information about each patient according to the designed questionmire. Based on the recorded information, the investigators can determine the initial syndromes of TCM. Finally, the syndromes of TCM were further determined by specialists.Results] The top 10 TCM syndromes are liver stagnation causing spleenic deficiency (25.7%), liver-qi stagnation (22.8%), heart-spleen deficiency(12.5%), kidney-yang deficiency(9.1%), liver-kidney yin-defi-ciency(5.5%), heart-gallbladder-qi deficiency(5.1%), qi stagnation blood stasis(4.7%), heart-kidney disharmony (3.5%), gallbladder stagnation phlegm disturbance (3.3%), and yin-yang deficiency(2.9%). The percentage of Qi-ji disorder is 56.5% in the all syndromes based on the first ten syndromes.Conclusions] From the point of view of zang-fu, depression involves heart, liver, spleen and kidney et al. The properties of the disease include sthenia syndrome and deficient syndrome. And both happen at the same time. If the syndrome is from the point of view of basic pathogenesis, the main syndrome characteristic is Qi-Ji disorder.