抑郁症肝郁气滞证及肝郁脾虚证证候标准的研究

目的 探讨抑郁症肝郁气滞证、肝郁脾虚证的证候辨证标准。方法 选择抑郁症临床流行病学调查肝郁气滞证588例，肝郁脾虚证487例，共1075例，对75项证候指标进行频数分析、X^2检验等统计学处理，并建立判别方程。根据统计分析，采取主证辨证法确定两证的证候标准。结果 肝郁气滞证的证候标准为：情绪抑郁、悲观厌世、善叹息、烦躁、脉弦，5项中具备3项(情绪抑郁必备)，记分在4分以上者，即可诊断。肝郁脾虚证的证候标准为：情绪抑郁、悲观厌世、善叹息、倦怠乏力、纳差、形体消瘦、脉细，7项中具备4项，即肝郁两项(情绪抑郁必备)，脾虚两项者，总记分在6分以上者，即可诊断。结论 情绪抑郁、善叹息等5项为肝郁气滞证的证候标准，情绪抑郁、倦怠乏力、纳差等7项为肝郁脾虚证的证候标准。

Studies on standards for syndromes of Hepatic Qi Stagnation and Hepatic Stagnation causing Splenic Deficiency for depression

Objective:To explore the standard of syndrome differentiation of the Hepatic Qi Stagnation and Hepatic Stagnation causing Splenic Deficiency for depression. Methods:588 cases with syndromes of the Hepatic Qi Stagnation and 487 cases with syndromes of the Hepatic Stagnation causing Splenic Deficiency, 1075 cases in sum,were from clinical epidemiological survery. 75 indexes were analyzed by frequency analysis and Chi-squared test. Then discriminant equations were established.According to the results of statistic analysis, by the differentiation of primary symptoms, the standard of syndrome with the Hepatic Qi Stagnation and syndrome with Hepatic Stagnation causing Splenic Deficiency for depression were developed. Results:The standard of syndrome with the Hepatic Qi Stagnation was the five symptoms including emotion depression, pessimism, sigh, dysphoria and stringy pulse.When more than three symptoms occur(emotion depression is necessary ) and the total scores are more than 4 ,the differentiation can be established. The standard of differentiation of syndrome with Hepatic Stagnation causing Splenic Deficiency was seven symptoms including emotion depression,pessimism,sigh, lassitude and inertia ,anorexia, emaciation and faint pulse.When more than four symptoms occur, that is , two Hepatic Stagnation symptoms (emotion depression is necessary ) and two Splenic Deficiency symptoms are needed, total scores are more than 6, the differentiation can be established.Conclusions:The standard of differentiation of syndrome with Hepatic Qi Stagnation consisted of the five symptoms including emotion depression, sighing and so on.The standard of differentiation of syndrome with Hepatic Stagnation causing Splenic Deficiency consisted of the seven symptoms including emotion depression, lassitude and inertia, anorexia and so on.