老年期抑郁症中医证候要素及相关因素分析

目的探讨老年期抑郁症中医证候要素特征以及与相关因素之间的关系。方法采用自制“老年期抑郁症中医证候观察表”和汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）对100例60岁以上首次发作的抑郁症患者进行四诊资料的收集，并进行评定。结果老年期抑郁症证候要素以血虚、气郁和气虚为主。证候要素组合以3证组合最常见，3证组合中以血虚、气郁和气虚组合情况最多。结论老年期抑郁症病机复杂，属本虚标实，虚证以气血两虚为主，兼有髓亏，实证以气郁、血瘀为主，辨证病位在肝、脾、肾最为常见；证型以肝郁脾虚和肝郁肾虚多见。

TCM syndrome elements and relevant factors of senile depression

Objective To investigate the relationship between TCM syndrome elements and relevant factors of senile depression. Methods The materials collected by TCM four diagnosis methods from 100 patients （over 60 year-old） with depression for the first time were reviewed by applying self-made ＂Observation Table of TCM Syndromes of Senile Depression＂, Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA）. Results The TCM syndrome elements of senile depression included mostly blood deficiency, qi stagnation and qi deficiency, and the combination of these three elements was the most common in the combinations of syndrome elements. Conclusion The pathogenesis of senile depression is complicated characterized by deficiency of the root and excess of the tip. The deficiency syndromes are mainly syndrome of dual deficiency of qi and blood accompanied by marrow loss, and the excess syndromes are mainly qi stagnation syndrome and blood stasis syndrome. The locations of the disease are commonly in the liver, spleen and kidney by syndrome differentiation, and the syndrome types are mostly liver depression and spleen deficiency, and liver depression and kidney deficiency.