口腔扁平苔藓患者C型行为特征分析

目的： 探讨口腔扁平苔藓（oral lichen planus, OLP）与C型行为特征的关系，以期为临床预防、治疗和心理干预提供依据。方法： 采用C型行为量表对北京大学口腔医院黏膜科已确诊的符合纳入标准的OLP患者（85例）及非OLP（85例）进行调查，量表包含焦虑（anxiety）、抑郁（depression）、愤怒（anger）、愤怒内向（anger toward inside, anger in）、愤怒外向（anger toward outside, anger out）、理智（reasoning）、控制（domination）、乐观（optimism）、社会支持（social support）9个分项，将OLP组与对照组之间的各项得分进行计算并进行统计学分析，并将患者的各项C型行为特征得分按照性别、病损网纹 糜烂 溃疡分型、病程长短等分组，分别进行统计、对比。结果： 85例OLP患者中，女性多于男性，OLP最常好发的部位为颊部，非糜烂型患者多于糜烂型患者。C型行为量表中，OLP组与对照组的焦虑、抑郁、愤怒、乐观得分分别为（43.01±7.47）与（37.94±8.70）、（44.02±7.61）与（39.58±7.35）、（21.56±5.26）与（18.12±5.39）、（22.15±4.00）与（24.05±3.23），差异有统计学意义（P<0.05）；其中女性患者与对照组女性在焦虑、抑郁、愤怒、理智、控制、乐观得分分别为（43.21±6.97）与（37.20±8.68）、（44.29±7.54）与（39.33±7.33）、（21.64±5.09）与（17.64±5.28）、（39.12±5.66）与（41.23±4.71）、（16.29±3.95）与（17.85±3.69）、（22.05±4.12）与（24.20±3.12），差异有统计学意义（P<0.05）;男性患者各项得分与对照组男性差异无统计学意义。糜烂型OLP患者愤怒得分（22.94±5.26）高于非糜烂型OLP患者（20.60±5.03），差异有统计学意义（P<0.05）。病程越长，OLP患者抑郁和愤怒的倾向越明显，乐观得分越低。患病时间3年以上患者的外向愤怒得分（17.36±3.35）高于患病3年以内（包含3年）的患者（15.19±3.99），差异具有统计学意义（P<0.05）。结论： OLP患者的焦虑、抑郁、愤怒、低乐观等C行行为特征明显，在OLP的诊治过程中应关注患者的心理变化，可以此为依据进一步制定相应的干预措施。

Analysis of type C behavior in patients with oral lichen planus

Objective:To assess type C behavior in patients with oral lichen planus (OLP) in order to provide basis for clinical prevention,treatment and psychological intervention of OLP.Methods:Type C behavior scale was used on 85 OLP patients and 85 control patients,who were in accordance with the inclusion criteria,in order to investigate their type C behavior.The scale included 9 items:anxiety,depression,anger,anger toward inside (anger-in),anger toward outside (anger-out),reasoning,domination,optimism,and social support.Scores of the 9 items between OLP patients and control group were calculated under the instruction of the scale and were statistically analyzed,and OLP group was further stratified statistically by sex,reticulate-erosive-ulcerative (REU) pathological type and course of diseases,and the scores of each group were analyzed and compared.Results:Among the 85 OLP patients,there were more females,more non-erosive lesion type,and the most common site for OLP was the buccal mucosa.The scores of the type-C behavior questionnaire for anxiety,depression,anger and optimism were respectively 43.01 ± 7.47,44.02 ± 7.61,21.56 ± 5.26,22.15 ± 4.00 among the OLP patients and were 37.94 ±8.70,39.58 ±7.35,18.12 ±5.39,24.05 ±3.23 among control group,with significant differences (P ＜ 0.05 for all) between the two groups.The female OLP patients had higher anxiety,depression,anger scores (43.21 ± 6.97,44.29 ± 7.54,21.64 ± 5.09) and lower reasoning,domination,optimism scores (39.12 ±5.66,16.29 ±3.95,22.05 ±4.12) with significant differences (P ＜0.05 for all) compared with those of the female controls.The scores between male patients and male controls showed no significant difference.The patients with erosive lesions had higher anger score (22.94 ± 5.26) than that of the patients without erosive lesions (20.60 ± 5.03),with a significant difference (P ＜ 0.05).With the development of the disease,the tendency of anxiety and depression of the patients were more obvious,while optimism scores remained declining.The patients suffering more than 3 years of OLP had higher anger-toward-outside scores (17.36 ± 3.35) than the patients suffering less than 3 years of OLP (15.19±3.99),with a significant difference (P ＜0.05).Conclusion:OLP patients showed an obvious type C behavior characteristic,especially in anxiety,depression,anger and low optimism.This research provides the C behavior characteristic of OLP for further psychological consultation or intervention during OLP treatment.