基于韦氏成人智力量表探索肝郁脾虚抑郁症患者认知功能特征

目的初步探索肝郁脾虚抑郁症患者认知功能特征。方法制定《肝郁脾虚中医证候观察表》，搜集抑郁症肝郁脾虚组患者30例，抑郁症非肝郁脾虚组患者29例，健康对照组23例，进行人口学资料（年龄、性别、学历）、汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）、韦氏成人智力量表的观察（WAIS-RC）。排除文化程度、情绪障碍轻重对认知的影响，分析WAIS-RC各因子，初步探索肝郁脾虚抑郁症患者认知功能特征。抑郁症两组情绪量表总分比较经t检验；WAIS—RC各因子经方差分析，如P〈0．05两两之间再经SNK检验。结果（1）抑郁症肝郁脾虚和非肝郁脾虚组在HAMD、HAMA总分上无明显统计学差异（P〉0．05）。（2）在相似性、数字广度、图画填充、物体拼凑、言语量表、操作量表、全量表因子上P〈0．05，提示三组存在明显统计学差异，两两之间再进行SNK检验。经检验在相似性、数字广度、言语量表、操作量表、全量表因子上抑郁症肝郁脾虚组和非肝郁脾虚组与健康对照组存在明显统计学差异（P〈0．05），抑郁症两组间无差异；在物体拼凑因子上抑郁症肝郁脾虚组均值均小于非肝郁脾虚组及健康对照组，与两组间均存在明显统计学差异（P〈0．05），非肝郁脾虚组及健康对照组无差异；在图画填充因子上抑郁症肝郁脾虚组均值大于健康对照组，两组存在明显统计学差异（P〈0．05），抑郁症非肝郁脾虚组与其它两组无明显统计学差异。在知识、领悟、算术、词汇、数字符号、木块图案、图片排列因子上P〉0．05，提示三组在以上因子上无明显统计学差异。结论抑郁症患者存在不同程度语言智商、操作智商的下降，主要表现为注意力下降、思维不够灵活、短时记忆力下降、信息加工能力差、归纳推理能力下降等，长时记忆力不受影响。且肝郁脾虚型较非肝郁脾虚型抑郁症患者信息加工能力更差，思维和推理能力更迟缓。

Explore the characteristics of cognitive function liver spleen in patients with depression based onWechsler adult intelligence scale

Objective To explore the characteristics of cognitive function liver spleen in patients with depression. Method Development of ＂stagnation and spleen deficiency syndromes observed table＂, collecting depression liver spleen group of 30 patients, non-depression liver spleen group of 29 patients and healthy control group of 23 patients, observing demographic data （age, gender, education）, Hamilton de- pression scale （HAMD）, Hamilton anxiety scale （HAMA）, Weehsler adult intelligence Scale （WAIS- RC ）. Educational level, the severity of the impact on cognitive emotional disorders are the exception, anal ysis of WAIS-RC various factors, preliminary exploration of cognitive function in patients with depression characterized by stagnation and spleen deficiency. T-test for two groups of patients with depression moodscale total score ; WAIS-RC each factor analysis of variance, such as P 〈 0. 05 and then by SNK test be tween any two. Results （ 1 ） Depression liver spleen and non-depression liver spleen group of Hamilton depression scale, the Hamilton anxiety on the total score was no significant difference （P 〉 0.05 ）. （2） On the similarity, digit span, picture fills, objects patchwork, verbal scale, the operation scale, full scale fac tor P 〈 0. 05, prompted significant difference between the three groups exist, then SNK test between any two. Upon examination at the similarities, digit span, verbal scale, the operation scale, there are signifi- cant difference on a full scale factor for depression liver spleen liver spleen group and non-group and the healthy control group （P 〈 0. 05 ）, depression no difference between the two groups ; patchwork factor on the subject of depression liver spleen group means were less than non-liver spleen group and the healthy control group, and the two groups were statistically significant differences exist （ P 〈 0. 05 ）, non-liver spleen group and the healthy control group, no difference; in the picture fill factor for depression liver spleen group means more than the healthy control group, there is a significant difference （ P 〈 0. 05 ） groups, depression groups and other non-liver spleen there was no significant difference. Knowledge, com- prehension, arithmetic, vocabulary, numbers, symbols, wood pattern, picture arrangement the factor P 〉 0. 05, prompted the three groups was no significant difference in the above factors. Conclusion Patients with depression verbal IQ, performance IQ varying degrees of decline, mainly in decreased attention, thinking not flexible enough, short-term memory loss, information processing ability, the ability to fall in inductive reasoning so, long memory is not affected. Liver and spleen deficiency than non-depressed pa- tients liver and spleen deficiency of information processing capacity is even worse, thinking and reasoning skills more slowly.