抑郁症中医证候的群体分布特点及其相关因素研究

目的分析抑郁症群体中医证候分布特点及其相关因素，探讨抑郁症不同证候的发生发展规律。方法根据临床流行病学调查获得的抑郁症病例四诊资料，经过动态聚类和探索性因子分析，结合中医辨证，得到每个病例所属的证候，而后，比较不同群体特征的证候类型构成及其与西医临床类型的关系。结果397例抑郁症患者六种证型构成从高到低依次为肝气郁结、心神不宁证（108例，27．2％），心脾两虚、湿浊中阻证（94例，23．7％），心肝气郁、痰浊阻滞证（76例，19．1％）、心肝气郁、经络不和证（57例，14．3％）、心肾两亏、气滞络痹证（34例，8．6％）和心肝气郁、化热扰神证（28例，7．1％）。不同年龄或西医类型组（轻性、有或无精神病性症状性）的中医证型构成间的差异均有统计学意义（P〈0．01）。不同性别、有无精神疾病家系史、单双相及首发或复发患者的中医证型构成间的差异均无统计学意义（P〉0．05）。结论本结果基本符合中医理论的认识规律，为论治提供了可靠的辨证基础。

Study on the Characteristics of Population Distribution of TCM Syndromes and Its Related Factors in Patients of Depression

Objective To study the rules of occurrence and development of TCM syndromes in patients of depression by analysing the population distribution and related factors of it. Methods A clinical epidemiologic survey was carried out with the materials collected by the four-diagnostic method from patients of depression to gain the syndrome types of 397 patients through dynamic cluster analysis, factor analysis and TCM syndrome differentiation. The constitution of syndrome types in different population and the relation between TCM syndrome types and the clinical types differentiated by Western medicine of depression was analyzed.Results Six syndrome types were found in 397 patients with depression. They were, ranging in occurrence order, the Gan-Qi stagnation with mental uneasiness type (108 cases, 27.2%); the Xin-Pi deficiency with dampness retention type (94 cases, 23.7%); the Xin-Gan Qi-stagnation with Phlegm retention type (76 cases, 19.1%); the Xin-Gan Qi stagnation with Jing-Luo disharmony type (57 cases, 14.3%); the Xin-Shen Qi stagnation with collateral obstruction type (34 cases, 8.6%); and the Xin-Gan Qi stagnation with Heat interfering mental type (28 cases, 7.1%). There were statistical significance (P<0.01) in comparison of the syndrome types constitution among patients of different ages or different Western medicinal types (mild, with or without psychotic symptoms), but no significant difference was shown in that among patients of different sexes, with or without familial history of mental diseases, with monophasic or biphasic, initial or recurrent episode (P>0.05). Conclusion The result obtained in this study is basically in accord with the cognitive rule of TCM theory, it provides a reliable base of syndrome differentiation for treatment.