抑郁症患者肝郁气滞及肝郁脾虚型HAMD抑郁量表结构因素分析

目的探讨中医辨证为肝郁气滞型与肝郁脾虚型抑郁症患者在HAMD抑郁量表结构因素方面的差异。方法对91例经中医辨证属于肝郁气滞、肝郁脾虚型的抑郁症患者进行HAMD量表评分,并对两证型患者的HAMD量表7个症状因子结构因素进行统计分析。结果肝郁气滞与肝郁脾虚两证型患者的HAMD抑郁量表7个症状因子构成因素存在显著差异(P0.01),有统计学意义。肝郁气滞型患者在认知障碍、病情日夜变化症状因子上载荷较大,而肝郁脾虚型患者在迟滞症状、体重减轻因子上载荷突出。结论抑郁症患者虽然HAMD量表得分相同,但是其症状构成差异较大,更适合个体化的治疗。

Analysis on Hamilton Depression Scale Structural Factor of Depression Patients with Liver Qi Stagnation Syndrome and Liver Stangation and Spleen Defieiency Syndrome

Objective To discuss the different factorial structure of HAMD Scale between the patients of liver Qi stagnation syndrome and liver stagnation and spleen deficiency syndrome. Methods Factorial structure of HAMD Scale of 91 depression patients of liver Qi stagnation syndrome and liver depression and spleen deficiency syndrome were statistically analyzed. Result There was difference between the two types of patients in factorial structure of HAMD Scale （P 〈 0.01）. The patients of liver Qi stagnation syndrome had high loading in symptom factors of cognitive impairment and changes in condition, while the patients of liver stagnation and spleen deficiency syndrome in block symptoms and weight loss. Conclusion Depression patients with different syndromes have significant differences in factorical structure, though they may have the same HAMD scores, so individualized treatment is more suitable.