摘要
目的 探讨冠心病合并抑郁状态的影响因素及中医证候分布特点。方法 连续入选2020年6月—2021年4月在北京中医药大学东直门医院心血管内科就诊的冠心病患者共200例,符合纳排标准共172例,根据汉密尔顿抑郁量表(HAMD)评分结果分为无抑郁(≤7分)58例、轻度抑郁(8~17分)84例、中度抑郁(18~24分)21例、重度抑郁(≥25分)9例。比较无抑郁和抑郁状态患者性别、年龄、文化程度、就诊方式、病史(吸烟史、饮酒史、心力衰竭、高血压、糖尿病、高血脂症、PCI术后、脑卒中、心房纤颤、肾功能不全)。同时根据2017年《双心疾病中西医结合诊治专家共识》的诊断标准探讨冠心病合并抑郁状态的证候特点。结果 单因素分析显示,冠心病合并抑郁状态的影响因素有性别、年龄、就诊方式、吸烟、肾功能不全(P均<0.05)。多变量Logistic回归分析结果显示:女性、CCU住院、肾功能不全是冠心病合并抑郁状态的独立影响因素(P均<0.05);114例冠心病合并抑郁状态患者中,心血瘀阻证38例(33.3%),肝气郁结证28例(24.6%),痰火扰心证17例(14.9%),心脾两虚证12例(10.5%),心肾阳虚证10例(8.8%),心肾不交证9例(7.8%)。结论 冠心病患者抑郁状态的患病率为66.3%;女性、CCU住院、肾功能不全为冠心病合并抑郁状态的独立影响因素;冠心病合并抑郁状态的证候特点以心血瘀阻证和肝气郁结证为主,其他依次为痰火扰心证、心脾两虚证、心肾阳虚证、心肾不交证。
Objective It is to explore the influencing factors and distribution characteristics of traditional Chinese medical syndromes of coronary heart disease complicated with depression.Methods A total of 200 patients with coronary heart disease treated in the Department of Cardiovascular Medicine,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine from June 2020 to April 2021 were consecutively selected,in which a total of 172 patients met the admission and exclusion criteria.There were 58 cases without depression(≤7 points),84 cases with mild depression(8-17 points),21 cases with moderate depression(18-24 points),and 9 cases with severe depression(≥25 points)according to their score of Hamilton Depression Scale(HAMD).The gender,age,educational level,medical treatment,medical history(smoking history,drinking history,heart failure,hypertension,diabetes,hyperlipidemia,post-PCI,stroke,atrial fibrillation,renal function)between the patients depression and those without depression.At the same time,according to the diagnostic criteria of the 2017“Expert Consensus on Diagnosis and Treatment of Double Heart Diseases with Integrated Traditional Chinese and Western Medicine”,the syndrome characteristics of coronary heart disease combined with depression were discussed.Results Univariate analysis showed that the influencing factors of coronary heart disease complicated with depression were gender,age,way of seeing a doctor,smoking,and renal insufficiency(all P<0.05).The results of multivariate Logistic regression analysis showed that female,CCU hospitalization,and renal insufficiency were independent influencing factors of coronary heart disease complicated with depression(all P<0.05).Among the 114 patients with coronary heart disease complicated with depression,there were 38 cases(33.3%)of syndrome of heart-blood stasis,28 cases(24.6%)of syndrome of liver-qi stagnation,17 cases(14.9%)of syndrome of phlegm fire harassing heart,and 12 cases(10.5%)of syndrome of heart-spleen deficiency,10 cases(8.8%)of syndrome of heart-kidney yang deficiency,and 9 cases(7.8%)of syndrome of non-interaction between heart and kidney.Conclusion The prevalence rate of depression in patients with coronary heart disease is 66.3%;female,CCU hospitalization,and renal insufficiency are independent influencing factors of coronary heart disease complicated with depression.The syndrome characteristics of coronary heart disease complicated with depression are mainly the syndrome of heart blood stasis and liver qi stagnation,other syndrome are as follows:syndrome of phlegm fire harassing heart,syndrome of heart-spleen deficiency,syndrome of heart-kidney yang deficiency,syndrome of non-interaction between heart and kidney.
作者
刘用
吴旸
马立永
庄锐
刘佳
张立晶
LIU Yong;WU Yang;MA Liyong;ZHUANG Rui;LIU Jia;ZHANG Lijing(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《现代中西医结合杂志》
CAS
2022年第14期1934-1938,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
国家重点研发计划“中医药现代化研究”重点专项(2017YFC1700402)
北京中医药大学重点攻关项目(2020-JYB-ZDGG-116)。
关键词
冠心病
抑郁状态
危险因素
证候
coronary heart disease
depressive state
risk factors
syndrome
作者简介
刘用,男,在读博士,研究方向为中医药防治心血管病;通信作者:张立晶,E-mail:dzmyyccu@163.com。
