本文選題：支氣管哮喘 + 支氣管哮喘合并抑郁　； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究支氣管哮喘合并抑郁情況及其中醫(yī)分型,為臨床進一步認(rèn)識及治療支氣管哮喘合并抑郁提供理論依據(jù)。方法:收集2016年1月至2016年12月在新疆醫(yī)科大學(xué)第一附屬醫(yī)院、新疆醫(yī)科大學(xué)第四附屬醫(yī)院就診的支氣管哮喘患者409例,在經(jīng)過患者同意后,對患者進行支氣管哮喘合并抑郁調(diào)查表、SDS抑郁自評量表及漢密爾頓抑郁量表調(diào)查,經(jīng)副高級及以上中醫(yī)醫(yī)師診斷后進行中醫(yī)辨證分型,利用統(tǒng)計軟件分析支氣管哮喘患者合并抑郁情況及其中醫(yī)證型特點。結(jié)果:1)409例支氣管哮喘患者中共有282例患者合并抑郁占68.9%,其中輕度抑郁患者195例占69.1%,中度抑郁患者53例占18.8%,重度抑郁患者34例占12.1%;2)對支氣管哮喘患者進行辨證論治后得出409例患者中腎虛痰瘀型患者145例占35.5%,風(fēng)痰哮型患者137例占33.5%,冷哮型患者85例占20.8%,熱哮型患者42例占10.3%;3)支氣管哮喘合并抑郁患者282例,其中腎虛痰瘀型患者124例占44.0%,風(fēng)痰哮型患者82例占29.1%,冷哮型患者57例占20.2%,熱哮型患者19例占6.7%;4)利用統(tǒng)計學(xué)軟件分析282例支氣管哮喘合并抑郁患者的中醫(yī)證型在一般資料(性別、年齡、民族、生活習(xí)慣)、臨床表現(xiàn)(發(fā)病季節(jié)、主要癥狀)以及抑郁程度、哮喘控制程度中的差異性,結(jié)果發(fā)現(xiàn)中醫(yī)證型在患者性別中的比較無差異,結(jié)果無統(tǒng)計學(xué)意義(P0.05),中醫(yī)證型在患者民族、生活習(xí)慣等因素中的比較均沒有明顯的差異,結(jié)果無統(tǒng)計學(xué)意義(P0.05),中醫(yī)證型在患者年齡分布中的對比有明顯差異,結(jié)果有統(tǒng)計學(xué)意義(X~2=27.724,P0.05);中醫(yī)證型在發(fā)病季節(jié)中的比較有明顯的差異,結(jié)果有統(tǒng)計學(xué)意義(X~2=25.744,P0.05);分別比較中醫(yī)證型在患者的臨床癥狀(咳嗽、氣喘、胸痛、夜間氣憋,失眠情況)中的差異,結(jié)果沒有明顯差異,無統(tǒng)計學(xué)意義(P0.05);中醫(yī)證型在患者的抑郁程度中的對比無差異,結(jié)果無統(tǒng)計學(xué)意義(P0.05);中醫(yī)證型在哮喘的控制程度中的對比有明顯差異,結(jié)果有統(tǒng)計學(xué)意義(X~2=8.426,P0.05)。結(jié)論:1)支氣管哮喘患者常伴有抑郁;2)對支氣管哮喘患者進行中醫(yī)分型后發(fā)現(xiàn)患者所有證型中都伴有“肝郁”的情況,而肝郁的程度與患者的病程長短以及病情的嚴(yán)重程度密切相關(guān),故在支氣管哮喘的治療過程中除了予以解痙平喘、宣肺化痰等治療外應(yīng)予以疏肝解郁結(jié)合干預(yù)治療;3)支氣管哮喘合并抑郁患者的所有中醫(yī)分型中也常伴有“肝郁”,肝郁程度以及辨證分型結(jié)果與患者的病情嚴(yán)重程度、年齡及發(fā)病季節(jié)關(guān)系密切。
[Abstract]:Objective: to study the status of asthma combined with depression and its TCM classification, and to provide theoretical basis for further understanding and treatment of asthma with depression. Methods: from January 2016 to December 2016, 409 patients with bronchial asthma were collected from the first affiliated Hospital of Xinjiang Medical University and the fourth affiliated Hospital of Xinjiang Medical University. Self-rating SDS Depression scale and Hamilton Depression scale were used to investigate the patients with bronchial asthma and depression. Statistical software was used to analyze the depression in bronchial asthma patients and the characteristics of TCM syndromes. Results out of 409 cases of bronchial asthma, 282 cases were complicated with depression, including 195 cases of mild depression (69.1%), 53 cases of moderate depression (18.8%) and 34 cases of severe depression (12.1g / 2). The results showed that 145 of 409 patients had kidney deficiency and phlegm stasis, 137 were wind and phlegm asthma, 85 were cold asthma, 42 were heat asthma, and 282 were bronchial asthma complicated with depression. 124 patients with kidney deficiency and phlegm stasis, 82 with wind and phlegm asthma, 57 with cold asthma and 19 with heat asthma were analyzed by statistical software. Age, nationality, living habits, clinical manifestations (onset season, main symptoms), depression and asthma control degree were different. The results showed that there was no difference in TCM syndromes in patients' sex. Results there was no significant difference in the difference of TCM syndromes in the factors of patients' nationality and living habits, but there was no significant difference in the difference of TCM syndromes in the distribution of patients' age, the results showed that there was no significant difference in the distribution of TCM syndromes in the age distribution of the patients, and there was no significant difference in the differences between the TCM syndromes and other factors. Results there were significant differences in the clinical symptoms (cough, asthma, chest pain, nocturnal choke) of the TCM syndromes in the patients, and there were significant differences in the types of TCM syndromes in the onset season, the results were statistically significant, the clinical symptoms of TCM syndromes in the patients were compared. There was no significant difference in the results between the two groups. There was no significant difference in the degree of depression in the patients with TCM, but there was no significant difference in the degree of depression of the patients, and there was no significant difference in the control degree of asthma between TCM syndromes and TCM syndromes. The results showed that there was statistical significance (P 0.05). Conclusion (1) Asthma patients are often accompanied by depression. After classifying bronchial asthma patients with traditional Chinese medicine, it is found that all syndrome types of bronchial asthma patients are accompanied by "liver depression". The degree of liver depression is closely related to the duration of the disease and the severity of the patient's condition, so in the treatment of bronchial asthma, in addition to the treatment of spasmolysis and asthma, All TCM types of bronchial asthma complicated with depression should also be accompanied by "liver depression", the degree of liver depression, the result of syndrome differentiation and the severity of the patient's condition. Age and onset season are closely related.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R256.12;R277.7

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