本文選題：強(qiáng)迫癥 + 中醫(yī)五態(tài)人格　； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景強(qiáng)迫癥(obsessive-compulsive disorder,OCD)是一種臨床上主要表現(xiàn)為強(qiáng)迫思維、強(qiáng)迫行為和/或強(qiáng)迫沖動(dòng)等癥狀的神經(jīng)癥�；颊呙髦肋@些強(qiáng)迫癥狀不必要、不合理,但卻無法擺脫和控制他們,因而感到焦慮和煩躁。強(qiáng)迫思維和行為是一種令人討厭的癥狀,常常會(huì)使患者的工作、人際交往等各個(gè)方面的發(fā)展受到明顯影響,嚴(yán)重者還會(huì)使患者的各項(xiàng)社會(huì)功能受損,給個(gè)人、家庭及社會(huì)均造成極大傷害。其終生患病率為1%~3%,強(qiáng)迫癥的發(fā)病率正呈現(xiàn)出逐年上升的趨勢。中醫(yī)認(rèn)為,強(qiáng)迫癥是由情志失調(diào)導(dǎo)致氣機(jī)不暢,臟腑功能失調(diào)所引起的一類病癥,常見病機(jī)有肝郁化火、肝郁脾虛、心脾兩虛、肝郁痰阻、氣虛血瘀等。屬于“郁病”范疇。隨著傳統(tǒng)文化在中國的重視及心理學(xué)在神經(jīng)癥發(fā)病中的作用越來越多,中醫(yī)研究及強(qiáng)迫癥患者的人格特征越來越受到關(guān)注,而目前該方面研究較少,尤其是強(qiáng)迫癥患者的中醫(yī)五態(tài)人格特征分類研究幾乎空白。因此對強(qiáng)迫癥患者的中醫(yī)五態(tài)人格特征及完美主義傾向研究有重要的理論和實(shí)際意義。目的1.分析不同強(qiáng)迫癥癥狀群患者的中醫(yī)五態(tài)人格及其完美主義傾向特點(diǎn),旨在找出他們之間的關(guān)聯(lián)性;2.探討不同強(qiáng)迫癥癥狀群與中醫(yī)五態(tài)人格特征及完美主義之間的關(guān)系,以期為不同癥狀群的強(qiáng)迫癥的臨床診療開辟新的途徑。方法本研究采用橫斷面調(diào)查法,實(shí)驗(yàn)組:選取2015年10月至2016年11月在洛陽市精神衛(wèi)生中心、河南省洛陽榮康醫(yī)院和洛陽市第五人民醫(yī)院精神科門診、心理門診就診及住院部收治的經(jīng)知情同意后參加本次研究測試的120例強(qiáng)迫癥患者為研究對象,入組患者均符合《國際疾病分類與診斷標(biāo)準(zhǔn)》(第10版)(ICD-10)強(qiáng)迫癥的診斷標(biāo)準(zhǔn),其中男55例,女65例,年齡范圍18-45歲。同時(shí)對照組招募114例健康志愿者,男57例,女57例,年齡范圍19-48歲。測試評估時(shí)采用的研究工具為:一般情況問卷、中醫(yī)五態(tài)人格量表、中文Frost完美主義問卷(CFMPS)、耶魯-布朗強(qiáng)迫癥嚴(yán)重程度量表等作為研究工具,對性別、年齡、文化程度等維度上的差異進(jìn)行統(tǒng)計(jì)分析,并分別分析強(qiáng)迫癥強(qiáng)迫思維型、強(qiáng)迫行為型和強(qiáng)迫思維與強(qiáng)迫行為混合型患者人格在中醫(yī)五態(tài)人格的分布規(guī)律及其完美主義心理傾向。全部資料采用SPSS19.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)處理。結(jié)果1.不同強(qiáng)迫癥癥狀群患者的一般情況分析強(qiáng)迫思維型強(qiáng)迫癥組強(qiáng)迫程度量表分?jǐn)?shù)顯著高于對照組(t=19.062,P=0.000),差異有統(tǒng)計(jì)學(xué)意義;強(qiáng)迫行為型強(qiáng)迫癥組強(qiáng)迫程度量表分?jǐn)?shù)顯著高于對照組(t=14.856,P=0.000),差異有統(tǒng)計(jì)學(xué)意義;強(qiáng)迫思維與強(qiáng)迫行為混合型強(qiáng)迫癥組強(qiáng)迫程度量表分?jǐn)?shù)顯著高于對照組(t=32.751,P=0.000),差異有統(tǒng)計(jì)學(xué)意義。三種類型強(qiáng)迫癥組人口學(xué)變量上無差異,即性別、年齡、民族、職業(yè)、婚姻狀況、文化程度等相關(guān)因素對患者組強(qiáng)迫量表得分無顯著影響。2.不同強(qiáng)迫癥癥狀群與中醫(yī)五態(tài)人格的關(guān)系分析強(qiáng)迫思維型強(qiáng)迫癥組五態(tài)人格在太陽(t=-5.958,P=0.000)、少陽(t=-7.738,P=0.000)、陰陽平和(t=-12.925,P=0.000)3個(gè)維度得分均低于對照組,差異有統(tǒng)計(jì)學(xué)意義,在太陰(t=9.713,P=0.000)及少陰(t=19.933,P=0.000)維度得分高于對照組,差異有統(tǒng)計(jì)學(xué)意義;強(qiáng)迫行為型強(qiáng)迫癥組五態(tài)人格在少陽(t=-12.425,P=0.000)、陰陽平和(t=-13.222,P=0.000)2個(gè)維度得分均低于對照組,差異有統(tǒng)計(jì)學(xué)意義,在太陽(t=7.141,P=0.000)、太陰(t=19.094,P=0.000)及少陰(t=8.298,P=0.000)維度得分高于對照組,差異有統(tǒng)計(jì)學(xué)意義;強(qiáng)迫思維與強(qiáng)迫行為混合型強(qiáng)迫癥組五態(tài)人格在少陽(t=-8.981,P=0.000)、陰陽平和(t=-15.777,P=0.000)2個(gè)維度得分均低于對照組,差異有統(tǒng)計(jì)學(xué)意義,在太陽(t=11.263,P=0.000)、太陰(t=21.538,P=0.000)及少陰(t=10.120,P=0.000)維度得分高于對照組,差異有統(tǒng)計(jì)學(xué)意義。強(qiáng)迫思維型強(qiáng)迫癥患者組女性較男性在少陰維度得分差異有統(tǒng)計(jì)學(xué)意義(t=2.378,P=0.023),未婚較已婚者在太陽維度得分差異有統(tǒng)計(jì)學(xué)意義(t=-2.462,P=0.019)。強(qiáng)迫程度與陰陽平和(r=-0.610,P=0.000)、少陽(r=-0.450,P=0.000)之人的個(gè)性特點(diǎn)之間呈顯著負(fù)相關(guān),強(qiáng)迫程度與少陰(r=0.510,P=0.000)、太陰(r=0.697,P=0.000)、太陽(r=0.347,P=0.000)之人的個(gè)性特點(diǎn)之間顯著的正相關(guān)。其余不同組患者在五個(gè)維度得分均無差異性(P0.05)。3.不同強(qiáng)迫癥癥狀群與追求完美的關(guān)系分析強(qiáng)迫思維型強(qiáng)迫癥組的完美主義得分(t=22.674,P=0.000)高于對照組,差異有統(tǒng)計(jì)學(xué)意義;強(qiáng)迫行為型強(qiáng)迫癥組的完美主義得分(t=24.438,P=0.000)高于對照組,差異有統(tǒng)計(jì)學(xué)意義;強(qiáng)迫思維與強(qiáng)迫行為混合型強(qiáng)迫癥組的完美主義得分(t=25.950,P=0.000)高于對照組,差異有統(tǒng)計(jì)學(xué)意義。強(qiáng)迫行為型強(qiáng)迫癥組在性別組別上的因子得分差異具有顯著性(t=4.287,P=0.000),綜合一起分析,強(qiáng)迫嚴(yán)重程度和追求完美呈顯著正相關(guān)(r=0.714,P=0.000)。4.不同強(qiáng)迫癥癥狀群五態(tài)人格特點(diǎn)與完美主義特點(diǎn)相關(guān)性分析強(qiáng)迫行為型組五態(tài)人格少陽維度與完美主義特點(diǎn)(r=-0.376,P=0.020)呈負(fù)相關(guān);混合型組太陽維度與完美主義特點(diǎn)(r=0.379,P=0.010)呈顯著正相關(guān)。結(jié)論1.在中醫(yī)五態(tài)人格分類中,同時(shí)具有太陽人格及太陰人格及具有太陰人格、少陰人格的人更易患強(qiáng)迫癥,強(qiáng)迫癥患者人格中均不符合少陽人格、陰陽平和人格。性格維度傾向于太陰或少陰、太陽維度的人出現(xiàn)強(qiáng)迫的幾率較大。同為少陰性格之人女性較男性發(fā)生強(qiáng)迫思維型強(qiáng)迫癥的風(fēng)險(xiǎn)更高,與已婚者相比較,同為太陽人格的未婚者同為太陽性格之人未婚者較已婚者發(fā)生強(qiáng)迫思維型強(qiáng)迫癥的風(fēng)險(xiǎn)更高。2.不同強(qiáng)迫癥癥狀群(強(qiáng)迫思維型、強(qiáng)迫行為型、強(qiáng)迫性思維與行為混合型)與完美主義均具有較顯著關(guān)系,且強(qiáng)迫癥嚴(yán)重程度與完美主義強(qiáng)度呈正相關(guān)。強(qiáng)迫行為型強(qiáng)迫癥組患者中女性表現(xiàn)出明顯的完美主義傾向。
[Abstract]:Obsessive-compulsive disorder (OCD) is a neurosis which is mainly manifested in symptoms of forced thinking, compulsive behavior and / or compulsion. Patients know that these compulsive symptoms are not necessary and unreasonable, but they can not get rid of and control them, because they feel anxious and irritable. Compulsive thinking and behavior is a kind of order. People hate symptoms, often make the patient's work, interpersonal communication and other aspects of the development of the development are obviously affected, serious people will also make the social function of the patient, to the individual, family and society all cause great harm. The lifetime prevalence rate is 1%~3%, the incidence of obsessive-compulsive disorder is increasing year by year. Chinese medicine thinks, strong The disease is a kind of disease caused by the disorder of the Qi and the dysfunction of the viscera. The common pathogenesis is liver depression fire, liver depression and spleen deficiency, two deficiency of the heart and spleen, stagnation of liver and phlegm, Qi deficiency and blood stasis. The personality characteristics of the patients with obsessive-compulsive disorder are becoming more and more concerned, but at present there are few studies in this area, especially in the patients with obsessive-compulsive disorder, the classification of the personality characteristics of the five state of Chinese medicine is almost blank. Therefore, it has important theoretical and practical significance to study the characteristics of the five state personality of Chinese medicine and the perfectionism tendency of the OCD patients. The five state personality of Chinese medicine and its perfectionist tendencies in the patients with symptomatic group are designed to find the relationship between them; 2. to explore the relationship between the symptom groups of different obsessive-compulsive disorder and the character of five state of traditional Chinese medicine and perfectionism, in order to open up a new way for the clinical treatment of the obsessive-compulsive disorder with different symptom groups. Surface investigation method and experimental group: 120 cases of obsessive-compulsive disorder were selected from October 2015 to November 2016 in Luoyang mental health center, Henan Luoyang Rong Kang Hospital and Luoyang City Fifth People's hospital psychiatric clinic, psychological outpatient consultation and inpatient department. The criteria for the diagnosis of obsessive-compulsive disorder (ICD-10) (ICD-10), including 55 men, 65 women and 18-45 years of age, were recruited in 114 healthy volunteers, 57 men, 57 women and 19-48 years of age. The general situation questionnaire, Chinese medicine five personality scale, Chinese F The Rost perfectionist questionnaire (CFMPS), Yale Brown obsessive-compulsive severity scale, etc. were used as research tools to analyze the differences in gender, age, and educational level, and analyze the distribution of the personality of obsessive compulsive thinking, compulsive behavior and forced thinking and forced behavior in the five state of Chinese medicine. Regularity and psychological tendency of perfectionism. All data were processed by SPSS19.0 software. Results 1. the general situation of patients with different obsessive-compulsive disorder symptoms group analysis of obsessive-compulsive obsessive compulsive degree scale score was significantly higher than that of the control group (t=19.062, P=0.000), the difference was statistically significant; compulsive obsessive compulsive disorder group was strong The score of the forced course measurement was significantly higher than that of the control group (t=14.856, P=0.000), and the difference was statistically significant. The Obsessive-Compulsive Scale score of the obsessive and compulsive obsessive compulsive disorder group was significantly higher than that of the control group (t=32.751, P=0.000), and the difference was statistically significant. There was no difference in the demographic variables between the three types of obsessive-compulsive disorder group, that is, sex, age, and nationality, Occupational, marital status, cultural degree and other related factors have no significant influence on the score of.2. in patients with obsessive-compulsive disorder (t=-5.958, P=0.000), Shaoyang (t=-7.738, P =0.000), and t=-12.925, P=0.000 (t=-12.925, P=0.000) in the group of obsessive compulsive obsessive compulsive disorder Compared with the control group, the difference was statistically significant. The scores of t=9.713, P=0.000 and t=19.933, P=0.000 were higher than those in the control group, and the difference was statistically significant. The scores of the five state personality in the obsessive-compulsive obsessive compulsive disorder group were lower than those of the control group in the 2 dimensions of Shaoyang (t=-12.425, P=0.000), Yin Yang Ping and (t=-13.222, P=0.000). The difference was statistically significant. Meaning, the scores in the t=7.141, P=0.000, t=19.094, P=0.000 and t=8.298, P=0.000 (t=8.298, P=0.000) were higher than those of the control group, and the difference was statistically significant. The scores of the five state personality in the mixed obsessive-compulsive disorder group (t=-8.981, P=0.000), Yin Yang and t=-15.777, P=0.000 (t=-15.777, P=0.000) were all lower than the control group, the difference was lower than that of the control group. There were statistical significance in the dimensions of the dimensions of the sun (t=11.263, P=0.000), t=21.538, P=0.000 and t=10.120, P=0.000 (t=10.120, P=0.000), and the difference was statistically significant. There was a statistically significant difference between the women of the obsessive-compulsive obsessive compulsive disorder group and the male (t=2.378, P=0.023), and the unmarried married people were in the sun dimension. The differences were statistically significant (t=-2.462, P=0.019). There was a significant negative correlation between the degree of compulsion and the personality characteristics of people with r=-0.610, P=0.000 and r=-0.450 (P=0.000). The degree of obsessive compulsion was positively correlated with the personality characteristics of the people of less Yin (r=0.510, P=0.000), Tai Yin (r=0.697, P= 0), and the sun (r=0.347, P=0.000). There was no difference in the scores of five dimensions (P0.05) in different groups of patients (.3.) and the relationship between the symptoms of obsessive-compulsive disorder and the pursuit of perfection. The perfectionism score of the obsessive-compulsive obsessive compulsive disorder group (t=22.674, P=0.000) was higher than that of the control group, the difference was statistically significant; the perfectionism score of the obsessive-compulsive group (t=24.438, P=0.000) was higher than that of the obsessive-compulsive obsessive compulsive disorder group. The difference was statistically significant in the control group; the perfectionism score (t=25.950, P=0.000) in the obsessive and compulsive obsessive compulsive disorder group was higher than that of the control group. The difference was statistically significant. The scores of factors in the group of obsessive-compulsive obsessive compulsive obsessive compulsive disorder were significant (t=4.287, P=0.000), combined analysis, and forced severity. The correlation analysis between the five state personality characteristics and perfectionism characteristics of the symptoms group of different obsessive-compulsive disorder (r=0.714, P=0.000).4., the analysis of the five state personality Shaoyang dimension of the compulsive behavior group was negatively correlated with the perfectionism (r=-0.376, P=0.020), and the mixture group too Yang dimension and perfectionism (r=0.379, P=0.010) showed significant positive Conclusion 1. in the classification of five state personality of Chinese medicine, there are both the personality of the sun and the Taiyin personality and the Taiyin personality. The people with the personality of the less Yin are more susceptible to obsessive-compulsive disorder. The personality of the patients with obsessive-compulsive disorder does not conform to the personality of Shaoyang, Yin and Yang and the personality. The risk of compulsive obsessive compulsive obsessive compulsive disorder in women with less Yin character is higher than that of men. Compared with married people, the risk of obsessive compulsive obsessive compulsive disorder with the same sun personality as unmarried and unmarried people of the sun personality is higher in.2. different obsessive-compulsive disorder group (forced thinking, compulsive behavior, compulsive thinking). It has a significant relationship with perfectionism, and the severity of obsessive-compulsive disorder has a positive correlation with perfectionism intensity. The women in obsessive compulsive obsessive compulsive disorder show a clear tendency to perfectionism.

【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.7

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