本文選題：酒精使用障礙 + 酒精依賴��； 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的 1.調(diào)查某個時間段內(nèi)消化科門診和住院部,研究人群(AUDIT≥7分)中可能患有酒精依賴的患者(女性AUDIT≥13分,男性AUDIT≥15分)所占的比例。 2.了解研究人群(AUDIT≥7分)的人口學(xué)特點、飲酒模式及心理狀態(tài)。 3.通過SF-36量表描述研究人群(定義為AUDIT≥7分)的生命質(zhì)量,BDI量表評估研究對象的心理狀況。 4.比較研究人群中7分≤AUDIT13或15分人群和可能有酒精依賴人群(女性AUDIT≥13分,男性AUDIT≥15分)之間人口學(xué)特征、心理情況及生活質(zhì)量之間的差異。 5.了解酒精使用障礙程度的影響因素和危險因素。 方法 本研究為非干預(yù)性橫斷面調(diào)查,調(diào)查將收集因軀體疾病而到湘雅二醫(yī)院消化科門診或病房尋求醫(yī)療幫助的患者基線信息。無論其軀體疾病是否與飲酒相關(guān)均使用AUDIT量表篩選患者,滿足入組條件者收集其飲酒頻率、模式、飲酒行為等飲酒相關(guān)信息,并使用SF-36量表收集其生命質(zhì)量各維度情況及用Beck抑郁自評量表進(jìn)行自我評估。將入組研究對象按危險飲酒(定義為：女性患者7分≤AUDIT評分13分；男性患者7分≤AUDIT評分15分)和可能患有酒依賴的患者(定義為：女性患者AUDIT評分≥13分；男性患者AUDIT評分≥15分)分為兩組,分別比較兩組之間人口學(xué)資料、生命質(zhì)量及抑郁程度等指標(biāo)的差異。該研究僅進(jìn)行一次訪視,通過研究者評定和患者自評的問卷和量表收集臨床信息。將問卷和量表進(jìn)行數(shù)據(jù)收集,建立數(shù)據(jù)庫并進(jìn)行統(tǒng)計分析。 結(jié)果 1.我院消化科可能患酒精使用障礙(男性AUDIT評分≥15分、女性AUDIT評分≥13分)比例門診為5.95%,病房為3.05%,與全國性調(diào)查發(fā)現(xiàn)酒精依賴患病率1993年為3.4%,2003年為3.8%相比,門診高于全國性酒精依賴患病率,而病房略低于全國性；而危險飲酒(7分≤AUDIT評分≤13/15分)門診和病房的比例分別為3.81%和0.78%。 2.入組的149例研究對象經(jīng)過統(tǒng)計,其中有47%最常飲高度白酒(52°及以上),余下依次為啤酒26.2%、米酒/谷酒15.4%；7分AUDIT13/15分人群最常飲酒類型為啤酒,其比例為50%,高度白酒和米酒/谷酒次之,比例分別為25%和14.6%；而AUDIT≥13/15分人群最常飲酒為高度白酒,其比例為57.4%,米酒/谷酒和啤酒次之,分別為15.8%和14.9%。提示在不同程度的酒精使用人群中,最常飲酒類型不一致。 3.入組研究人群的平均每周飲酒次數(shù)為8.31士6.19次/周,最多可達(dá)30次；平均每次飲酒量在3-5個標(biāo)準(zhǔn)杯之間；四周飲酒天數(shù)主要集中在10天和28天。提示在入組人群中按照飲酒天數(shù)分組明顯分為兩組組,且兩組之間在飲酒程度、飲酒次數(shù)和在酒精依賴的程度上各具特點。 4. AUDIT評分高組(男性AUDIT評分≥15分、女性AUDIT評分≥13分)的平均每周飲酒次數(shù)(χ2=34.89,p0.05)、平均每周飲酒天數(shù)(χ2=38.77,p0.05)和平均每次飲酒標(biāo)準(zhǔn)杯(χ2=10.84,p=0.0010.05)均明顯高于低分組(7分≤AUDIT評分13/15分)。 5.研究人群(AUDIT評分≥7分)在不同年齡階段、家庭人均月收入、病人來源的飲酒類型差異具有統(tǒng)計學(xué)意義。而在婚姻狀況、就業(yè)狀況、文化程度上飲酒的類型差別無統(tǒng)計學(xué)意義。 6.根據(jù)AUDIT評分劃分兩個等級的Beck抑郁評分等級差異具有統(tǒng)計學(xué)意義(χ2=27.754,p0.05),且AUDIT等級和Beck抑郁評分等級間存在線性趨勢(χ2=23.726,p0.05),可能隨著ADUIT評分的增加,抑郁評分等級隨之增加,即可能患抑郁程度逐漸增大(U=1072,p0.05)。 7.酒精使用程度嚴(yán)重人群中,飲酒所造成的損害更多集中于生理功能、生理職能上,在軀體疾病的基礎(chǔ)上可能進(jìn)一步發(fā)展,進(jìn)而影響其活力、社會職能和情感職能。 8.AUDIT評分等級的單因素影響分析發(fā)現(xiàn)性別、婚姻狀況、就業(yè)狀況對AUDIT評分等級的影響無統(tǒng)計學(xué)意義,而年齡、文化程度、收入分組和病人來源等因素對AUDIT評分有統(tǒng)計學(xué)意義。AUDIT評分等級的多因素Logistic回歸分析：隨著年齡的增加可能患酒精使用障礙的風(fēng)險增大,且45-59歲之間時可能為患病高峰期,此后隨著年齡繼續(xù)增加,酒精使用障礙的患病率無明顯改變；高中或中專的中等文化水平為酒精使用程度的危險因素；低收入和高收入水平是酒精使用程度的危險因素。而性別、婚姻狀況、工作狀況和病人來源在回歸模型中無統(tǒng)計學(xué)意義。 結(jié)論 1.酒精使用障礙程度越重,患抑郁癥風(fēng)險越大。 2.酒精使用程度嚴(yán)重人群中,飲酒所造成的損害更多集中于生理功能、生理職能上,在軀體疾病的基礎(chǔ)上進(jìn)一步發(fā)展,進(jìn)而影響其活力、社會職能和情感職能。 3.消化科就診的中老年人、中等文化水平、低收入或高收入且飲高度白酒的人群考慮為酒精使用障礙的高危人群,作為判斷早期干預(yù)對象的參考依據(jù)。
[Abstract]:objective
1. a survey was conducted to investigate the proportion of patients with alcohol dependence (female AUDIT > 13, male AUDIT > 15) in the Department of Gastroenterology and hospitalization in a certain period of time (AUDIT > 7).
2. to understand the demographic characteristics, drinking patterns and psychological state of the study population (AUDIT > 7).
3. describe the quality of life of the study population (defined as AUDIT > 7) through the SF-36 scale, and assess the psychological status of the subjects by BDI scale.
4. the differences in demographic characteristics, psychological conditions and quality of life were compared between 7 or 15 AUDIT13 or 15 people and a population of alcohol dependent people (female AUDIT > 13, and male AUDIT > 15).
5. understand the influencing factors and risk factors of alcohol use disorders.
Method
This study was a non intervention cross-sectional survey. The survey would collect baseline information for patients seeking medical help in the Department of digestive department or ward of Xiangya No.2 Hospital for physical diseases. Whether their physical diseases were associated with alcohol consumption, the AUDIT scale was used to screen patients to meet the intake conditions and to collect drinking frequency, pattern, drinking behavior and so on. Alcohol related information, and the use of the SF-36 scale to collect the quality of life and the self-assessment of the Beck depression self rating scale. The subjects were selected for risk drinking (defined as: 7 points of female patients < 13 AUDIT score, 7 points for male patients, 15 scores) and patients with alcohol dependence (defined as: female patients. The AUDIT score was more than 13, and the AUDIT score of male patients was more than 15 scores. The difference between the demographic data, the quality of life and the degree of depression among the two groups was compared. The study only conducted a visit and collected the clinical information through the questionnaire and scale of the researcher and the patient's self evaluation. Establish a database and carry out statistical analysis.
Result
1. the Department of Gastroenterology in our hospital may suffer from alcohol use disorder (male AUDIT score more than 15 points, female AUDIT score more than 13) in the outpatient clinic is 5.95%, the ward is 3.05%, and the national survey found that the alcohol dependence prevalence rate is 3.4% in 1993 and 3.8% in 2003, the outpatient is higher than the national alcohol dependence incidence, and the ward is slightly lower than the national; and dangerous drink The proportion of alcohol (7 points less than AUDIT score less than 13/15) was 3.81% and 0.78%. respectively in outpatient and ward.
Among the 149 subjects in the 2. group, 47% of the most frequent Liquors (52 degrees and above) were the most frequent. The remaining ones were beer 26.2%, rice wine / Valley wine 15.4%, and the most common drinking type in the 7 AUDIT13/15 group was beer, the proportion was 50%, the high liquor and rice wine / wine were 25% and 14.6%, while AUDIT > 13/15 was the most popular. The average alcohol consumption is high liquor, the proportion of which is 57.4%, rice wine / grain wine and beer are 15.8% and 14.9%., respectively, and the most frequent alcohol use types are not consistent among the people with different degrees of alcohol use.
The average drinking times per week in the 3. group were 8.31 and 6.19 times per week, up to 30 times, and the average alcohol consumption was between 3-5 standard cups. The number of drinking days around the group was mainly in 10 days and 28 days. It was suggested that the number of drinking days in the group was divided into two groups, and the degree of drinking and drinking between the two groups was between the two groups. And the degree of dependence on alcohol has its own characteristics.
The average weekly drinking times (x 2=34.89, P0.05), average weekly drinking days (x 2=38.77, P0.05) and average drinking standard cup (chi 2=10.84, p=0.0010.05) were significantly higher in 4. AUDIT scores (male AUDIT score or more than 13). The average weekly drinking days (x 2=38.77, P0.05) and average drinking standard cups (chi 2=10.84, p=0.0010.05) were significantly higher than those of the lower group (7 points < AUDIT score 13/15 score).
5. the study population (AUDIT score > 7) was statistically significant at different age stages, per capita monthly income of the family, and the type of drinking type of patient sources, but there was no significant difference in the types of drinking in marital status, employment status and education.
6. according to the AUDIT score, the scores of two grades were statistically significant (x 2=27.754, P0.05), and there was a linear trend between the AUDIT grade and the Beck depression score (P0.05). It may increase with the increase of ADUIT score and the depression score, which can increase the degree of depression (U=1072, p0.0). 5).
7. of the people with severe alcohol use, the damage caused by drinking is more concentrated on the physiological function. On the basis of physical function, it may further develop on the basis of physical disease, and then affect its vitality, social function and emotional function.
The single factor impact analysis of 8.AUDIT scores showed that gender, marital status, and employment status had no significant influence on the grade of AUDIT, while age, educational level, income group and patient source were statistically significant in the.AUDIT score of AUDIT scores: with the increase of age The risk of alcohol use disorders increases and may be the peak period between 45-59 years of age, and the prevalence of alcohol use disorders is not significantly changed as age continues; secondary and secondary school levels in high school or secondary school are risk factors for alcohol use; low income and high income are the risk factors for alcohol use. There was no statistical significance in sex, marital status, work status and patient source in the regression model.
conclusion
1. the more severe alcohol use disorders, the greater the risk of depression.
2. of the people with severe alcohol use, the damage caused by drinking is more concentrated on the physiological function, and the physiological function is further developed on the basis of somatic disease, which affects its vitality, social function and emotional function.
The middle aged and elderly people in the 3. digestive department, medium level, low income or high income and drinking high spirits are considered as the high risk groups of alcohol use barriers as a reference for judging early intervention.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R749.6

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