發(fā)布時間：2018-04-22 09:25

  本文選題：共情 + 焦慮癥��； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究目的:選取抑郁、焦慮癥各30名患者,分別對兩類患者各自進行證候及共情評估,探析兩種疾病的中醫(yī)證候與共情的關(guān)聯(lián)性,并與前期精神分裂癥患者進行共情及中醫(yī)證型的差異性研究。研究方法:1.本研究以中醫(yī)癥狀入手,依據(jù)《中醫(yī)診斷學(xué)》相關(guān)內(nèi)容,制定了中醫(yī)證候觀察評分表,同時運用國內(nèi)與國外合作翻譯的八種共情量表,分別對抑郁、焦慮癥患者進行共情能力及中醫(yī)證候評估。2.以紙質(zhì)版量表為病例收集工具,病例所有資料來源于2016年01月至2017年01月,安定醫(yī)院及北京中醫(yī)藥大學(xué)第三附屬醫(yī)院腦病科的門診病人。3.運用SPSS軟件,采用相關(guān)統(tǒng)計學(xué)方法,分別對抑郁、焦慮癥患者的中醫(yī)證候觀察表及共情指數(shù)量表(EQ Empathy Quotient)、過度競爭性態(tài)度量表(HCA Hypercompetitive Attitude Scale)、自閉癥譜系量表(AQ The Autism-spectrum Quotient)、自我建構(gòu)量表(SCS Self-Construction Scale)、人際反應(yīng)指數(shù)量表(IRI Interpersonal Reactivity Index)、伯克利情緒表達量表(BEQ Berkeley Expressivity Questionnaire)、情緒調(diào)節(jié)量表(ERQ Emotion Regulation Questionnaire)及多倫多述情障礙量表(TAS Toronto AlexithymiaScale)八種量表進行評估,并探討共情能力與中醫(yī)證候的內(nèi)在相關(guān)性。并依據(jù)兩類患者的研究結(jié)果分別與前期業(yè)已得出的精神分裂癥的成果,三者之間進行證候及共情能力的差異性對比。研究結(jié)果:1.抑郁癥組共納入30例,男性為17例,女性13例,男女比例約為1.3:1,年齡平均為35.4±9.48,最小為22歲,最大為54歲;焦慮癥組共納入30例患者中,男性為17例,女性13例,男女比例約為1.3:1,年齡平均為33.93± 10.70,最小為18歲,最大為64歲;正常組共納入34例,男性為30例,女性4例,男女比例約為7.5:1,年齡平均為33.91±9.52,最小為18歲,最大為56歲。2.通過對抑郁、焦慮患者各自中醫(yī)證候觀察表評分發(fā)現(xiàn):抑郁癥組主要證型為肝氣郁結(jié),心(陰)血虛,肝火熾盛,心(陽)氣虛;焦慮癥患者主要證型為肝氣郁結(jié),心(陰)血虛,膽郁痰擾,肝火熾盛。3.抑郁、焦慮癥患者與正常組之間的共情量表分值研究結(jié)果如下:兩組患者F1(難以識別自己的情感)因子分數(shù)高于正常組,差異具有統(tǒng)計學(xué)意義(P0.05),提示兩類患者對自己的情感難以識別,且兩組患者F2(難以描述自己的情感)因子分數(shù)低于正常組,差異具有統(tǒng)計學(xué)意義(P0.05),說明兩類患者描述自身情感方面存在缺陷;兩組患者表達抑制因子分數(shù)低于正常組,差異均具有統(tǒng)計學(xué)意義(P0.05),說明兩類患者較正常人更易因難以表達情緒,而產(chǎn)生較強的主觀情緒體驗;兩組患者注意力因子(AS)評分低于正常組,差異具有統(tǒng)計學(xué)意義(P0.05),說明兩類患者在注意力集中及轉(zhuǎn)換能力方面較差。此外,焦慮癥組患者個體憂傷(PD)及量表中負向因子(PD+FS)總分,均高于正常組,差異具有統(tǒng)計學(xué)意義(P0.05),說明焦慮癥患者,面對他人所處困境或壓力情景時,不能準確地的產(chǎn)生自我內(nèi)心反應(yīng)。4.中醫(yī)證候與共情之間的相關(guān)性:抑郁癥組:肝火熾盛、膽郁痰擾與PD因子存在相關(guān)性;痰證與STR因子存在相關(guān)性,脾胃氣虛與Interdependent-self因子存在相關(guān)性。焦慮癥組:血瘀及肝氣郁結(jié)證型與PD因子及FS+PD負向因子均存在明顯相關(guān)性;血瘀型與F1、AD因子與亦存在明顯的相關(guān)性;肝氣郁結(jié)與STR存在較強的相關(guān)性;腎陰虛與Interdependent-self因子存在相關(guān)性;脾氣虛、腎陽虛證型與表達抑制因子存在相關(guān)性。5.3組患者證型對比結(jié)果發(fā)現(xiàn):三種疾病中肝火熾盛、心(陰)血虛型多見;焦慮及精神分裂癥中膽郁痰擾型多見;抑郁癥心陽氣虛型多見,精神分裂癥痰證多見。6.3組患者共情量表的差異性結(jié)果發(fā)現(xiàn):TAS量表在三種疾病均可見評分異常;ERQ、AQ量表在抑郁、焦慮癥均見評分異常;IRI量表在精神分裂、焦慮癥中可見評分異常;BEQ量表僅在精神分裂癥見評分異常。結(jié)論:1.抑郁、焦慮癥患者各自存在一定的共情缺陷,兩者均涉及難以識別自己的情感、難以描述自己的情感、表達抑制及注意力轉(zhuǎn)換等方面;此外,焦慮患者在個體憂傷及個體憂傷與幻想因子兩方面存在共情缺陷。2.抑郁癥主要證型為肝氣郁結(jié),心(陰)血虛,肝火熾盛,心(陽)氣虛;焦慮癥為肝氣郁結(jié),心(陰)血虛,膽郁痰擾,肝火熾盛。3.抑郁癥患者:偏于擴大自身痛苦的患者,可嘗試從清肝利膽,瀉火化痰法治療;情緒表達強度較強的患者,可嘗試從痰論治;對他人及朋友依賴較強的患者,可嘗試從補益脾胃治療。焦慮癥患者:易于擴大自身痛苦患者,可嘗試用疏肝解郁,活血化瘀治療;難于識別自身情感及細節(jié)注意力較差的患者,可嘗試從活血化瘀論治;易產(chǎn)生主觀情緒體驗的患者,可嘗試從補脾益腎治療;對外界環(huán)境依賴性較強的患者,可嘗試從補腎育陰治療。4.抑郁、焦慮與精神分裂癥患者肝火熾盛、心(陰)血虛型多見;焦慮及精神分裂癥膽郁痰擾型多見;抑郁癥心陽氣虛型多見,精神分裂癥痰證多見。5.TAS可用于抑郁、焦慮及精神分裂癥的量表評定;ERQ、AQ量表可用于抑郁、焦慮癥的評判;IRI量表適用于精神分裂、焦慮癥的評估;BEQ量表僅用于精神分裂癥的量表測評。
[Abstract]:Objective: to select 30 patients with depression and anxiety, each of the two types of patients, respectively, to carry out their respective syndromes and empathy, to explore the correlation between the TCM syndromes and empathy of the two diseases, and to study the difference between the empathy and the TCM syndrome type in the early schizophrenic patients. The research methods: 1. studies are based on the TCM symptoms and according to the TCM syndrome. Diagnostics > related contents, formulating the scale of TCM syndrome observation, at the same time using eight empathy scales translated by domestic and foreign cooperation, the empathy and TCM syndrome assessment of patients with depression, anxiety, and TCM syndrome.2. are used as a case collection tool. The data from 01 months to 01 months of 2017 from 2016 to 01 months in 2017 .3., the Third Affiliated Hospital of Beijing University of Chinese Medicine, used SPSS software in the outpatient department of the Department of encephalopathy in the Third Affiliated Hospital of the hospital. The related statistical methods were used to observe the TCM syndromes and the empathy index scale (EQ Empathy Quotient), the excessive competitive attitude scale (HCA Hypercompetitive Attitude Scale), and the autism spectrum of the patients with depression and anxiety. The AQ The Autism-spectrum Quotient, the self construction scale (SCS Self-Construction Scale), the interpersonal response index scale (IRI Interpersonal Reactivity Index), the Berkeley emotional expression scale, the emotion regulation scale and the Toronto alexithymia The eight scales of TAS Toronto AlexithymiaScale were evaluated, and the intrinsic correlation between the empathy ability and TCM syndromes was discussed. The results of the schizophrenia in the two types of patients were compared with the previous results of schizophrenia, and the differences in the syndrome and empathy between the three were compared. The results of the study were included in the 1. depression group, 3 In 0 cases, there were 17 males and 13 females, the average age of men and women was about 1.3:1, the average age was 35.4 + 9.48, the minimum was 22, and the maximum was 54 years old. Among the 30 patients, the anxiety group had 17 men and 13 women, the male and female ratio was about 1.3:1, the average age was 33.93 + 10.70, the smallest was 18 years and the largest was 64. In 4 women, the proportion of men and women was about 7.5:1, the average age was 33.91 + 9.52, the youngest was 18 years old and the maximum was 56 years old.2.. The main syndrome types of depression group were liver qi stagnation, heart (Yin) blood deficiency, liver fire flaming, heart (Yang) Qi deficiency, and the main syndromes of anxiety patients were liver qi depression, heart (Yin) blood. Deficiency, cholera phlegm disturbance, liver fire and.3. depression, the results of the empathy scale between the patients with anxiety and the normal group are as follows: two groups of patients F1 (difficult to identify their own emotion) scores are higher than the normal group, the difference is statistically significant (P0.05), suggesting that the two types of patients are difficult to identify their own emotions, and the two groups of patients F2 (difficult to describe) The factor scores of their own emotions were lower than those of the normal group, the difference was statistically significant (P0.05), indicating that the two types of patients described their own emotional defects, and the two groups were lower than the normal group, and the difference was statistically significant (P0.05), indicating that the two types of patients were more likely to be more difficult to express their emotions than the normal ones. The two groups of patients' attention factor (AS) score was lower than the normal group, the difference was statistically significant (P0.05), indicating that the concentration and conversion ability of the two types of patients were poor. In addition, the individual sadness (PD) and the total score of negative factor (PD+FS) in the scale of the anxiety group were higher than those in the normal group, and the difference was statistically significant. (P0.05), indicating that patients with anxiety disorders, in the face of the predicament or stress situation of others, can not accurately produce the correlation between.4. syndrome and empathy: depression group: liver fire, cholera phlegm disturbance and PD factor correlation; phlegm syndrome and STR factor correlation, spleen and stomach qi deficiency and Interdependent-self factor There was a significant correlation between the syndrome of blood stasis and the syndrome of liver Qi Stagnation with PD factor and FS+PD negative factor; blood stasis type and F1, AD factor also have obvious correlation; liver qi stagnation and STR have strong correlation; kidney yin deficiency and Interdependent-self cause the correlation; spleen qi deficiency, kidney yang deficiency syndrome type and expression inhibition The result of the correlation of the.5.3 group with the related factors found that the liver fire was flourishing and the heart (Yin) blood deficiency was more common in the three diseases; the anxiety and schizophrenia were most common in the cholera phlegm disturbance type; the depression of the heart yang deficiency type was more common, the schizophrenia phlegm syndrome was found in the.6.3 group and the difference results of the empathy scale of the group were found: the TAS scale was all in the three diseases. The score abnormality was seen in the ERQ and AQ scales in the depression and anxiety disorder; the IRI scale in schizophrenia and anxiety showed a score abnormality; the BEQ scale was only in the schizophrenia score abnormality. Conclusion: 1. the patients with depression and anxiety have some empathy, both of which are difficult to identify their own emotions and are difficult to describe themselves. In addition, the main syndromes of.2. depression in anxiety patients and individual melancholy and individual melancholy and fantasy factor two were liver qi stagnation, heart (Yin) blood deficiency, liver fire blaming, heart (Yang) Qi deficiency, anxiety disorder for liver qi stagnation, heart (Yin) blood deficiency, cholera phlegm disturbance and liver fire blowing.3. depression. Patients who are inclined to enlarge their own pain can try to treat them from liver clearing and diarrhea and cremation and phlegm therapy; the patients with strong emotional expression can try to treat them from phlegm, and can try to treat the patients who have strong dependence on others and their friends. The patients who are difficult to identify their own feelings and the poor attention in detail can try to treat the patients from activating blood and removing blood stasis. The patients who are prone to subjective emotional experience can try to treat the spleen and kidney and benefit the kidney. The patients with strong external environment dependence can try to treat.4. depression, anxiety and schizophrenia patients' liver fire, heart (Yin) and heart (Yin). Blood deficiency type is common; anxiety and schizophrenia cholera phlegm type is common; depression heart yang deficiency syndrome is more common, schizophrenia phlegm syndrome can be used to evaluate depression, anxiety and schizophrenia; ERQ, AQ scale can be used for the evaluation of depression and anxiety; IRI scale is suitable for schizophrenia, anxiety assessment; BEQ scale is only used in the BEQ scale. A scale assessment of schizophrenia.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R277.7

【參考文獻】

相關(guān)期刊論文 前10條

1 吳姍姍;朱春燕;解方舟;鐘慧;莫大明;張立花;汪凱;;青少年精神分裂癥共情能力的研究[J];中國臨床心理學(xué)雜志;2016年05期

2 陳璇;張宏耕;宋煒熙;;精神分裂癥的中醫(yī)證候規(guī)律研究[J];湖南中醫(yī)雜志;2016年09期

3 胡鳳嬋;胡愛麗;牛小群;;共情護理對剖宮產(chǎn)產(chǎn)婦焦慮情緒及護理滿意度的影響[J];昆明醫(yī)科大學(xué)學(xué)報;2016年08期

4 汪金濤;郝秀梅;;精神分裂癥可從“痰瘀”論治[J];世界中西醫(yī)結(jié)合雜志;2016年07期

5 郭婷;;共情護理對病毒性肝炎肝硬化患者抑郁情緒的影響[J];護理實踐與研究;2016年13期

6 邵靜;王清賢;;劉玉潔教授從痰論治抑郁癥經(jīng)驗[J];河北中醫(yī);2016年05期

7 李國輝;郭冠呈;陳少東;王宏國;周海虹;;基于文獻的抑郁癥中醫(yī)證候分類分析[J];中華中醫(yī)藥學(xué)刊;2016年04期

8 鄭世景;;礞石滌痰湯聯(lián)合西藥治療精神分裂癥67例臨床觀察[J];河北中醫(yī);2016年01期

9 于學(xué)平;牛明明;鄒偉;;鄒偉從痰論治抑郁癥經(jīng)驗介紹[J];中華中醫(yī)藥雜志;2015年11期

10 張曉絲;于睿;;從心論治抑郁癥[J];實用中醫(yī)內(nèi)科雜志;2015年01期

，

本文編號：1786607