本文選題：肺癌 + 抑郁　； 參考：《新疆醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討肺癌患者臨床合并抑郁的情況及影響因素,分析肺癌相關(guān)性抑郁的中醫(yī)辨證分型特點(diǎn),為臨床更好的認(rèn)識(shí)、治療肺癌相關(guān)性抑郁提供參考及依據(jù)。方法:收集2016年1月-2016年7月來(lái)自新疆醫(yī)科大學(xué)附屬腫瘤醫(yī)院、新疆醫(yī)科大學(xué)附屬中醫(yī)醫(yī)院住院的肺癌患者319例,進(jìn)行一般狀況評(píng)價(jià)表、自制中醫(yī)癥候表、24項(xiàng)漢密爾頓抑郁量表(Hamilton)、抑郁自評(píng)量表(SDS)評(píng)分,將采集后信息輸入數(shù)據(jù)庫(kù),利用統(tǒng)計(jì)分析軟件對(duì)合并抑郁情況、中醫(yī)辨證分型特點(diǎn)進(jìn)行分析研究。結(jié)果:1.319例肺癌患者中,262例患者合并抑郁,抑郁發(fā)生率為82.0%;2.262例抑郁患者中,輕度、中度、重度抑郁患者分別為126例、114例、22例,分別占百分比為39%、36%、7%;3.病程、病理分期、是否轉(zhuǎn)移、文化程度與抑郁無(wú)明顯統(tǒng)計(jì)學(xué)意義(P0.05),疼痛與抑郁有統(tǒng)計(jì)學(xué)意義(P0.05),且隨著抑郁程度的加重,疼痛比例明顯上升,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);4.肺癌合并抑郁中醫(yī)證素有14種,病性證素以痰(23.0%)、陰虛(22.3%)、氣虛(16.0%)、瘀(15.0%)為主,病位證素以肺(47.0%)、脾(20%)、腎(16%)、肝(15.5%)為主,輕中度抑郁患者中,氣陰兩虛證為67例,占34.1%,痰瘀互阻證40例,占20.4%,痰濕蘊(yùn)肺34證例,占17.3%;重度抑郁中,痰瘀互阻12例,占54.5%;84例合并疼痛的抑郁患者中,痰瘀互阻證31例,占36.9%,氣陰兩虛22例,占26.2%。結(jié)論:1.肺癌患者臨床多伴有抑郁;2.不同程度的抑郁可貫穿肺癌發(fā)生、發(fā)展的全過(guò)程,與病程的長(zhǎng)短、病理類型的不同、文化程度的差異、是否轉(zhuǎn)移無(wú)明顯關(guān)系,伴有疼痛的肺癌患者更易合并抑郁,且重度抑郁中,合并疼痛的患者多見(jiàn);3.肺癌合并抑郁患者中以氣陰兩虛證、痰瘀互阻證多見(jiàn),重度抑郁、合并有疼痛的抑郁患者以痰瘀互阻證多見(jiàn),痰、瘀、虛、郁、痛在肺癌的發(fā)生、發(fā)展過(guò)程中多同時(shí)存在,且�；橐蚬�,并易相互轉(zhuǎn)化、相互影響;4.臨床要多關(guān)注肺癌患者合并的抑郁情況,不僅要從傳統(tǒng)的角度治痰、治瘀、治虛,同時(shí)要以治郁、治痛并重,不僅要以補(bǔ)虛化痰去瘀為法,還要以解郁舒絡(luò)止痛為要,進(jìn)行綜合干預(yù)。
[Abstract]:Objective: to explore the clinical status and influencing factors of lung cancer patients with depression, analyze the characteristics of TCM syndrome differentiation of lung cancer associated depression, and provide reference and basis for clinical better understanding and treatment of lung cancer associated depression. Methods: from January 2016 to July 2016, 319 lung cancer patients from the affiliated Cancer Hospital of Xinjiang Medical University and the affiliated TCM Hospital of Xinjiang Medical University were collected and evaluated. Twenty-four items of Hamilton Depression scale (Hamilton Depression scale) and self-rating depression scale (SDS) score were made by ourselves. The collected information was input into the database, and the characteristics of syndromes and syndrome differentiation were analyzed and studied by statistical analysis software. Results among 319 lung cancer patients, 262 cases were complicated with depression. The incidence of depression was 82. 0% and 2. 262 cases. There were 126 cases of mild, moderate and severe depressive patients. There were 114 cases (22 cases) of mild, moderate and severe depressive patients, respectively. The percentage of them was 39 36 36 7%. The disease course, pathological stage, metastasis, education level and depression had no significant difference (P 0.05), but pain and depression had statistical significance (P 0.05), and with the severity of depression, the proportion of pain increased significantly, the difference was statistically significant (P 0.05). There are 14 kinds of TCM syndromes of lung cancer combined with depression, there are 14 kinds of TCM syndromes of lung cancer complicated with depression, 23% of them are phlegm, 22.3% of Yin deficiency, 16.0% of Qi deficiency, 15.0% of blood stasis, and 47.0% of lung syndrome. The main symptoms of disease are lung syndrome 47.0%, spleen 20%, kidney 20%, kidney 15. 5). In mild and moderate depression, there are 67 cases with deficiency of qi and yin, accounting for 34 1 points, and 40 cases with phlegm and stasis blocking syndrome. In severe depression, there were 12 cases of phlegm and blood stasis mutual obstruction, accounting for 54.5N 84 cases of depression with pain, 31 cases (36.9%) of phlegm and stasis mutual obstruction syndrome, 22 cases of deficiency of Qi and Yin, 22 cases of deficiency of Qi and Yin, and 26.2B. Conclusion 1. Most patients with lung cancer are associated with depression. Depression of different degrees can run through the whole process of the occurrence and development of lung cancer, and it is not related to the length of the course of disease, the difference of pathological type, the difference of education level, the metastasis of lung cancer, and the patients with pain are more likely to be complicated with depression. Among the patients with severe depression, the patients with pain were more than 3%. In patients with lung cancer combined with depression, qi and yin deficiency syndrome, phlegm and blood stasis mutual obstruction syndrome are more common, severe depression patients with pain and phlegm stasis mutual obstruction syndrome, phlegm, blood stasis, deficiency, depression, pain in the occurrence and development of lung cancer more than at the same time, And often cause and effect each other, and easy to transform each other, influence each other. Clinical attention should be paid to the depression of lung cancer patients, not only from the traditional point of view to treat phlegm, blood stasis, and deficiency, but also to treat depression and pain, not only by reinforcing deficiency and removing phlegm and removing blood stasis, but also by relieving depression and soothing collaterals to relieve pain. Comprehensive intervention.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R273

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