本文選題：糖尿病足 + 抑郁　； 參考：《大連醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:對(duì)比糖尿病足(Diabetic foot,DF)患者與2型糖尿病(Type 2 diabetic mellitus,T2DM)患者的心理狀況,調(diào)查DF患者抑郁患病率,探究DF合并抑郁患者的影響因素及中醫(yī)證型的分布規(guī)律,為臨床論治糖尿病足合并抑郁狀態(tài)患者提供客觀依據(jù)。方法:本研究經(jīng)北京空軍總醫(yī)院倫理委員會(huì)審核與批準(zhǔn),根據(jù)納入標(biāo)準(zhǔn)選取2015年3月至2015年11月就診于空軍總醫(yī)院內(nèi)分泌科、中醫(yī)科病區(qū)、糖尿病足門診換藥室的DF患者171例,及同期就診于內(nèi)分泌科、中醫(yī)科病區(qū)的T2DM患者120例,分別填寫(xiě)癥狀自評(píng)量表(symptom check list-90,SCL-90),根據(jù)DF及T2DM患者的心理因子得分情況進(jìn)行心理狀況對(duì)比。制定調(diào)查表記錄171例DF患者的性別、年齡、個(gè)人史、家族史及血糖、血脂等指標(biāo),運(yùn)用SPSS l7.0軟件對(duì)以上數(shù)據(jù)行因素相關(guān)性的統(tǒng)計(jì)分析。對(duì)其中抑郁單因子得分≥2分的71例DF患者,進(jìn)行整體和局部(足)中醫(yī)辨證,根據(jù)頻數(shù)統(tǒng)計(jì)結(jié)果,探討DF抑郁患者的整體及局部中醫(yī)證型分布規(guī)律。結(jié)果:1.DF患者與T2DM患者相比,軀體化、抑郁、恐怖、精神病性四個(gè)因子具有統(tǒng)計(jì)學(xué)差異(P0.05),DF患者抑郁的患病率為41.52%,T2DM患者抑郁的患病率為27.50%。2.性別、年齡、病程、脂肪肝病史、吸煙史、治療方式、血糖水平、CRP等指標(biāo)與DF患者抑郁的發(fā)生具有統(tǒng)計(jì)學(xué)差異(P0.05)。3.DF合并抑郁患者中醫(yī)辨證以肝氣郁結(jié)型最多,抑郁因子得分最高,局部(足)中醫(yī)證型以熱盛肉腐型最多,抑郁因子得分最高。肝氣郁結(jié)證型的DF抑郁患者的局部中醫(yī)證型中以熱盛肉腐型最多。結(jié)論:1.DF患者以明顯的軀體化障礙為主,易產(chǎn)生抑郁、恐怖、精神病性等消極情緒,且DF患者抑郁的患病率顯著高于T2DM患者。2.中老年、女性、糖尿病(Diabetic mellitus,DM)及DF病程長(zhǎng)、脂肪肝病史、吸煙史、血糖控制差、聯(lián)合多種方式控制血糖、局部感染嚴(yán)重、炎癥因子較高的DF患者,為抑郁的高發(fā)人群。3.肝氣郁結(jié)證是DF抑郁患者的主要證型,熱盛肉腐型是DF抑郁患者局部(足)辨證的主要證型。局部熱盛肉腐與肝郁氣結(jié)有相互的影響關(guān)系。
[Abstract]:Objective: to compare the psychological status of type 2 diabetic foot with type 2 diabetes mellitus type 2 diabetic mellitus T2DM, investigate the prevalence of depression in DF patients, explore the influencing factors of DF patients with depression and the distribution of TCM syndromes. To provide objective basis for clinical treatment of diabetic foot patients with depression. Methods: this study was examined and approved by the Ethics Committee of Beijing Air Force General Hospital. According to the inclusion criteria, 171 cases of DF patients were selected from March 2015 to November 2015 in the Department of Endocrinology, the Department of traditional Chinese Medicine, and the Department of Diabetes foot. 120 cases of T2DM in endocrine department and traditional Chinese medicine department were treated at the same time. The symptom checklist (SCL-90) was filled out respectively. The psychological status was compared according to the scores of psychological factors of DF and T2DM patients. Sex, age, personal history, family history, blood sugar and blood lipid were recorded in 171 DF patients. The correlation of the above data was analyzed by SPSS L7.0 software. The integral and local TCM syndrome differentiation was performed in 71 cases of DF patients with depression score 鈮，

本文編號(hào)：1932822