2018 年第 1 期 第 13 卷

不稳定型心绞痛患者中医证型与心理状态的关系

作者：赖伟兰蔡海荣郭永宁蔡惠铃黄秋萍蔡鑫桂毕启超陈梦雅        

英文作者：

单位：510006广州中医药大学第二附属医院急诊科（赖伟兰、黄秋萍、蔡鑫桂、毕启超、陈梦雅）；528000广东省佛山市中医院急诊科（蔡海荣）；510405广州中医药大学第二临床医学院2016级中西医结合临床专业（郭永宁）；525400广东茂名健康职业学院2017级护理学专业（蔡惠铃）

英文单位：

关键词：不稳定型心绞痛；中医证候；心理状态；症状自评量表

英文关键词：

• 摘要：

• 【摘要】目的    探讨不稳定型心绞痛患者不同中医证型与心理状态的关系。方法    纳入2015年1—12月于广州中医药大学第二附属医院冠状动脉粥样硬化性心脏病（冠心病）不稳定型心绞痛患者86例。由心内科中医专家对患者进行中医辨证评估，分为实证组（46例）和虚证组（40例）。通过调查问卷形式，采用症状自评量表(SCL-90)、焦虑自评量表（SAS）及抑郁自评量表（SDS）对患者进行心理状态调查，比较不同中医证型患者心理状态的差异及与国内常模的差异。结果    不稳定型心绞痛患者SCL-90中躯体化、强迫症状、抑郁、焦虑、恐怖、偏执、精神病性7项因子评分明显高于国内常模（P＜0.05）。实证组强迫症状、偏执2项因子评分明显高于虚证组，人际关系敏感、抑郁、焦虑、敌对、恐怖、精神病性6项因子评分低于虚证组（均P＜0.05）。不稳定型心绞痛患者SAS和SDS评分明显高于国内常模［（56±11）分比（38±12）分、（50±12）分比（42±10）分］（P＜0.05）。实证组SAS和SDS评分明显低于对照组［（50±9）分比（60±10）分、（48±11）分比（52±12）分］（P＜0.05）。结论    不稳定型心绞痛患者多存在明显的心理问题，且不同证型患者心理问题不一致，护理人员应进行辨证心理干预，提高患者的心理健康。

• Relation between traditional Chinese medicine syndrome of unstable angina and mental state

  Lai Weilan, Cai Hairong, Guo Yongning, Cai Huiling, Huang Qiuping, Cai Xingui, Bi Qichao, Chen Mengya

  Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, China（Lai WL, Huang QP, Cai XG, Bi QC, Chen MY）; Department of Emergency, Foshan Hospital of Traditional Chinese Medicine, Guangdong Province, Foshan 528000, China（Cai HR）; Specialty of Integrated Traditional Chinese and Western Medicine, Grade 2016, the Second Clinical Medical School, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, China（Guo YN）; Specialty of Nursing, Grade 2017, Maoming Academy of Health, Guangdong Province, Maoming 525400, China（Cai HL）

  Corresponding author: Lai Weilan, Email: laiweilan2004@163.com

  【Abstract】Objective     To explore the relation between traditional Chinese medicine(TCM) syndrome and mental state in patients with unstable angina. Methods    Eighty-six patients with unstable angina were enrolled from January to December 2015 in the Second Affiliated Hospital of Guangzhou University of Chinese Medicine. According to TCM syndrome of unstable angina, the patients were divided into sthenia syndrome group（46 cases） and asthenia syndrome group（40 cases）. Mental state of patients was assessed by the Symptom Checklist-90(SCL-90), the Self-rating Anxiety Scale（SAS） and the Self-rating Depression Scale（SDS）. Relation between TCM syndrome and mental state was analyzed. Results    Scores of somatization, obsessive-compulsive disorder, depression, anxiety, phobia anxiety, paranoid ideation and psychoticism in SCL-90 in unstable angina patients were significantly higher than those of the national norm（P＜0.05）. Scores of obsessive-compulsive and paranoid ideation in sthenia syndrome group were significantly higher than those in asthenia syndrome group（P＜0.05）; scores of interpersonal sensitivity, depression, anxiety, hostility, phobia anxiety and psychoticism in sthenia syndrome group were significantly lower than those in asthenia syndrome group（P＜0.05）. Scores of SAS and SDS in unstable angina patients were significantly higher than those of the national norm［（56±11）points vs（38±12）points, （50±12）points vs（42±10）points］（P＜0.05）. Scores of SAS and SDS in sthenia syndrome group were significantly lower than those in asthenia syndrome group［（50±9）points vs（60±10）points, （48±11）points vs（52±12）points］（P＜0.05）. Conclusion    There are psychological problems in patients with unstable angina, which have a certain relation with the TCM syndrome of unstable angina.

  【Key words】Unstable angina;Traditional Chinese medicine syndrome;Mental state;Symptom Checklist