【作者】 郑开梅；

【导师】 李慧吉； 武成；

【作者基本信息】 天津中医学院 ， 中医基础理论， 2005， 博士

【摘要】 目的: 本研究之进行,是为获得抑郁症的常见中医证候特征并探讨社会心理因素在抑郁症发病中所起的作用,特别是中医的五态人格与抑郁症的发生是否存在关联,这种关联与现代人格理论的解释相比又具有怎样的特点。前者将为中医辨证治疗抑郁症提供依据;而后者应为挖掘抑郁症的中医心理学治疗提供理论基础。 方法: (1) 证候学调查:采用自拟抑郁症中医证候学调查表,在多个临床点同时以同样方式对487名抑郁症患者进行了调查,调查人员依据调查表逐一询问、记录各调查对象的情况,充分收集辨证信息,详细填写调查表,进行临床初步辨证。最后由专人对调查表集中进行流调后辨证,以排除临床诊务繁忙、资料采集者辨证差异等影响,从而减少误差。 (2) 社会心理因素调查:采用成组设计的回顾性临床对照研究方法,使用信度和效度较好的五态人格调查表、艾森克人格调查表(EPQ)、修订卡特尔十六种人格因素调查表(16PF)、生活事件量表(LES)及社会支持量表(SSRS)对308名抑郁症患者和322名健康志愿者展开调查。 结果: (1) 常见中医证候 抑郁症的常见中医证候位于前十位的是:肝郁脾虚证;肝郁气滞证;心脾两虚证;肾阳不足证;肝肾阴虚证;心胆气虚证;气滞血瘀证;心肾不交证;胆郁痰扰证和阴阳两虚证,以前五位更有意义,其他证型出现较少,以气滞为主或兼有气滞者占56.5%。 (2) 人格因素 五态人格调查结果为太阳,少阳,阴阳和平人格维度得分,病例组明显低于健康对照组;少阴,太阴人格维度得分病例组明显高于健康对照组,结果均具统计学意义,与全国常模相比得到了相同的结果。通过主成分分析证明对抑郁症影响最大为少阴人格维度和少阳人格维度。 艾森克个性量表调查结果显示E量表得分病例组低于对照组,P量表得分病例更多还原

【Abstract】 Objective:The purpose of this research is to explore the main TCM syndromes characteristics in depression and study the functions of social-psychologic factors in occurrence of depression. We are especially interested in investigating whether there is a connection between the depression and the personality of five-type in TCM(Wu-Tai personality), and what characteristics this connection has when compared with modern personality theory. The former will provide the foundation for depression of TCM treatment and the theoretical basis of psychological treatment of TCM will be explored by the latter. Methods 1 .the investigation of syndromes in TCM487 patients were interviewed with the self-designed questionnaire of TCM syndromes. All of the interviews were carried out in many different clinical places with same method at the same time. During each interview, the investigators kept the record for each patient according to the designed questionnaire, collected sufficient information, filled in the investigation form in each detail. Based on the recorded information, the investigators can determine the initial syndromes of TCM. Finally, the syndromes of TCM were further determined by specialists so that we can reduce the inaccuracies caused by the difference among different investigators and the busy diagnose or treatment. 2.Social- psychological factors investigationA retrospective compared study designed by group was conducted using the personality of five-type in TCM questionnaire (Wu-Tai personality questionnaire) , Eysenck personality questionnaire(EPQ), Catel 16 personality factors questionnaire(16PF), life events(LES) questionnaire and social support (SSRS) questionnaire, all of which have high reliability and validity. 308 subjects as depression group and 322 volunteers as normal control group were questioned.Results1 .Main TCM syndromesThe top 10 TCM syndromes are liver stagnation causing spleenic deficiency, liver-qi stagnation, heart-spleen deficiency, kidney-yang deficiency, liver-kidney ym deficiency, heart-gallbladder-qi deficiency, qi stagnation blood stasis, heart-kidney disharmony, gallbladder stagnation phlegm disturbance, and yin-yang deficiency. The first five syndromes are more significant. In these syndromes, qi stagnation syndrome or simultaneous qi stagnation are accounted up to 56.5 percent. 2. Personality factorsThe scores of Taiyang dimension, Shaoyang demendion and Yin-yang harmony of Wu-Tai in depression group are significantly lower than the normal control group. And the scores of Shaoyin dimension and Taiyin dimension in the depression group are significantly higher than those in the normal control group. The same result has been obtained when compared with Chinese norm. According to the factor analysis, the top two factors which affect depression are Shaoyin personality dimension and Shaoyang personality dimension.The result of investigation of EPQ shows that the depression patients group is significantly lower than the normal control groups in E and P dimensions, but significantly higher than the normal control group in N dimension.The result of 16PF shows that the stability, flauntality, excitability, daring, self-restraint, attemptility, introversion-extroversion, timidity-resoluteaess and be swayed by one’s emotions-serenity and vigilance in depression group are significant lower than the normal control group. But sensitivity, doubtfulness, iutelligent, anxious, independent, nervous, adaptability-anxiety in depression group are significantly higher than those in the normal control group. The scores of persevering, illusion, gregariousness and wonldly-wise suggest that there is no significant difference between the depression group and the normal control group . 3.Life events and social supportThere is no significant difference between depression group and normal control更多还原