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目的:了解临床医生对于情志病发病因素的认识,各疾病与情志因素致病的相关性,为临床流行病学调查提供基础。方法:参照情志病证诊断标准,采用整群分层抽样法对山东省立医院、济南市中心医院、山东省中医院近3年54 703份住院病历进行回顾性病因学调查。结果:与情绪有关病历共筛出506份,占总病历数的0.92%。情志病分布情况,心内科疾病占62.5%,神经内科疾病占12.06%,消化科疾病占7.11%,妇科疾病占3.56%;致病情绪中情绪激动占43.87%,怒占25.69%;女性占56.72%。情志病的脏腑定位以五脏为主,五脏中以肝为最多,心、脾、肾次之。临床出现最多的情志病证型为气阴两虚,其次为肝郁痰凝。结论:心内科疾病与负性情绪关系较大,其中“怒”与疾病关系较大,女性情志病发生率高于男性,年龄与情志病证发生率呈正相关;情志致病,首伤五脏,以肝为主,主要证候是气阴两虚。
OBJECTIVE: To understand the clinician’s understanding of the pathogenesis of the disease and the correlation between the disease and the emotional factors, and provide the basis for the clinical epidemiological investigation. Methods: According to the diagnostic criteria of emotional symptoms, a clustered sampling method was used to retrospectively investigate the etiological investigation of 54 703 inpatient records in Shandong Province Hospital, Jinan Central Hospital, and Shandong Provincial Hospital. Results: A total of 506 cases were screened out with emotion-related medical records, accounting for 0.92% of the total medical records. The distribution of sentimental diseases was 62.5% for cardiac diseases, 12.06% for neurological diseases, 7.11% for digestive diseases, 3.56% for gynecological diseases, 43.87% for emotional emotions, and 25.69% for anger; 56.72%. The location of the viscera of emotionally-affected diseases is dominated by five organs, and the liver is the most common in the five organs, and the heart, spleen, and kidney are the second. The most common type of emotional symptoms in clinical practice is deficiency of both qi and yin, followed by stagnation of liver qi. Conclusion: There is a large relationship between cardiac diseases and negative emotions. Among them, “anger” has a greater relationship with the disease. The incidence of emotional symptoms in women is higher than that of men. The age is positively correlated with the incidence of emotional symptoms; The first wounded five organs, mainly liver, the main syndrome is the deficiency of both qi and yin.