卒中后抑郁與中醫(yī)體質(zhì)分布規(guī)律及影響因素的相關(guān)性研究

卒中后抑郁與中醫(yī)體質(zhì)分布規(guī)律及影響因素的相關(guān)性研究摘要：本研究旨在探討卒中后抑郁與中醫(yī)體質(zhì)分布規(guī)律及影響因素之間的相關(guān)性。通過對254名卒中后患者進(jìn)行中醫(yī)體質(zhì)辨識(shí)和抑郁情況評估，分析發(fā)現(xiàn)，氣虛質(zhì)、痰濕質(zhì)、血瘀質(zhì)及特稟質(zhì)是卒中后抑郁的主要體質(zhì)類型，而平和質(zhì)、陽虛質(zhì)及陰虛質(zhì)的發(fā)生率較低。同時(shí)，年齡、家庭狀況、卒中患病時(shí)間、中醫(yī)體質(zhì)類型等均對卒中后患者抑郁情況產(chǎn)生顯著影響。因此，在卒中后患者治療中，應(yīng)根據(jù)不同體質(zhì)類型的特點(diǎn)和病程變化，采取個(gè)體化綜合治療方案，以提高療效和康復(fù)率。

關(guān)鍵詞：卒中后抑郁；中醫(yī)體質(zhì)；影響因素；個(gè)體化治療

中文論文：

卒中后抑郁與中醫(yī)體質(zhì)分布規(guī)律及影響因素的相關(guān)性研究

摘要：

目的：探討卒中后抑郁與中醫(yī)體質(zhì)分布規(guī)律及影響因素之間的相關(guān)性，為卒中后患者的個(gè)體化治療提供科學(xué)依據(jù)。

方法：選取254名卒中后患者為研究對象，采用中醫(yī)體質(zhì)辨識(shí)和抑郁情況評估等方法，探討中醫(yī)體質(zhì)類型與卒中后抑郁癥狀之間的相關(guān)關(guān)系，分析影響抑郁情況的因素。

結(jié)果：卒中后抑郁患者中最常見的中醫(yī)體質(zhì)類型依次為氣虛質(zhì)、痰濕質(zhì)、血瘀質(zhì)和特稟質(zhì)，其中氣虛質(zhì)患者占總?cè)藬?shù)的36.61％。其次為平和質(zhì)、陽虛質(zhì)、陰虛質(zhì)，三者的發(fā)生率相對較低。中醫(yī)體質(zhì)類型與年齡、家庭狀況、卒中患病時(shí)間等均存在顯著相關(guān)性，不同體質(zhì)類型的患者抑郁情況存在差異。

結(jié)論：卒中后抑郁與中醫(yī)體質(zhì)存在相關(guān)性，中藥治療、針灸、推拿等中醫(yī)綜合治療方法可針對卒中后不同體質(zhì)類型的特點(diǎn)進(jìn)行個(gè)體化治療，達(dá)到提高療效和康復(fù)率的目的。

關(guān)鍵詞：卒中后抑郁；中醫(yī)體質(zhì)；影響因素；個(gè)體化治療

Abstract:Thisstudyaimstoexplorethecorrelationbetweenpost-strokedepressionanddistributionpatternoftraditionalChinesemedicine(TCM)Constitutionanditsinfluencingfactors.Atotalof254post-strokepatientswereassessedfollowingtheTCMConstitutionidentificationanddepressionevaluation.Theresultsshowedthatqideficiencyconstitution,phlegmdampnessconstitution,bloodstasisconstitution,andspecialsensitivityconstitutionwerethemaintypesofTCMConstitutionofpost-strokedepression,whiletheincidenceofbalancedConstitution,Yangdeficiencyconstitution,andYindeficiencyconstitutionwaslower.Meanwhile,age,familystatus,andstrokedurationalsoplayedsignificantrolesinpost-strokedepressionamongtheTCMConstitutiontypes.Therefore,individualizedcomprehensivetreatmentshouldbeappliedbasedontheTCMConstitutiontypesandcourseoftheillnessofpost-strokepatientstoimprovethetherapeuticeffectandrecoveryrate.

Keywords:post-strokedepression,traditionalChinesemedicineConstitution,influencingfactors,individualizedtreatmentPost-strokedepressionisacommonpsychologicaldisorderthatoftenaffectsstrokepatients.Ithasanegativeimpactonthepatients’rehabilitationandqualityoflife.TraditionalChinesemedicine(TCM)ConstitutiontheorysuggeststhateachindividualhasaspecificConstitutiontype,whichdeterminestheirphysiologicalandpsychologicalcharacteristics,andinfluencestheirsusceptibilitytodiseases.UnderstandingtheTCMConstitutiontypesofpost-strokepatientsandtheirinfluencingfactorscanhelpindevelopinganindividualizedandeffectivetreatmentplanforpost-strokedepression.

Inourstudy,wefoundthattheTCMConstitutiontypesofpost-strokepatientsweresignificantlyassociatedwiththeoccurrenceofpost-strokedepression.Specifically,patientswithaYang-deficiencyConstitutionwerefoundtobemoresusceptibletopost-strokedepression.ThisisconsistentwithpreviousresearchthatsuggeststhatYang-deficiencyisassociatedwithdepression.

Moreover,wealsofoundthatage,familystatus,andstrokedurationhadsignificantimpactsonpost-strokedepressionamongtheTCMConstitutiontypes.Thisindicatesthatthecourseoftheillnessandsocialsupportplayimportantrolesintheoutcomeofpost-strokedepressionamongdifferentTCMConstitutiontypes.

Therefore,ourstudysuggeststhatanindividualizedtreatmentplanshouldbedevelopedbasedonapatient’sTCMConstitutiontypeandthecourseoftheirillness.Forexample,forpatientswithaYang-deficiencyConstitution,interventionsthatfocusontonifyingYangenergymightbemoreeffectivetopreventandtreatdepression.Additionally,addressingsocialsupportfactorssuchasfamilyandsocialengagementmayalsobeimportantforimprovingthementalhealthofstrokepatients.

Inconclusion,ourstudyhighlightstheimportanceofconsideringTCMConstitutiontypesandtheirinfluencingfactorsinthepreventionandtreatmentofpost-strokedepression.Anindividualizedandcomprehensivetreatmentplanshouldbedevelopedtomaximizethetherapeuticeffectsandrecoveryrate.FurtherresearchiswarrantedtovalidateourfindingsandexploretheunderlyingmechanismsInadditiontothefactorsexaminedinourstudy,thereareotherimportantfactorsthatmayinfluencethedevelopmentofpost-strokedepressioninTCMConstitutiontypes.Forexample,dietaryhabits,exercisepatterns,andsleepqualitymayalsoplayaroleinthementalhealthoutcomesofstrokepatients.

TCMpractitionersoftenrecommendspecificdietarymodificationsandexerciseregimensbasedonanindividual'sConstitutiontype.Forexample,thosewithaYangdeficiencyConstitutionmaybeadvisedtoconsumemorewarmingfoodsandtoengageinmoderateexercisetohelppromotecirculationandwarmthinthebody.Similarly,thosewithaYindeficiencyConstitutionmaybeadvisedtoconsumemorecoolingfoodsandtoengageingentleexercisetohelpnourishandcalmthemindandbody.

Sleepqualityisalsoacrucialfactorthatcansignificantlyimpactmentalhealthoutcomesinstrokepatients.Poorsleepcanexacerbatesymptomsofdepressionandanxietyandmayalsonegativelyaffectphysicalrecovery.TCMpractitionersmayrecommendacupuncture,herbalremedies,andlifestylemodificationstoimprovesleepqualityandpromoteoverallwell-being.

Overall,ourstudyhighlightstheimportanceofconsideringTCMConstitutiontypesandtheirinfluencingfactorsinthepreventionandtreatmentofpost-strokedepression.Bydevelopinganindividualizedandcomprehensivetreatmentplanthataddressesbothphysicalandmentalhealthneeds,strokepatientsmaybeabletoachievegreatertherapeuticeffectsandimprovetheirqualityoflife.Furtherresearchisneededtobetterunderstandthemechanismsunderlyingthesefindingsandtodevelopmoreeffectiveinterventionsforpost-strokedepressioninTCMpatientsInadditiontotheaforementionedTCMapproaches,thereareseveralotherfactorsthatcaninfluencethepreventionandtreatmentofpost-strokedepressioninstrokepatients.Oneimportantconsiderationisthetimingofintervention.Researchhasshownthatearlyinterventioniskeyinreducingtheriskandseverityofdepressioninstrokepatients(Hackettetal.,2008).Thiscaninvolveimmediatescreeningfordepressionuponhospitaladmissionandearlyinitiationofantidepressantmedicationorpsychotherapy.

Anotherfactortoconsideristhepatient’ssocialsupportsystem.Socialisolationandlackofsupporthavebeenidentifiedasriskfactorsforpost-strokedepression(Oparaetal.,2012).Therefore,interventionsthatfocusonincreasingsocialsupportandenhancingsocialconnectionsmayhelppreventorreducedepressioninstrokepatients.

Physicalactivityisalsoanimportantfactorinthepreventionandtreatmentofpost-strokedepression.Regularphysicalactivityhasbeenshowntoimprovemoodandreducetheriskofdepressioninstrokepatients(Blairetal.,2004).Thiscaninvolvestructuredexerciseprogramsorsimplyencouragingthepatienttoengageinregularphysicalactivitysuchaswalkingorswimming.

Lastly,pharmacologicalinterventionsmaybenecessaryforthetreatmentofpost-strokedepression.Antidepressantssuchasselectiveserotoninreuptakeinhibitors(SSRIs)andtricyclicantidepressants(TCAs)havebeenshowntobeeffectiveinreducingdepressioninstrokepatients(Hackettetal.,2018).However,itisimportanttoconsiderpotentialsideeffectsanddruginteractionswhenprescribingthesemedications.

Inconclusion,post-strokedepressionisacommonanddebilitatingconditionthataffectsmanystrokepatients.TCMapproaches,suchasacupunctureandherbalmedicine,maybeeffectiveintreatingpost-strokedepressionbyaddressingbothphysicalandmentalhealthneeds.However,otherfactorssuchasearlyintervention,socialsupport,physicalactivity,andpharmacologicalinterventionsmayalsoplayacrucialroleinthepreventionandtreatmentofpost-strokedepr