情志致病源流探讨及情志因素与妇科疾病的相关性研究
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摘要
目的：
在现代医学领域,传统的生物医学模式正在向生物—心理—社会医学模式转变。人们越来越重视心理(情志)、社会因素与躯体、疾病的关系。由于情志社会因素影响人们健康,因此情志与疾病的关系就成为医学各学科热衷研究的课题。而中医学,有关情志致病的理论认识和临床实践,都有十分丰富的内容。它是中医基础理论体系中的一个重要组成部分。因此,把散见于医籍中有关情志致病的内容挖掘出来,并加以条理化、系统化是本文的任务之一。
同时,在中医整体观、心身合一、情志致病理论的指导下,本文旨在探讨情志因素与妇科疾病的关系,分析导致妇科疾病的有关生活事件和情绪方面的高危因素和保护因素,从群体水平探索病因假说,为中医“情志致病”理论和妇科疾病的预防提供循证依据。
方法：
采用文献分析法、心理测量学、临床流行病学和循证医学等科研方法,以团体用心理社会应激调查表(PSSG)和90项症状自评量表(SCL-90)为研究载体。对来自广东省中医院妇科门诊符合诊断标准、纳入标准的204例患者问卷调查,进行数据整合、处理、格式转换后,利用SPSS18.0软件进行描述性分析,组间比较采用卡方检验、秩和检验,影响因素分析采用Logistic回归分析。分析内容：1.分别比较月经失调组、子宫肌瘤组、更年期综合征组与健康对照组的SCL-90各维度总分、因子分、总均分,了解四组的情志状况。2.分别比较月经失调组、子宫肌瘤组、更年期综合征组与健康对照组的PSSG各指标,挖掘患者与健康对照者经历的生活事件、情志、应对方式的不同之处。3.分别做生活事件、情绪与月经失调、子宫肌瘤、更年期综合征三种妇科疾病的多因素Logistic回归分析。探讨生活事件、消极情绪与月经失调、子宫肌瘤、更年期综合征与妇科疾病的相关性。
结果：
1月经失调组与健康对照组PSSG各指标比较
(1)月经失调组与健康对照组在劳累过度、家庭和婚姻、人际关系、子女前途、生活环境、个人健康方面存在差异,差异具有统计学意义(P<0.05)。月经失调者均较健康者发生频率多。
(2)月经失调组与健康对照组在害怕、忧郁、气愤方面存在差异,差异具有统计学意义(P<0.05)。月经失调者均较健康对照者显著。
(3)月经失调组与健康对照组在高兴、愉快、欢喜、欣慰方面存在差异,差异具有统计学意义(P<0.05)。健康对照者均较月经失调者显著。
(4)月经失调组与健康对照组在陷入回忆、变得沉闷、痛哭一场、苦苦思索、独处方面存在差异,差异具有统计学意义(P<0.05)。月经失调者均较健康对照者严重。
(5)月经失调组与健康对照组在尽快忘掉、当作未发生、想开些、算不了什么、积极转化、幽默方面存在差异,差异具有统计学意义(P<0.05)。健康者较月经失调者显著。
2月经失调组与健康对照组SCL90各指标比较
(1)月经失调组与健康对照组在躯体化总分得分、焦虑总分得分、偏执总分得分、精神病性总分得分、抑郁总分得分、敌对总分得分、恐怖总分得分、其它总分得分方面比较有明显差异,差异具有统计学意义(P<0.05)。月经失调组均高于健康对照组。
(2)月经失调组与健康对照组在躯体化因子分、强迫症因子分、抑郁因子分、焦虑因子分、偏执因子分、敌对因子分、精神病性因子分、人际关系敏感因子分、恐怖因子分、其它因子分方面比较,有明显差异,差异具有统计学意义(P<0.05)。月经失调组均高于健康对照组。表明,月经失调患者躯体化症状、强迫症状、抑郁、焦虑、偏执、敌对、精神病性、人际敏感、恐怖、其它方面较健康人群严重。
(3)月经失调组和健康对照组Sc190总均分比较有差异,差异具有统计学意义(P<0.05)。健康对照组没有症状较月经失调者多,而月经失调者有点症状和轻度者比健康对照组多。
3.家庭不和婚姻问题、个人健康变化、忧郁、气愤是月经失调的危险因素,子女前途问题、愉快、欢喜、欣慰是月经失调的保护因素。
4.子宫肌瘤组与健康对照组PSSG各指标比较
(1)子宫肌瘤组与健康对照组在个人健康方面存在差异,差异具有统计学意义(P<0.05)。子宫肌瘤者较健康者发生频率多。
(2)子宫肌瘤组与健康对照组在忧郁、着急、悲伤、无助方面存在差异,差异具有统计学意义(P<0.05)。在忧郁、着急、悲伤方面子宫肌瘤患者较健康者严重,而在无助方面健康者较子宫肌瘤者严重。
(3)子宫肌瘤组与健康对照组在高兴、愉快、欢喜、兴奋、欣慰方面存在差异,差异具有统计学意义(P<0.05)。健康对照组较子宫肌瘤组显著。
(4)子宫肌瘤组与健康对照组在变得沉闷、苦苦思索方面存在差异,差异具有统计学意义(P<0.05)。子宫肌瘤患者较健康者严重。
(5)子宫肌瘤组与健康对照组在尽快忘掉、当作未发生、想开些、积极转化、幽默方面存在差异,差异具有统计学意义(P<0.05)。健康者较子宫肌瘤患者显著。
5.子宫肌瘤组与健康对照组SCL90各指标比较
(1)子宫肌瘤组与健康对照组在躯体化总分得分、焦虑总分得分、精神病性总分得分、抑郁总分得分、敌对总分得分方面比较有明显差异,差异具有统计学意义(P<0.05)。子宫肌瘤组均高于健康对照组。
(2)子宫肌瘤组与健康对照组在躯体化因子分、强迫症因子分、抑郁因子分、焦虑因子分、其它因子分方面比较有明显差异,差异具有统计学意义(P<0.05)。子宫肌瘤组均高于健康对照组。表明,子宫肌瘤患者躯体化症状、强迫症状、抑郁、焦虑、其它方面较健康对照者严重。
(3)子宫肌瘤组和健康对照组Sc190总均分比较有差异,差异具有统计学意义(P<0.05)。健康对照组没有症状较子宫肌瘤者多,而子宫肌瘤者有点症状比健康对照组多。
6.个人健康变化、忧郁是子宫肌瘤的危险因素,愉快、欢喜、兴奋、欣慰是子宫肌瘤的保护因素。
7.更年期综合征组与健康对照组PSSG各指标比较
(1)更年期综合征组与健康对照组在劳累过度、子女前途、个人成就、个人健康方面存在差异,差异具有统计学意义(P<0.05)。更年期综合征者较健康者发生频率多。
(2)更年期综合征组与健康对照组在害怕、苦恼、忧郁、紧张、气愤、焦虑、着急、悲伤方面存在差异,差异具有统计学意义(P<0.05)。更年期综合征者较健康者严重。
(3)更年期综合征组与健康对照组在高兴、愉快、欢喜、兴奋、欣慰方面存在差异,差异具有统计学意义(P<0.05)。
(4)更年期综合征组与健康对照组在陷入回忆、迁怒别人、变得沉闷、压在心底、痛哭一场、苦苦思索、独处方面存在差异,差异具有统计学意义(P<0.05)。
(5)更年期综合征组与健康对照组在尽快忘掉、当作未发生、算不了什么、换个环境方面存在差异,差异具有统计学意义(P<0.05)。健康者较子宫肌瘤者显著。
8.更年期综合征组与健康对照组SCL90各指标比较
(1)更年期综合征组与健康对照组在躯体化总分得分、焦虑总分得分、偏执总分得分、精神病性总分得分、抑郁总分得分、敌对总分得分、恐怖总分得分、其它总分得分方面比较有明显差异,差异具有统计学意义(P<0.05)。更年期综合征组均高于健康对照组。
(2)更年期综合征与健康对照组在躯体化因子分、强迫症因子分、抑郁因子分、焦虑因子分、敌对因子分、精神病性因子分、人际关系敏感因子分、恐怖因子分、其它因子分方面比较有明显差异,差异具有统计学意义(P<0.05)。更年期综合征组均高于健康对照组。表明,更年期综合征患者躯体化症状、强迫症状、抑郁、焦虑、敌对、精神病性、人际关系敏感、恐怖、其它方面较健康者严重。
(3)更年期综合征组和健康对照组Sc190总均分比较有差异,差异具有统计学意义(P<0.05)。健康对照组没有症状较更年期综合征者多,而更年期综合征者有点症状和轻度者比健康对照组多。
9.劳累过度、个人健康变化、苦恼、忧郁、紧张、气愤、焦虑是是更年期综合征的危险因素,个人成就、愉快、欢喜、兴奋、欣慰是更年期综合征的保护因素。
结论：
情志因素在妇科疾病发生、发展、转归中起重要作用,面对不良生活事件时,应保持健康良好的心态,采取积极的应对方式,以减少妇科疾病的发生,有利于妇科疾病的康复。
Objective
In the field of modern medicine, the traditional biomedical model is changing to bio-psycho-social medical mode. People pay more and more attention to the relation between psychological&social factors and body&disease. Psychological and social factors act on body through people's emotions, so the relationship between emotions and disease becomes a topic which all subjects of medicine are keen to study. However, the traditional Chinese medicine has very rich content regarding the cognitive theory and clinical practice of emotional disease, which is an important component of the basic theory system of traditional Chinese medicine. Therefore, one task of this paper is to dig out the content regarding emotional diseases that scattered in the medical books, and to make it methodized and systematic.
Meanwhile, under the guidance of traditional Chinese medicine holism, psychosomatic unity and the theory of emotional diseases, this paper aims to explore the relationship between emotional factors and gynecological diseases, analyze high risk factors and protective factors related to life events and emotional aspects which lead to gynecological diseases, and explore etiological hypothesis at the population level, and provide evidence-based basis for "emotional diseases" theory and the prevention of gynecological diseases.
Methods
This paper adopts the research methods of literature analysis, psychometrics, clinical epidemiology and evidence-based medicine, and takes self-made questionnaire for general situation, psychosocial stress questionnaire for groups (PSSG) and90symptoms checklist (SCL-90) as the carrier of study. We make questionnaire survey upon204patients in gynecology outpatient from Guangdong Province Traditional Chinese Medical Hospital, who have obvious emotional incentives and are consistent with the diagnostic criteria and brought into criteria, after carrying out data integration, processing, format conversion, then use SPSS18.0software to undertake descriptive analysis; the comparison among groups adopts analysis of variance, the rank-sum test, and correlation analysis adopts Logistic regression analysis. The analysis content includes:1.through the comparing the total scores of all dimensions, factor scores, total average scores of SCL-90among four groups, to learn about the mental health status of three kinds of disease patients and the comparison persons.2. Through the comparison of the total scores of life events, negative emotions, positive emotions, positive coping ways and negative coping ways of PSSG among four groups, to dig out the difference of undergone life events, emotions and coping ways between patients and healthy comparison persons.3. To understand the correlation among life events, negative emotions and all gynecological diseases. Then make Logistic regression analysis respectively on life events, emotions and three kinds of gynecological diseases.
Results
1. The comparison of all indexes in PSSG between menstrual disorder group and health comparison group
(1)There are difference regarding aspects of overstrain, family&marriage, interpersonal relations, the children's future, life environment and individual health between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The occurrence frequency of the menstrual disorder group is higher than that of the health comparison group.
(2) There are differences regarding aspects of fear, melancholy and anger between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is more obvious than the health comparison group.
(3) There are differences regarding aspects of happiness, gladness, joy and delight between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is more serious than the health comparison group.
(4) There are differences regarding aspects of being lost in memory, getting oppression, crying, puzzling out and living alone between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is more serious than the health comparison group.
(5) There are differences regarding aspects of forgetting as soon as possible, regarding something non-occurrence, being optimistic, nothing, actively changing, and being humorous between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is higher than the health comparison group.
2. The comparison of all indexes in PSSG between menstrual disorder group and health comparison group
(1) There are obvious differences through the comparison of the total scores of somatization, anxiety, paranoia, psychosis, depression, hostility, terror and other scores between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is higher than the health comparison group.
(2) There are obvious differences through the comparison of the factor scores of somatization, obsessive-compulsive, depression, anxiety, paranoia, hostility, psychosis, interpersonal sensitivity, terror and other between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is higher than the health comparison group. It indicates that the systems of somatization, obsessive-compulsive, depression, anxiety, paranoia, hostility, psychosis, interpersonal sensitivity, terror and other aspects existing in the menstrual disorder group are more serious than the health group.
(3) There are differences regarding the total average scores of SCL90between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The health comparison group is less than menstrual disorder group, but persons with some symptoms and slight degree in the menstrual disorder group are more than those in the health comparison group.
3. Family marital problem, personal health change, depression&anger are dangerous factors of menstrual disorder; children's prospect, happiness, joy&comfort are protective factors of menstrual disorders.
4. The comparison of all indexes in PSSG between the hysteromyoma group and the health comparison group
(1) There are differences regarding the individual health between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The occurrence frequency of the hysteromyoma group is higher than that of the health comparison group.
(2) There are differences regarding the aspects of depression, worry, sorrow and helplessness between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The hysteromyoma group is more serious than the health comparison group.
(3)There are differences regarding the aspects of happiness, gladness, joy, excitement and delight between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05).
(4) There are differences regarding the aspects of getting oppression, and puzzling out between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The hysteromyoma group is more serious than the health comparison group.
(5)There are differences regarding the aspects of forgetting as soon as possible, regarding something non-occurrence, being optimistic, actively changing and being humorous between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The healthy persons are more obvious than the hysteromyoma patients.
5. The comparison of all indexes in SCL90between the hysteromyoma group and the health comparison group
(1)There are obvious differences through the comparison of the total scores of somatization, anxiety, psychosis, depression and hostility between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The hysteromyoma group is higher than the health comparison group.
(2) There are obvious differences through the comparison of the factor scores of somatization, obsessive-compulsive, depression, anxiety and other between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The hysteromyoma group is higher than the health comparison group. It indicates that persons with the symptoms of somatization, obsessive-compulsive, depression, anxiety and other in the hysteromyoma group are more serious than the health comparison group.
(3) There are differences regarding the total average scores of SCL90between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The health comparison group is less than the hysteromyoma group, but persons with some symptoms and slight degree in the hysteromyoma group are more than those in the health comparison group.
6. Personal health change and depression are dangerous factors of hysteromyoma, and gladness, joy, excitement and delight are protective factors of hysteromyoma.
7.The comparison of all indexes in PSSG between the climacteric syndrome group and the health comparison group
(1)There are differences regarding the aspects of overstrain, children' s prospect, individual achievements and personal health between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The occurrence frequency of the climacteric syndrome group is higher than that of the health comparison group.
(2)There are differences regarding the aspects of fear, affliction, depress, tension, anger, anxiety, worry and sorrow between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The climacteric syndrome group is serious than the health comparison group.
(3)There are differences regarding the aspects of happiness, gladness, joy and delight between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05).
(4)There are differences regarding aspects of being lost in memory, venting anger on others, getting oppression, putting into heart, crying, puzzling out and living alone between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05).
(5)There are differences regarding the aspects of forgetting as soon as possible, regarding something non-occurrence, nothing, adapting a new environment between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The healthy persons are more obvious than the climacteric syndrome group.
8. The comparison of all indexes in SCL90between the climacteric syndrome group and the health comparison group
(1)There are obvious differences through the comparison of the total scores of somatization,anxiety, obsessive-compulsive, psychosis, depression, hostility, terror and other between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The climacteric syndrome group is higher than the health comparison group.
(2)There are obvious differences through the comparison of the factor scores of somatization, obsessive-compulsive, depression, anxiety, hostility, psychosis, interpersonal sensitivity, terror and other between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The climacteric syndrome group is higher than the health comparison group. It indicates that persons with the symptoms of somatization, obsessive-compulsive, depression, anxiety, hostility, psychosis, interpersonal sensitivity, terror and other aspects in the climacteric syndrome group are more serious than the health comparison group.
(3) There are differences regarding the total average scores of SCL90between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The health comparison group is less than the climacteric syndrome group, but persons with some symptoms and slight degree in the climacteric syndrome group are more than those in the health comparison group.
9. Overstrain, personal health change, distress, depression, tension, anger and anxiety are danger factors of climacteric syndrome; individual achievements, happiness, joy, excitement and comfort are protective factors of climacteric syndrome.
Conclusion
Emotional factors play an important role in occurrence, development and prognosis of gynecological disease. In the face of adverse life events, people should maintain good state of mind and adopt positive coping ways in order to reduce the occurrence of gynecological diseases and be in favor of the recovery of diseases.
在现代医学领域,传统的生物医学模式正在向生物—心理—社会医学模式转变。人们越来越重视心理(情志)、社会因素与躯体、疾病的关系。由于情志社会因素影响人们健康,因此情志与疾病的关系就成为医学各学科热衷研究的课题。而中医学,有关情志致病的理论认识和临床实践,都有十分丰富的内容。它是中医基础理论体系中的一个重要组成部分。因此,把散见于医籍中有关情志致病的内容挖掘出来,并加以条理化、系统化是本文的任务之一。
同时,在中医整体观、心身合一、情志致病理论的指导下,本文旨在探讨情志因素与妇科疾病的关系,分析导致妇科疾病的有关生活事件和情绪方面的高危因素和保护因素,从群体水平探索病因假说,为中医“情志致病”理论和妇科疾病的预防提供循证依据。
方法：
采用文献分析法、心理测量学、临床流行病学和循证医学等科研方法,以团体用心理社会应激调查表(PSSG)和90项症状自评量表(SCL-90)为研究载体。对来自广东省中医院妇科门诊符合诊断标准、纳入标准的204例患者问卷调查,进行数据整合、处理、格式转换后,利用SPSS18.0软件进行描述性分析,组间比较采用卡方检验、秩和检验,影响因素分析采用Logistic回归分析。分析内容：1.分别比较月经失调组、子宫肌瘤组、更年期综合征组与健康对照组的SCL-90各维度总分、因子分、总均分,了解四组的情志状况。2.分别比较月经失调组、子宫肌瘤组、更年期综合征组与健康对照组的PSSG各指标,挖掘患者与健康对照者经历的生活事件、情志、应对方式的不同之处。3.分别做生活事件、情绪与月经失调、子宫肌瘤、更年期综合征三种妇科疾病的多因素Logistic回归分析。探讨生活事件、消极情绪与月经失调、子宫肌瘤、更年期综合征与妇科疾病的相关性。
结果：
1月经失调组与健康对照组PSSG各指标比较
(1)月经失调组与健康对照组在劳累过度、家庭和婚姻、人际关系、子女前途、生活环境、个人健康方面存在差异,差异具有统计学意义(P<0.05)。月经失调者均较健康者发生频率多。
(2)月经失调组与健康对照组在害怕、忧郁、气愤方面存在差异,差异具有统计学意义(P<0.05)。月经失调者均较健康对照者显著。
(3)月经失调组与健康对照组在高兴、愉快、欢喜、欣慰方面存在差异,差异具有统计学意义(P<0.05)。健康对照者均较月经失调者显著。
(4)月经失调组与健康对照组在陷入回忆、变得沉闷、痛哭一场、苦苦思索、独处方面存在差异,差异具有统计学意义(P<0.05)。月经失调者均较健康对照者严重。
(5)月经失调组与健康对照组在尽快忘掉、当作未发生、想开些、算不了什么、积极转化、幽默方面存在差异,差异具有统计学意义(P<0.05)。健康者较月经失调者显著。
2月经失调组与健康对照组SCL90各指标比较
(1)月经失调组与健康对照组在躯体化总分得分、焦虑总分得分、偏执总分得分、精神病性总分得分、抑郁总分得分、敌对总分得分、恐怖总分得分、其它总分得分方面比较有明显差异,差异具有统计学意义(P<0.05)。月经失调组均高于健康对照组。
(2)月经失调组与健康对照组在躯体化因子分、强迫症因子分、抑郁因子分、焦虑因子分、偏执因子分、敌对因子分、精神病性因子分、人际关系敏感因子分、恐怖因子分、其它因子分方面比较,有明显差异,差异具有统计学意义(P<0.05)。月经失调组均高于健康对照组。表明,月经失调患者躯体化症状、强迫症状、抑郁、焦虑、偏执、敌对、精神病性、人际敏感、恐怖、其它方面较健康人群严重。
(3)月经失调组和健康对照组Sc190总均分比较有差异,差异具有统计学意义(P<0.05)。健康对照组没有症状较月经失调者多,而月经失调者有点症状和轻度者比健康对照组多。
3.家庭不和婚姻问题、个人健康变化、忧郁、气愤是月经失调的危险因素,子女前途问题、愉快、欢喜、欣慰是月经失调的保护因素。
4.子宫肌瘤组与健康对照组PSSG各指标比较
(1)子宫肌瘤组与健康对照组在个人健康方面存在差异,差异具有统计学意义(P<0.05)。子宫肌瘤者较健康者发生频率多。
(2)子宫肌瘤组与健康对照组在忧郁、着急、悲伤、无助方面存在差异,差异具有统计学意义(P<0.05)。在忧郁、着急、悲伤方面子宫肌瘤患者较健康者严重,而在无助方面健康者较子宫肌瘤者严重。
(3)子宫肌瘤组与健康对照组在高兴、愉快、欢喜、兴奋、欣慰方面存在差异,差异具有统计学意义(P<0.05)。健康对照组较子宫肌瘤组显著。
(4)子宫肌瘤组与健康对照组在变得沉闷、苦苦思索方面存在差异,差异具有统计学意义(P<0.05)。子宫肌瘤患者较健康者严重。
(5)子宫肌瘤组与健康对照组在尽快忘掉、当作未发生、想开些、积极转化、幽默方面存在差异,差异具有统计学意义(P<0.05)。健康者较子宫肌瘤患者显著。
5.子宫肌瘤组与健康对照组SCL90各指标比较
(1)子宫肌瘤组与健康对照组在躯体化总分得分、焦虑总分得分、精神病性总分得分、抑郁总分得分、敌对总分得分方面比较有明显差异,差异具有统计学意义(P<0.05)。子宫肌瘤组均高于健康对照组。
(2)子宫肌瘤组与健康对照组在躯体化因子分、强迫症因子分、抑郁因子分、焦虑因子分、其它因子分方面比较有明显差异,差异具有统计学意义(P<0.05)。子宫肌瘤组均高于健康对照组。表明,子宫肌瘤患者躯体化症状、强迫症状、抑郁、焦虑、其它方面较健康对照者严重。
(3)子宫肌瘤组和健康对照组Sc190总均分比较有差异,差异具有统计学意义(P<0.05)。健康对照组没有症状较子宫肌瘤者多,而子宫肌瘤者有点症状比健康对照组多。
6.个人健康变化、忧郁是子宫肌瘤的危险因素,愉快、欢喜、兴奋、欣慰是子宫肌瘤的保护因素。
7.更年期综合征组与健康对照组PSSG各指标比较
(1)更年期综合征组与健康对照组在劳累过度、子女前途、个人成就、个人健康方面存在差异,差异具有统计学意义(P<0.05)。更年期综合征者较健康者发生频率多。
(2)更年期综合征组与健康对照组在害怕、苦恼、忧郁、紧张、气愤、焦虑、着急、悲伤方面存在差异,差异具有统计学意义(P<0.05)。更年期综合征者较健康者严重。
(3)更年期综合征组与健康对照组在高兴、愉快、欢喜、兴奋、欣慰方面存在差异,差异具有统计学意义(P<0.05)。
(4)更年期综合征组与健康对照组在陷入回忆、迁怒别人、变得沉闷、压在心底、痛哭一场、苦苦思索、独处方面存在差异,差异具有统计学意义(P<0.05)。
(5)更年期综合征组与健康对照组在尽快忘掉、当作未发生、算不了什么、换个环境方面存在差异,差异具有统计学意义(P<0.05)。健康者较子宫肌瘤者显著。
8.更年期综合征组与健康对照组SCL90各指标比较
(1)更年期综合征组与健康对照组在躯体化总分得分、焦虑总分得分、偏执总分得分、精神病性总分得分、抑郁总分得分、敌对总分得分、恐怖总分得分、其它总分得分方面比较有明显差异,差异具有统计学意义(P<0.05)。更年期综合征组均高于健康对照组。
(2)更年期综合征与健康对照组在躯体化因子分、强迫症因子分、抑郁因子分、焦虑因子分、敌对因子分、精神病性因子分、人际关系敏感因子分、恐怖因子分、其它因子分方面比较有明显差异,差异具有统计学意义(P<0.05)。更年期综合征组均高于健康对照组。表明,更年期综合征患者躯体化症状、强迫症状、抑郁、焦虑、敌对、精神病性、人际关系敏感、恐怖、其它方面较健康者严重。
(3)更年期综合征组和健康对照组Sc190总均分比较有差异,差异具有统计学意义(P<0.05)。健康对照组没有症状较更年期综合征者多,而更年期综合征者有点症状和轻度者比健康对照组多。
9.劳累过度、个人健康变化、苦恼、忧郁、紧张、气愤、焦虑是是更年期综合征的危险因素,个人成就、愉快、欢喜、兴奋、欣慰是更年期综合征的保护因素。
结论：
情志因素在妇科疾病发生、发展、转归中起重要作用,面对不良生活事件时,应保持健康良好的心态,采取积极的应对方式,以减少妇科疾病的发生,有利于妇科疾病的康复。
Objective
In the field of modern medicine, the traditional biomedical model is changing to bio-psycho-social medical mode. People pay more and more attention to the relation between psychological&social factors and body&disease. Psychological and social factors act on body through people's emotions, so the relationship between emotions and disease becomes a topic which all subjects of medicine are keen to study. However, the traditional Chinese medicine has very rich content regarding the cognitive theory and clinical practice of emotional disease, which is an important component of the basic theory system of traditional Chinese medicine. Therefore, one task of this paper is to dig out the content regarding emotional diseases that scattered in the medical books, and to make it methodized and systematic.
Meanwhile, under the guidance of traditional Chinese medicine holism, psychosomatic unity and the theory of emotional diseases, this paper aims to explore the relationship between emotional factors and gynecological diseases, analyze high risk factors and protective factors related to life events and emotional aspects which lead to gynecological diseases, and explore etiological hypothesis at the population level, and provide evidence-based basis for "emotional diseases" theory and the prevention of gynecological diseases.
Methods
This paper adopts the research methods of literature analysis, psychometrics, clinical epidemiology and evidence-based medicine, and takes self-made questionnaire for general situation, psychosocial stress questionnaire for groups (PSSG) and90symptoms checklist (SCL-90) as the carrier of study. We make questionnaire survey upon204patients in gynecology outpatient from Guangdong Province Traditional Chinese Medical Hospital, who have obvious emotional incentives and are consistent with the diagnostic criteria and brought into criteria, after carrying out data integration, processing, format conversion, then use SPSS18.0software to undertake descriptive analysis; the comparison among groups adopts analysis of variance, the rank-sum test, and correlation analysis adopts Logistic regression analysis. The analysis content includes:1.through the comparing the total scores of all dimensions, factor scores, total average scores of SCL-90among four groups, to learn about the mental health status of three kinds of disease patients and the comparison persons.2. Through the comparison of the total scores of life events, negative emotions, positive emotions, positive coping ways and negative coping ways of PSSG among four groups, to dig out the difference of undergone life events, emotions and coping ways between patients and healthy comparison persons.3. To understand the correlation among life events, negative emotions and all gynecological diseases. Then make Logistic regression analysis respectively on life events, emotions and three kinds of gynecological diseases.
Results
1. The comparison of all indexes in PSSG between menstrual disorder group and health comparison group
(1)There are difference regarding aspects of overstrain, family&marriage, interpersonal relations, the children's future, life environment and individual health between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The occurrence frequency of the menstrual disorder group is higher than that of the health comparison group.
(2) There are differences regarding aspects of fear, melancholy and anger between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is more obvious than the health comparison group.
(3) There are differences regarding aspects of happiness, gladness, joy and delight between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is more serious than the health comparison group.
(4) There are differences regarding aspects of being lost in memory, getting oppression, crying, puzzling out and living alone between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is more serious than the health comparison group.
(5) There are differences regarding aspects of forgetting as soon as possible, regarding something non-occurrence, being optimistic, nothing, actively changing, and being humorous between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is higher than the health comparison group.
2. The comparison of all indexes in PSSG between menstrual disorder group and health comparison group
(1) There are obvious differences through the comparison of the total scores of somatization, anxiety, paranoia, psychosis, depression, hostility, terror and other scores between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is higher than the health comparison group.
(2) There are obvious differences through the comparison of the factor scores of somatization, obsessive-compulsive, depression, anxiety, paranoia, hostility, psychosis, interpersonal sensitivity, terror and other between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The menstrual disorder group is higher than the health comparison group. It indicates that the systems of somatization, obsessive-compulsive, depression, anxiety, paranoia, hostility, psychosis, interpersonal sensitivity, terror and other aspects existing in the menstrual disorder group are more serious than the health group.
(3) There are differences regarding the total average scores of SCL90between menstrual disorder group and health comparison group. These differences have statistical significance (P<0.05). The health comparison group is less than menstrual disorder group, but persons with some symptoms and slight degree in the menstrual disorder group are more than those in the health comparison group.
3. Family marital problem, personal health change, depression&anger are dangerous factors of menstrual disorder; children's prospect, happiness, joy&comfort are protective factors of menstrual disorders.
4. The comparison of all indexes in PSSG between the hysteromyoma group and the health comparison group
(1) There are differences regarding the individual health between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The occurrence frequency of the hysteromyoma group is higher than that of the health comparison group.
(2) There are differences regarding the aspects of depression, worry, sorrow and helplessness between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The hysteromyoma group is more serious than the health comparison group.
(3)There are differences regarding the aspects of happiness, gladness, joy, excitement and delight between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05).
(4) There are differences regarding the aspects of getting oppression, and puzzling out between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The hysteromyoma group is more serious than the health comparison group.
(5)There are differences regarding the aspects of forgetting as soon as possible, regarding something non-occurrence, being optimistic, actively changing and being humorous between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The healthy persons are more obvious than the hysteromyoma patients.
5. The comparison of all indexes in SCL90between the hysteromyoma group and the health comparison group
(1)There are obvious differences through the comparison of the total scores of somatization, anxiety, psychosis, depression and hostility between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The hysteromyoma group is higher than the health comparison group.
(2) There are obvious differences through the comparison of the factor scores of somatization, obsessive-compulsive, depression, anxiety and other between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The hysteromyoma group is higher than the health comparison group. It indicates that persons with the symptoms of somatization, obsessive-compulsive, depression, anxiety and other in the hysteromyoma group are more serious than the health comparison group.
(3) There are differences regarding the total average scores of SCL90between the hysteromyoma group and the health comparison group. These differences have statistical significance (P<0.05). The health comparison group is less than the hysteromyoma group, but persons with some symptoms and slight degree in the hysteromyoma group are more than those in the health comparison group.
6. Personal health change and depression are dangerous factors of hysteromyoma, and gladness, joy, excitement and delight are protective factors of hysteromyoma.
7.The comparison of all indexes in PSSG between the climacteric syndrome group and the health comparison group
(1)There are differences regarding the aspects of overstrain, children' s prospect, individual achievements and personal health between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The occurrence frequency of the climacteric syndrome group is higher than that of the health comparison group.
(2)There are differences regarding the aspects of fear, affliction, depress, tension, anger, anxiety, worry and sorrow between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The climacteric syndrome group is serious than the health comparison group.
(3)There are differences regarding the aspects of happiness, gladness, joy and delight between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05).
(4)There are differences regarding aspects of being lost in memory, venting anger on others, getting oppression, putting into heart, crying, puzzling out and living alone between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05).
(5)There are differences regarding the aspects of forgetting as soon as possible, regarding something non-occurrence, nothing, adapting a new environment between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The healthy persons are more obvious than the climacteric syndrome group.
8. The comparison of all indexes in SCL90between the climacteric syndrome group and the health comparison group
(1)There are obvious differences through the comparison of the total scores of somatization,anxiety, obsessive-compulsive, psychosis, depression, hostility, terror and other between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The climacteric syndrome group is higher than the health comparison group.
(2)There are obvious differences through the comparison of the factor scores of somatization, obsessive-compulsive, depression, anxiety, hostility, psychosis, interpersonal sensitivity, terror and other between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The climacteric syndrome group is higher than the health comparison group. It indicates that persons with the symptoms of somatization, obsessive-compulsive, depression, anxiety, hostility, psychosis, interpersonal sensitivity, terror and other aspects in the climacteric syndrome group are more serious than the health comparison group.
(3) There are differences regarding the total average scores of SCL90between the climacteric syndrome group and the health comparison group. These differences have statistical significance (P<0.05). The health comparison group is less than the climacteric syndrome group, but persons with some symptoms and slight degree in the climacteric syndrome group are more than those in the health comparison group.
9. Overstrain, personal health change, distress, depression, tension, anger and anxiety are danger factors of climacteric syndrome; individual achievements, happiness, joy, excitement and comfort are protective factors of climacteric syndrome.
Conclusion
Emotional factors play an important role in occurrence, development and prognosis of gynecological disease. In the face of adverse life events, people should maintain good state of mind and adopt positive coping ways in order to reduce the occurrence of gynecological diseases and be in favor of the recovery of diseases.
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