| Objective:The purpose of this study was to investigate the correlation between anxiety and depression in patients with pulmonary nodules and their traditional Chinese medicine(TCM)constitution,and the related factors affecting anxiety and depression in patients with pulmonary nodules,and to provide new ideas for the prevention and treatment of anxiety and depression in patients with pulmonary nodules.It also explores the clinical intervention effect of Qingjin Sanjie Granules in TCM clinical symptoms and anxiety and depression,and provides a reference for the subsequent research and treatment related to pulmonary nodules.Methods:This study adopted a clinical survey combined with prospective,single-arm clinical observation.The clinical survey was conducted in the form of a web-based questionnaire to investigate the General Information,Disease Information,and the information of the TCM Constitution Classification and Determination Scale,Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)of patients with pulmonary nodules.The information was used to count the prevalence of anxiety and depression and the distribution of TCM constitution in patients with pulmonary nodules.The chi-square test was used to analyze the differences of anxiety and depression of patients with pulmonary nodules in terms of general information,disease information,and TCM constitution,and the binary logistic regression was used to analyze the differences of anxiety and depression of patients with pulmonary nodules in terms of general information,disease information,and TCM constitution.The clinical observation of patients with pulmonary nodules who met the inclusion and exclusion criteria were used Qingjin Sanjie Granules,the observation period was 3 months,the TCM Syndrome Scale,the Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale-24(HAMD-24)were collected from patients before enrollment and after 3 months of intervention.The changes in the scores of the scales before and after the intervention were observed to determine the clinical efficacy of Qingjin Sanjie Granules in TCM clinical symptoms and anxiety and depression.Both used Microsoft Excel 2019 to establish the database and summarize the data,and SPSS 26.0 was used for statistical analysis.Results:1 Results of anxiety and depression occurrence in patients with pulmonary nodules:of the 103 patients in this study,24 patients(23.30%)with anxiety,34 patients(33.01%)with depression,and 19 patients(18.45%)with anxiety combined with depression.The mean score of SAS was 43.12 and the mean score of SDS was 45.41,both of which were higher than the Chinese anxiety and depression score norm,and the differences were statistically significant(P<0.05).2 Results of TCM constitution distribution in patients with pulmonary nodules:the TCM constitution type of 103 patients was mainly biased constitution,accounting for 79.61%.The distribution of TCM constitution in descending order was:28 cases of yang deficiency(27.18%),21 cases of peace(20.39%),19 cases of qi stagnation(18.45%),12 cases of phlegm-dampness(11.65%),9 cases of qi deficiency(8.74%),9 cases of blood stasis(8.74%),8 cases of yin deficiency(7.77%),7 cases of dampness-heat(6.80%),and 4 cases of special constitution(3.88%).3 Results of TCM constitution distribution in anxious and depressed patients with pulmonary nodules:24 anxious patients with pulmonary nodules all had biased constitution,and the distribution of TCM constitution in descending order was:13 cases of qi stagnation(54.17%),9 cases of yang deficiency(37.50%),4 cases of qi deficiency(16.67%),3 cases of phlegm-dampness(12.50%),1 with cases of yin deficiency(4.17%),and 1 cases of blood stasis(4.17%).Thirty-four depressed patients had predominantly biased constitution,accounting for 91.18%.The distribution of TCM constitution in descending order was:15 cases of qi stagnation(44.18%),11 cases of yang deficiency(32.35%),5 cases of qi deficiency(14.71%),4 cases of phlegm-dampness(11.76%),4 cases of blood stasis(11.76%),3 cases of peace(8.82%),1 cases of dampness-heat(2.94%),and 1 cases of special constitution(2.94%).Nineteen cases of anxiety combined with depression patients all had biased constitution,and the distribution of TCM constitution in descending order was:12 cases of qi stagnation(63.16%),6 cases of yang deficiency(31.58%),4 cases of qi deficiency(21.05%),3 cases of phlegm-dampness(15.79%),and 1 cases of blood stasis(5.26%).4 Results of correlation analysis between anxiety,depression and general information in patients with pulmonary nodules:the proportion of depression was higher in female patients with pulmonary nodules than in male patients,with statistically significant difference(P<0.05),and females(OR:2.515,95%CI:1.021～6.194,P=0.045)were independent influencing factor of depression in patients with pulmonary nodules.There were no significant difference in the distribution of depression in patients with pulmonary nodules by age(P>0.05).There were no significant difference in the distribution of anxiety in patients with pulmonary nodules by gender and age(P>0.05).5 Results of correlation analysis between anxiety,depression and disease information in patients with pulmonary nodules:the proportion of anxiety was higher in patients with a history of tumor than in patients without a history of tumor,with statistically significant difference(P<0.05),but have a history of tumor was not an independent influencing factor of anxiety in patients with pulmonary nodules(OR:3.530,95%CI:0.846～14.728,P=0.084).There were no significant differences in the distribution of depression in patients with pulmonary nodules by the tumor history(P>0.05).There were no significant differences in the distribution of anxiety and depression among patients with lung nodules by time of detection,growth in the past year,number,size,density,and location of nodules,description of margins,benign and malignant signs,tumor markers,pathological findings,history of smoking,history of lung disease,the tumor history of family,environmental history,and history of occupational exposure(P>0.05).6 Results of the correlation analysis between anxiety,depression and TCM constitution in patients with pulmonary nodules:the proportion of anxiety in patients with qi stagnation was higher than that in patients with non qi stagnation,and the proportion of anxiety in patients with peace was lower than that in patients with non peace,with statistically significant differences(P<0.05).The proportion of depression was higher in patients with qi stagnation than in patients with non qi stagnation,with statistically significant difference(P<0.05).The proportion of anxiety combined with depression was higher in patients with qi stagnation than in patients with non qi stagnation,and the proportion of anxiety combined with peace was lower in patients with pacification than in patients with non peace,with statistically significant differences(P<0.05).Qi stagnation was independent influencing factor of anxiety(OR:10.237,95%CI:2.221～47.183,P=0.003),depression(OR:20.152,95%CI:2.643～153.674,P=0.004),and anxiety combined with depression(OR:82.325,95%CI:4.217～1607.172,P=0.004)in patients with pulmonary nodules.7 Results of clinical observation:A total of 30 patients were included,26 completed the observation,3 were excluded,and 1 was shed.Twenty-six patients’ TCM Syndrome score,HAMA score,and HAMD-24 score decreased significantly after the intervention compared with the previous ones,and the differences were statistically significant(P<0.05).In terms of TCM clinical symptoms,after treatment,3 cases were clinically cured,6 cases were significantly effective,12 cases were effective,and 5 cases were ineffective,with an overall effective rate of 80.77%.In terms of anxiety and depression,the prevalence of anxiety decreased from 23.08%to 11.54%and the prevalence of depression decreased from 15.38%to 7.69%.Conclusions and implications:1 Among patients with pulmonary nodules,the prevalence of anxiety and depression were 23.30%and 33.01%,with relatively high proportions,and clinical treatment needs to pay attention to psychosomatic problems of patients with pulmonary nodules.2 The distribution of TCM constitution in patients with pulmonary nodules was dominated by biased constitution,accounting for 79.61%,with yang deficiency,qi stagnation and phlegm-dampness ranking in the top 3.It provides ideas for the prevention and treatment of pulmonary nodules from the perspective of TCM constitution.3 Females were the independent influencing factor of depression in patients with pulmonary nodules,suggesting that clinical treatment should focus on depression in female patients while paying attention to psychosomatic problems of patients with pulmonary nodules.4 The distribution of TCM constitution in patients with anxiety and depression in pulmonary nodules was dominated by biased constitution,and the top 3 were qi stagnation,yang deficiency and qi deficiency,among which qi stagnation was an independent influencing factor of anxiety and depression in patients with pulmonary nodules,reflecting the correlation between anxiety,depression and TCM constitution in patients with pulmonary nodules.In the future,the prevention and treatment of anxiety and depression in patients with pulmonary nodules can be achieved from the perspective of regulating qi deficiency constitution.5 Qingjin Sanjie Granules can improve the TCM clinical symptoms and the degree of anxiety and depression in patients with pulmonary nodules,and have a good safety profile,which has the value of clinical application and further in-depth study. |
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