| BackgroundAs a type of severe mental disorder,Schizophrenia is characteristic of abundant symptoms,high risk of self-injury and even public safety,as well as prolonged onset and difficult to be completedly cured.So far,most of the patients have been treated with longterm antipsychotic drugs.However,long-term use of antipsychotic drugs would lead to profound side effects,poor patient compliance,prolonged course,even mental disability,and imposed enormous economic pressure on the patient's family.The studies have shown that the traditional chinese medicine(TCM)or integrated traditional chinese and western medicine treatment could achieve better efficacy and less side effects.But TCM for the diagnosis and treatment of schizophrenia lacks of unified and objective standards.In the other hand,Constitution in Chinese Medicine Questionnaire(CCMQ)has been used as a standard constitutionl differentiation tool for the healthy population and a variety of physical diseases,has yet been used for physical condition survey in schizophrenic patients.Objectives1.To investigate the physical differentiation of schizophrenic patients.2.To analyze the correlation of physical differentiation and gender,age,symptom severity,course,insight,in order to provide evidence for the adjustment of constitution bias and prevention and treatment of schizophrenia.MethodsAccording to the diagnostic criteria for schizophrenia(ICD-10),350 inpatients were included in our study who were admitted to the Second Affiliated Hospital of Xinxiang Medical College from November,2015 to September,2016,the general information of patients,such as age,sex,condition course,numbers of admission,location of growth,family structure,emotional status,educational background have been collected.The psychiatric symptoms of patients were assessed by the Positive and Negative SymptomScale(PANSS).Patients' insight and treatment attitude were assessed by ITAQ(Selfknowledge and Attitude Questionnaire).Based on such scores,the patients were divided into nine groups,namely,constitution of yin-yang harmony,constitution of qi asthenia,constitution of phlegm-dampness,constitution of damp-heat,constitution of blood stasis,constitution of yang asthenia,constitution of yin asthenia,constitution of qi stagnation and allergic constitution.All the data were coded and the original database was established by SPSS22.0.Then statistic analysis were conducted with descriptive analysis,crossover analysis,independent sample t test and one-way ANOVA.Results1.The majority of schizophrenic patients is constitution of yin-yang harmony(52.6%),then qi asthenia(16.3%),followd by constitution of yang asthenia(8.8%),constitution of yin asthenia(6.3%),constitution of damp-heat(6.3%),constitution of qi stagnation(5.0%),constitution of phlegm-dampness(2.5%),constitution of blood stasis(1.3%)and allergic constitution(1.3%).2.The number of schizophrenic patients with constitution of yin-yang harmony significantly decreased with escalated severity of schizophrenia(increased PANSS score);and the number of schizophrenic patients with constitution of qi stagnation increased with escalated severity of schizophrenia(increased PANSS score).3.Compared with female schizophrenic patients,male schizophrenic patients were prone to show qi asthenia,yang asthenia,phlegm-dampness,damp-heat,qi stagnation and other biased constitution.The differences of constitution of yin-yang harmony(t=-2.727,P<0.05),qi asthenia constitution(t=2.181,P<0.05),constitution of yang asthenia(t=2.378,P<0.05),constitution of phlegm-dampness(t=2.886,P<0.05),constitution of damp-heat(t=2.045,P<0.05)and qi stagnation(t=3.256,P<0.05)were significant.The within group comparison indicated that the males with yang asthenia constitution,phlegm-dampness quality,damp-heat quality and qi-stagnation were all higher than those of females.Significantly different scores were observed in yang asthenia(F=8.719,P<0.05),yin asthenia constitution(F=7.154,P<0.05),phlegm-dampness(F=3.770,P<0.05),constitution of damp-heat(F=2.768,P<0.05),constitution of blood stasis(F=5.629,P<0.05)and allergic constitution(F=7.030,P<0.05)at different ages.The schizophrenic patients in different condition course groups demonstrated significantly different scores ofyang asthenia(F= 4.042,P <0.05),yin asthenia(F = 5.01,P <0.05),phlegm-dampness(F=2.621,P <0.05),blood stasis(F= 2.527,P <0.05)and allergic constitution(F= 3.109,P<0.05).The schizophrenic patients with different admissions scored differently in constitution of yin-yang harmony(t=-2.036,P<0.05),qi asthenia(t=3.396,P<0.05),yin asthenia(t=2.971,P<0.05),yin asthenia(t=3.871,P<0.05),phlegm-dampness(t=2.855,P<0.05),blood stasis(t=2.462,P<0.05)and qi-stagnation(t=2.171,P<0.05).The schizophrenic patients from different locations scored differently in constitution of yinyang harmony(t=-4.259,P<0.05),damp-heat(t=1.981,P<0.05)and allergic constitution(t=2.758,P<0.05).The schizophrenic patients with different family structures had different scores in constitution of qi asthenia(t=-2.267,P<0.05),yang asthenia constitution(t=2.497,P<0.05)and yin asthenia constitution(t=3.064,P <0.05).The schizophrenic patients with different emotional status had significantly different scores in constitution of qi asthenia(F=3.804,P<0.05),yang asthenia constitution(F=9.036,P<0.05),phlegmdampness(F=3.565,P<0.05),constitution of blood stasis(F=3.299,P<0.05)and allergic constitution(F=8.814,P<0.05).The schizophrenic patients with different educational background had significantly different scores in constitution of yin-yang harmony(F=12.493,P<0.05),Qi asthenia(F=4.454,P<0.05),yang asthenia constitution(F=3.708,P <0.05),yin asthenia constitution(F=8.791,P<0.05),blood stasis(F=4.000,P<0.05),qi stagnation(F=7.346,P<0.05),allergic constitution(F=4.787,P<0.05).4.There were significant differences in scores of PANSS positive factors(F= 2.778,P<0.05)in different types of schizophrenic patients.The Scheffe post hoc test did not show significant differences between groups.There were significant differences in PANSS negative factor scores in different types of schizophrenic patients(F=7.964,P<0.05).The Scheffe post hoc test indicated that the patients with constitutions of qi deficiency and yang deficiency had significantly higher PANSS negative factor scores than those patients with constitution of yin-yang harmony.The PANSSgeneral psychopathological factors were significantly different in patients with different types of constitutions(F=5.776,P<0.05).The Scheffe post hoc test indicated that PANSS general psychopathology factor scores in patients with constitution of qi asthenia,qi stagnation were significantly higher than those of patients with constitution of yin-yang harmony.The total PANSS scores were significantly different in patients with different types of constitutions(F=6.314,P<0.05).The Scheffe post hoc test found that total PANSS score in qi asthenia patients was significantly higher than that of patients with yin-yang harmony.The insight was significantly different in schizophrenic patients with different types of constitution(F=4.481,P<0.05).The Scheffe post hoc test showed that the insight of asthenia patients was significantly higher than yin-yang harmony patients.Conclusions1.The majority of schizophrenic patients are constitution of yin-yang harmony,then qi asthenia,followed by yang asthenia,yin asthenia,damp-heat,qi stagnation,phlegmdampness,blood stasis and allergic constitution.2.There were differences in the distribution of constitutions in schizophrenic patients with different gender,age,condition course,numbers of admission,location of grow,family structures,emotional status and educational background.3.The schizophrenic patients with constitution of yin-yang harmony have the least severity of mental symptoms,in contrast to most severe mental symptoms in patients with constitution of asthenia.The negative symptoms in constitution of qi asthenia and yang asthenia were more severe than that of yin-yang harmony.The hypochondria,depression and other general psychiatric symptoms in physical constitution of qi asthenia and qi stagnation were more serious than those of yin-yang harmony.The insight and attitude towards treatment in qi asthenia were significantly better than that of yin-yang harmony. |
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