| Purpose: The essay is based on epidemiology research,in order to understanding the current incidence of depression in patients with chronic hepatitis B,and analyzing the related factors of chronic hepatitis b patients with depression and to explore the TCM syndrome type distribution characteristic,to attach importance to patients with chronic hepatitis b clinical intervention of mental health,improve the clinical curative effect of chronic hepatitis b patients to provide certain theoretical reference.Materials And Methods:This research adopts the clinical epidemiological investigation research method,choose in January 2018-December 2019 in liaoning university hospital of traditional Chinese medicine liver disease outpatient treatment,diagnosis of chronic hepatitis b patients with viral hepatitis on-site questionnaire survey,fill in the self-evaluation depression scale(SDS)on the spot and recycling,collection of second liver patient clinical information to fill in self-made questionnaire,records of patients general data and clinical data(including name,gender,age,education,income,clinical examination,whether the antiviral,family history,course of diseases,and related information such as psychological factors).At the same time,the non hepatitis B population randomly selected from Liaoning University of traditional Chinese medicine outpatient physical examination for SDS questionnaire survey.Collate,input and assign all the data collected from the questionnaire.SPSS23.0 software was used for statistical analysis,and all the results were directly output by the computer.The use case and percentage of enumeration data were expressed,and the comparison between groups was tested by 2 test.The measurement data were described by mean±standard deviation((?)±s)and analyzed by variance.The correlation test and multi-factor linear regression analysis were used to analyze the factors affecting depression in hepatitis b patients,and P<0.05 indicated that the difference was statistically significant.Results:1 Depression investigation1.1 In this survey,350 questionnaires were distributed to chronic hepatitis B group,316 valid questionnaires,115 questionnaires to non hepatitis B group and 100 valid questionnaires.1.2 Among the 316 patients with chronic hepatitis b,165(52.2%)had no depression,151(47.8%)had depression,113(35.7%)had mild depression,29(9.1%)had moderate depression,and 9(2.8%)had severe depression.Among the 100 non hepatitis b group,76(76%)had no depression,24(24%)had depression,among which 21(21%)had mild depression,2(2%)had moderate depression,and 1(1%)had major depression.1.3 The SDS score of chronic hepatitis b patients was 49.70±12.25,and that of non hepatitis b group was 41.96 ±10.70.The depression of hepatitis b patients was worse than that of healthy people(F=32.15,P<0.001).1.4 The mean values of chronic hepatitis b patients in the four dimensions of mental-emotional symptoms,somatic disorders,psychomotor disorders and depressive psychological disorders were higher than those of non hepatitis b group(F=47.80,P<0.001;F=68.88,P<0.001;F=20.34,P<0.001;F=15.76,P<0.001).2 Related factors of depression in patients with hepatitis b2.1 In the correlation test,gender was negatively correlated with depression(r=-0.384,P<0.01),and women were more prone to depression.There was a positive correlation between income and depression(r=0.137,P < 0.05).There was a positive correlation between education background and depression(r=0.200,P < 0.01).Age,positive HBe Ag,antiviral status,and DNA replication were not significantly associated with depression(P > 0.05).2.2 In the multi-factor linear regression analysis,there was a significant negative correlation between gender and depression(?=-0.367,t=-0.710,P<0.001),and women were more prone to depression than men.There was a significant positive correlation between education background and depression(?=0.125,t=3.40,P<0.001).There was a significant positive correlation between hepatitis degree and depression(?=0.298,t=5.08,P<0.001).There was a significant positive correlation between duration of illness and depression(?=0.208,t=5.31,P<0.001).There was a significant positive correlation between family history and depression(?=0.423,t=11.99,P<0.001).Individuals with a family history were more likely to be depressed.There was a significant positive correlation between fear of disease progression and depression(?=0.0948,t=2.26,P<0.001).There was a significant negative correlation between treatment confidence and depression(?=-0.585,t=-17.30,P<0.001).The more confident the patients were about treatment,the less likely they were to suffer from depression.There was no significant correlation between medical burden and depression(P >0.05).3 Distribution of TCM syndromes of hepatitis b patients3.1 In this study,among the 316 patients with chronic hepatitis b,the number of TCM syndromes ranged from most to most were liver stagnation and spleen deficiency(103 cases,32.5%),dampness-heat internal node(101 cases,31.9%),blood stasis and collateral-blocking(49 cases,15.5%),liver and kidney Yin deficiency(37 cases,11.7%),spleen and kidney Yang deficiency(26 cases,8.2%).3.2 Among the TCM syndromes of hepatitis b patients,the percentage of those without depression in their syndromes ranged from most to least: damp-heat syndrome(66 cases,65.34%),spleen-kidney Yang deficiency(15 cases,57.69%),blood stasis(24 cases,48.97%),liver-stagnation and spleen-spleen deficiency(45 cases,43.68%),liver-kidney Yin deficiency(15 cases,40.54%).The proportion of mildly depressed patients in the syndrome types ranged from most to least: liver stagnation and spleen deficiency(50 cases,48.54%),liver and kidney Yin deficiency(14 cases,37.83%),blood stasis and collateral obstruction(17 cases,34.69%),damp-heat internal node(27 cases,26.73%),spleen and kidney Yang deficiency(5 cases,19.23%).The proportion of people with moderate depression in the syndromes was from most to least: spleen-kidney Yang deficiency(5 cases,19.23%),liver-kidney Yin deficiency(5cases,13.51%),blood stasis(6 cases,12.24%),damp-heat internal node(8 cases,7.92%),liver-yu and spleen-spleen deficiency(5 cases,4.85%).The proportion of the number of people with moderate to severe depression in the syndromes was from most to least: liver and kidney Yin deficiency(3 cases,8.1%),blood stasis blocking collateral-collateral(2 cases,4.08%),spleen and kidney Yang deficiency(1 case,3.84%),liver yu and spleen deficiency(3cases,2.91%),and damp-heat internal knot(0 cases,0%).The comparison between each syndrome type and depression was statistically significant(X~2=11.168,P<0.05).Conclusion:1.The incidence of depression in 316 patients with chronic hepatitis b was 47.8%,higher than that in non-hepatitis b patients.2.The degree of depression disorder in chronic hepatitis b patients was higher than that in non-hepatitis b patients,and the four dimensions of mental emotional symptoms,physical disorders,mental exercise disorders and depressive psychological disorders were significantly abnormal in non-hepatitis b patients.3.Among patients with chronic hepatitis b,women,low income,low educational background,severe hepatitis,long course of disease,and family history are more likely to be associated with depression,and the less worried about the disease and the stronger the treatment confidence are,the less likely to be associated with depression.4.All patients with each syndrome type of chronic hepatitis b have depressive disorders,and the degree distribution of depressive disorders among each syndrome type is different. |
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