广泛性焦虑障碍中医精神症状与躯体症状网络分析研究

doi:10.3969/j.issn.1006-7795.2023.04.011

首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (4): 568-577.doi: 10.3969/j.issn.1006-7795.2023.04.011

• 精神疾病中西医结合治疗 • 上一篇下一篇

广泛性焦虑障碍中医精神症状与躯体症状网络分析研究

李雪^1,2，冯正田^1,2，郑思思^1,2，段宇航^1,2，吴子遥^1,2，朱虹^1,2*#，贾竑晓^1,2*#

1.首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心精神疾病诊断与治疗北京市重点实验室，北京 100088；2.首都医科大学人脑保护高精尖创新中心，北京 100069

收稿日期:2023-04-02 出版日期:2023-08-21 发布日期:2023-07-26
通讯作者: 朱虹，贾竑晓 E-mail:zhuhong@ccmu.edu.cn; jhxlj@ccmu.edu.cn
基金资助:
北京市医院管理中心临床医学发展专项（ZYLX202129），北京市医院管理中心“登峰”人才培养计划项目（DFL20191901），高层次公共卫生技术人才建设项目培养计划项目（学科骨干-02-40）

Network analysis of mental and physical symptoms in patients with generalized anxiety disorder

Li Xue^1,2, Feng Zhengtian^1,2, Zheng Sisi^1,2, Duan Yuhang^1,2, Wu Ziyao^1,2, Zhu Hong^1,2*#, Jia Hongxiao^1,2*#

1.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; 2. Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China

Received:2023-04-02 Online:2023-08-21 Published:2023-07-26
Supported by:
This study was supported by Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support （ZYLX202129），Beijing Hospitals Authority’s Ascent Plan（DFL20191901），Training Plan for High Level Public Health Technical Talents Construction Project (Discipline Backbones -02-40).

摘要/Abstract

摘要： 目的探索广泛性焦虑障碍的中医核心精神症状与中医核心躯体症状，并分析症状间的关系。方法收集500例广泛性焦虑障碍患者的临床症状，采用网络分析方法对中医核心精神症状、中医核心躯体症状、中医核心精神症状与躯体症状关系、中医核心精神症状与中医核心躯体症状关系进行分析。结果广泛性焦虑障碍的中医核心精神症状是善恐易惊、善思、早醒和易激动；中医核心躯体症状是腰痛、胸闷、神疲乏力和口苦；中医核心精神症状与躯体症状研究提示善恐易惊与神疲乏力、善思与心悸、易激动与自汗、早醒与腰痛关联性较强。中医核心精神症状与中医核心躯体症状整合网络分析提示易激动和善思在整个网络中对其他症状影响较大，更多地参与症状间互动，且具有预测其他症状的作用。结论广泛性焦虑障碍与肾、心、肝关系密切，临床治疗应以精神症状为主进行辩证。

关键词: 广泛性焦虑障碍, 网络分析, 核心精神症状, 肾阴虚

Abstract: Objective To explore the core mental and physical symptoms of generalized anxiety disorder (GAD) in the view of traditional Chinese medicine and analyze the relationship between the symptoms. Methods We collected the clinical symptoms of 500 patients with GAD, and used network analysis method to analyze the core mental symptoms, core physical symptoms, core mental and physical symptoms, and core mental and physical symptoms in the view of traditional Chinese medicine. Results The core mental symptoms of GAD were as follow: prone to be frightened and afraid, overthinking, early awakening, and agitation. The core physical symptoms were as follow: low back pain, chest tightness, tired and weak spirit, and bitter mouth. Studies on core mental symptoms and physical symptoms suggested that there was a strong correlation between prone to be frightened and afraid and the tired and weak spirit, overthinking and palpitations, agitation and spontaneous sweating, early awakening and low back pain. The integrated network analysis of the core mental symptoms and core physical symptoms suggested that agitation and overthinking had a greater impact on other symptoms throughout the network. Conclusions GAD is closely related to the kidney, heart, and liver, and clinical treatment should be focused on dialectical treatment of mental symptoms.

Key words: generalized anxiety disorder, network analysis, core mental symptoms, kidney-yin deficiency

中图分类号:

R749.7+2

李雪, 冯正田, 郑思思, 段宇航, 吴子遥, 朱虹, 贾竑晓. 广泛性焦虑障碍中医精神症状与躯体症状网络分析研究[J]. 首都医科大学学报, 2023, 44(4): 568-577.

Li Xue, Feng Zhengtian, Zheng Sisi, Duan Yuhang, Wu Ziyao, Zhu Hong, Jia Hongxiao. Network analysis of mental and physical symptoms in patients with generalized anxiety disorder[J]. Journal of Capital Medical University, 2023, 44(4): 568-577.

参考文献

［1］ Penninx B W, Pine D S, Holmes E A, et al. Anxiety disorders［J］. Lancet, 2021, 397(10277): 914-927.
［2］ Li X Y, Wang X Q. Relationships between stroke, depression, generalized anxiety disorder and physical disability: some evidence from the Canadian Community Health Survey-Mental Health［J］. Psychiatry Res, 2020, 290: 113074.
［3］ Armbrecht E, Shah R, Poorman G W, et al. Economic and humanistic burden associated with depression and anxiety among adults with non-communicable chronic diseases (NCCDs) in the United States［J］. J Multidiscip Healthc, 2021, 14: 887-896.
［4］费氏清华. 中药治疗广泛性焦虑症的理论探讨及Meta分析［D］. 南京: 南京中医药大学, 2022.
［5］ Wang S, Zhao L L, Qiu X J, et al. Efficacy and safety of a formulated herbal granula, Jiu Wei Zhen Xin, for generalized anxiety disorder: a meta-analysis［J］. Evid Based Complement Alternat Med, 2018, 2018: 9090181.
［6］熊航, 王玉来, 郭蓉娟, 等. 基于现代文献的广泛性焦虑障碍辨证分型分析［J］. 中医药信息, 2014, 31(2): 27-30.
［7］孙文军, 曲淼, 唐启盛. 广泛性焦虑症中医证候的聚类研究［J］. 中华中医药杂志, 2014, 29(7): 2298-2300.
［8］董烁, 尹冬青, 贾竑晓. 广泛性焦虑障碍中医湿、热证素研究［J］. 中华中医药杂志, 2018, 33(8): 3671-3675.
［9］冯正田, 郑思思, 李雪, 等. 基于层次聚类与复杂症状网络的广泛性焦虑障碍之上热下寒证的症状关系［J］. 首都医科大学学报, 2022, 43(3): 398-406.
［10］蔡玉清, 董书阳, 袁帅, 等. 变量间的网络分析模型及其应用［J］. 心理科学进展, 2020, 28(1): 178-190.
［11］世界卫生组织. ICD-10精神与行为障碍分类: 研究用诊断标准［M］. 刘平, 译.北京: 人民卫生出版社, 1995: 114-115.
［12］ Hamilton M. The assessment of anxiety states by rating［J］. Br J Med Psychol, 1959, 32(1): 50-55.
［13］ Zimmerman M, Thompson J S, Diehl J M, et al. Is the DSM-5 Anxious Distress Specifier interview a valid measure of anxiety in patients with generalized anxiety disorder: a comparison to the Hamilton Anxiety Scale［J］. Psychiatry Res, 2020, 286: 112859.
［14］ Leucht S, Fennema H, Engel R, et al. What does the HAMD mean?［J］. J Affect Disord, 2013, 148(2/3): 243-248.
［15］ Morriss R, Leese M, Chatwin J, et al. Inter-rater reliability of the Hamilton Depression Rating Scale as a diagnostic and outcome measure of depression in primary care［J］. J Affect Disord, 2008, 111(2/3): 204-213.
［16］贾竑晓, 李雪, 尹冬青. 广泛性焦虑障碍中医证候辨证分型及量化分级标准专家共识［J］. 中医杂志, 2022, 63(11): 1096-1100.
［17］黄顺森, 罗玉晗, 来枭雄, 等. 中国青少年抑郁的核心症状及性别、抑郁程度间的比较: 基于网络分析方法［J］. 心理科学, 2022, 45(5): 1115-1122.
［18］ Epskamp S, Borsboom D, Fried E I. Estimating psychological networks and their accuracy: a tutorial paper［J］. Behav Res Methods, 2018, 50(1): 195-212.
［19］尹冬青, 贾竑晓, 周方. 中医 “肾藏精、主志” 的神经心理学内涵［J］. 中华中医药学刊, 2014, 32(1): 141-143.
［20］贾竑晓, 康玉春, 尹冬青. 王彦恒益肾平虑法治疗焦虑症的临床经验探讨［J］. 中华中医药杂志, 2014, 29(7): 2243-2246.
［21］ Belleville G, Cousineau H, Levrier K, et al. The impact of cognitive-behavior therapy for anxiety disorders on concomitant sleep disturbances: a meta-analysis［J］. J Anxiety Disord, 2010, 24(4): 379-386.
［22］ Van Mill J G, Hoogendijk W J, Vogelzangs N, et al. Insomnia and sleep duration in a large cohort of patients with major depressive disorder and anxiety disorders［J］. J Clin Psychiatry, 2010, 71(3): 239-246.
［23］赵文清, 宋立升. 焦虑障碍患者的共病失眠问题［J］. 精神医学杂志, 2016, 29(5): 392-396.
［24］李自艳, 宁艳哲, 王丹. 贾竑晓以五神藏理论结合睡眠异常模式辨治失眠经验［J］. 中医杂志, 2023, 64(3): 236-239.
［25］陈沛霖, 孟冬, 吴圣贤, 等. 肾虚所致口苦论治［J］. 山东中医药大学学报, 2022, 46(6): 694-697.

广泛性焦虑障碍中医精神症状与躯体症状网络分析研究

Network analysis of mental and physical symptoms in patients with generalized anxiety disorder

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