产后女性冷敏体质患者的躯体症状和心理特征

梁东风; 胡拯源; 朱剑; 姜荣环

doi:10.3969/j.issn.2095-5227.2022.07.007

产后女性冷敏体质患者的躯体症状和心理特征

Somatic symptoms and psychological features in postpartum female patients with cold-sensitivity constitution

摘要

摘要:
背景产后女性冷敏体质(cold-sensitivity constitution，CSC)是中国文化和中国传统医学关注的重要健康议题，但相关的实证研究较少。
目的认识产后女性CSC患者伴发躯体症状和心理特征，以及躯体症状与抑郁、焦虑之间的相关性。
方法回顾性分析2018年5月- 2020年6月在解放军总医院第一医学中心风湿免疫科门诊诊治的55例产后女性CSC患者的患者健康问卷-15(patient health questionnaire-15，PHQ-15)、产后抑郁筛查量表(postpartum depression screening scale，PDSS)、焦虑自评量表(self-rating anxiety scale，SAS)得分。使用Pearson相关分析PHQ-15与PDSS得分、SAS得分之间的相关性。
结果产后女性CSC患者年龄24 ~ 42(32.98±4.49)岁，产后中位发病时间为3(IQR：2，4)个月。伴有多躯体症状(PHQ-15≥10分)35例(63.6%)，发生率前3位的躯体症状依次为感到疲劳或无精打采(51例，92.7%)、手臂/腿/关节(膝盖或髋部等)疼痛(50例，90.9%)、睡眠问题或烦恼(44例，80.0%)。伴有抑郁(PDSS≥76.5分)44例(80.0%)，伴有焦虑(SAS≥50分)28例(50.9%)，同时伴有抑郁和焦虑27例(49.1%)。PHQ-15与SAS得分呈正相关(r=0.437，P=0.001)，与PDSS得分无相关性(r=0.084，P>0.05)。
结论产后女性CSC患者常伴有多躯体症状和抑郁焦虑，其躯体症状严重程度与焦虑程度呈正相关。

Abstract:
Background Cold-Sensitivity Constitution (CSC) in postpartum women is an important health-related topic under the Chinese culture and Chinese Traditional Medicine. However, few empirical research in this area has been conducted in China.
Objective To recognize the somatic symptoms, psychological features in postpartum female patients with CSC, and explore the correlations between somatic symptoms and depression, as well that with anxiety.
Methods Data about 55 postpartum female patients with CSC diagnosed in the outpatient clinic of the Department of Rheumatology and Immunology, the First Medical Center, Chinese PLA General Hospital, from May 2018 to June 2020, were collected and retrospectively analyzed, including Patient Health Questionnaire-15 (PHQ-15), Postpartum Depression Screening Scale (PDSS) and Self-Rating Anxiety Scale (SAS). Pearson correlation analysis was used to study the correlations between PHQ-15 and anxiety or depression.
Results Totally 55 postpartum female patients with CSC were included in this study, their age ranged from 24-42 years (average age of 32.98 ± 4.49 years). The median time to CSC occurred after delivery was 3 (2, 4) months. Multiple somatic symptoms, characterized as PHQ-15 ≥10 points, were found in 35 patients (63.6%). The most common somatic symptoms included feeling tired or having low energy (n=51, 92.7%), pain in arms, legs, or joints (knees, hips, etc.) (n=50, 90.9%) and troubles in sleeping (n=44, 80.0%) successively. Depression was found in 44 patients (80.0%) (PDSS ≥76.5 points), anxiety was found in 28 patients (50.9%) (SAS ≥50 points), and 27 patients (49.1%) were found to be concurrent with depression and anxiety. In correlation analysis, the score of PHQ-15 was positively correlated with SAS (r=0.437, P=0.001), while the score of PHQ-15 was not correlated with PDSS (r=0.084, P>0.05).
Conclusion Multiple somatic symptoms are common in postpartum female patients with CSC, who are prone to be in depression and anxiety, the severity of somatic symptoms is positively correlated with the extent of anxiety.

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