| Object: The patients with alopecia areata were investigated by psychological questionnaire.the correlation between the indexes of psychological scale and TCM syndrome of patients with alopecia areata was analyzed.the role of psychosocial factors in the pathogenesis of alopecia areata was discussed.and the pathogenesis of alopecia areata was analyzed from the point of view of psychology.This paper provides new ideas for the study of TCM emotional pathogenesis of alopecia areata,and provides social and psychological etiological basis for improving the accuracy and effectiveness of prevention and diagnosis of traditional Chinese medicine.Methods: The clinical data and psychological questionnaire of 175 patients with alopecia areata were collected by general data questionnaire,TCM five-state Personality scale,selfrating anxiety scale,self-rating Depression scale,coping style scale and perceived Social support scale.Finally,all the data are entered into the database and analyzed by SPSS20.0.Result:1.Patients with alopecia areata occurred in all age groups,and the main age group was 21mur50(82.9%).Among them,31mur35 accounted for the highest proportion(17.7%),85 males(48.6%),90 females(51.4%),61 manual workers(34.9%),90 mental workers(51.4%),and 24 brain-body combinations(13.7%).The number of patients with multiple alopecia areata was the most(111 cases,accounting for 63.4%).In the area classification of alopecia areata,S1(alopecia area ? 25%)was the most common(63 cases,36.0%).2.The levels of anxiety and depression in patients with alopecia areata were not different according to gender,age and nature of work(P > 0.05).The course of disease,frequency of illness and sleep status of patients with alopecia areata were the influencing factors of anxiety level(P < 0.05),and sleep status was the influencing factor of depression level(P < 0.05).And 40% of patients reported poor sleep.30% of the female patients showed abnormal menstruation,and there was a positive correlation between menstruation and sleep quality(P < 0.05).3.The scores of anxiety and depression in patients with alopecia areata were significantly higher than those in the norm(P < 0.05).Among them,69 people have varying degrees of anxiety,accounting for 39.4% of the total population;96 people have varying degrees of depression,accounting for 54.9% of the total population.4.Alopecia areata patients generally understand that social support is mainly medium and high,but their coping style is relatively inclined to negative coping,so the level of depression and anxiety is also relatively high.Generally speaking,the more anxiety and depression,the more negative coping style,the lower the degree of social support;the higher the degree of social support,the more positive the coping style,and the lower the level of anxiety and depression.5.Compared with the norm,there were significant differences in both positive and negative coping styles between patients with alopecia areata and the norm(P < 0.05).In the specific comparison,it is found that the patients' coping style tends to be negative coping style.Positive coping was negatively correlated with anxiety and depression(P < 0.05),while negative coping was positively correlated with anxiety and depression(P < 0.05).6.The patients with alopecia areata generally understood that the degree of social support was acceptable.Among them,only 7 people belong to the state of low support,accounting for 4%;only 4 people have serious problems with the social support system,with a score of less than 50;and 42 people,accounting for 24%,have certain problems with social support.Perceived social support was negatively correlated with anxiety,depression and negative coping(P < 0.05),and positively correlated with positive coping(P < 0.05).7.Anxiety was positively correlated with depression and negative coping(P < 0.05),anxiety was negatively correlated with perceived social support and positive coping(P < 0.05),depression was positively correlated with negative coping(P < 0.05),depression was negatively correlated with perceived social support and positive coping(P < 0.05),and perceived social support was positively correlated with positive coping(P < 0.05).There was a negative correlation between negative coping style and negative coping style(P < 0.05).8.The five-state personality characteristics of patients with alopecia areata were negative as a whole,belonging to the two dimensions of peace of yin and yang and Shaoyin(P < 0.05).The patients with alopecia areata with bad mood were more prominent in the dimension of Taiyin,and Taiyin was positively correlated with anxiety,depression and negative coping(P < 0.05).9.According to the clinical classification of alopecia areata,the five-state personality scores of patients with single-type alopecia areata and generalized alopecia areata were not significantly different from those of the norm(P > 0.05),but there were significant differences in yin-yang peace and Shaoyin dimensions of multiple alopecia areata(P < 0.05).There was significant difference in sun dimension in patients with total alopecia areata(P < 0.05).According to the alopecia areata area,S1(S1: alopecia area ? 25%)and S3(S3: alopecia area = 50-74%)had no significant difference compared with the norm(P > 0.05).S2(S2: alopecia area = 26-49%)has significant difference in yin-yang peace dimension(P < 0.05).S4(S4: hair loss area = 75-99%)had significant difference in yin-yang peace and Shaoyin dimension(P < 0.05),and S5(S5: total hair loss with partial body hair loss)had significant difference in sun dimension(P < 0.05).10.The scores of anxiety and depression of all TCM syndrome types of alopecia areata were higher than those of the norm,and the difference was statistically significant(P < 0.05).Among the patients with blood-heat and wind syndrome,19 patients(46.3%)had anxiety and 26 patients(63.4%)had depression;among the patients with blood stasis syndrome,13 patients(31.0%)had anxiety and 18 patients(42.9%)had depression;among the patients with deficiency of both qi and blood syndrome,23 patients(50.0%)had anxiety and 29 patients(63.0%)had depression.Among the patients with liver and kidney deficiency syndrome,there were 14 patients with anxiety(30.4%)and 23 patients with depression(50.0%).11.The negative coping of each syndrome type of alopecia areata was higher than that of the norm,and there was statistical significance(P < 0.05),but there was no statistical significance in positive coping with blood heat and wind syndrome and deficiency of both qi and blood syndrome(P > 0.05).There was statistical significance in positive coping with blood stasis syndrome and liver and kidney deficiency syndrome(P < 0.05).On the other hand,the scores of perceived social support of each syndrome type are OK.12.The overall characteristics of TCM five-state personality of patients with alopecia areata were yin-yang peace and Shaoyin(P < 0.05).According to the classification of TCM syndrome,there was no significant difference between the syndrome of exuberant blood heat and wind,the syndrome of deficiency of both qi and blood and the norm of five-state personality scale(P > 0.05),but the syndrome of blood stasis and deficiency of liver and kidney were different in the two dimensions of yin and yang and Shaoyin(P < 0.05).Conclusion:1.The main age group of patients with alopecia areata is 21-50 years old(82.9%),among which 31-35 years old accounts for the highest(17.7%).The number of mental workers is in the majority,and there is no significant gender difference.40% of the patients had poor sleep,48.6% of the patients were seriously ill,33.7% of the patients had recurrence,and 30% of the female patients had abnormal menstruation.Most of the clinical types of alopecia areata were multiple alopecia areata,and S1(alopecia area ? 25%)was the most common type of alopecia areata.2.The overall psychological stress of patients with alopecia areata is high,and the level of psychosomatic health of individuals is low,while depression(54.9%)and anxiety(39.4%)may be the main emotional disorders of patients with alopecia areata.Regardless of sex,age,nature of occupation,condition,course of disease,frequency of illness and sleep quality,the scores of anxiety and depression were high.3.Sex,age and nature of work had no significant effect on the level of anxiety and depression in patients with alopecia areata.The course of disease,the number of diseases and the quality of sleep will aggravate anxiety;the worse the sleep,the more depressed.Abnormal menstruation can affect the sleep quality of female patients.The longer the course of the disease and the more times of the disease,the more serious the disease.The more anxious and the longer the course of the disease,the more likely it is to cause recurrence of alopecia areata.4.The author speculates that although the patients with alopecia areata generally perceive moderate and high social support,their coping style is relatively inclined to negative coping,so the level of depression and anxiety is also relatively high.Generally speaking,anxiety, depression,perceived social support and coping style influence each other.That is,the more anxious and depressed,the more negative the coping style is,the lower the degree of social support is;the higher the degree of social support is,the more positive the coping style is,and the lower the level of anxiety and depression is.Therefore,with the cooperation of patients,family cooperation and the participation of doctors,the degree of social support of patients with alopecia areata should be improved,and the coping style of patients can be more positive,which can effectively reduce bad emotions.5.The patients with alopecia areata with bad mood were more prominent in the dimension of Taiyin.The higher the score of Taiyin,the higher the level of anxiety and depression,the more negative the coping style,and the lower the degree of social support.Therefore,try to alleviate the bad mood of patients with alopecia areata and prevent the development of alopecia areata to Taiyin dimension,which is helpful to prevent the aggravation of alopecia areata.6.The five-state personality characteristics of patients with single-type alopecia areata and generalized alopecia areata are no different from those of normal people.Patients with multiple-type alopecia areata are negative with good balance and persistence;patients with total alopecia are positive and have low reaction intensity;the five-state personality characteristics of patients with alopecia areata of S1(hair loss area ? 25%)and S3(hair loss area = 50-74%)are no different from those of normal people.S2(hair loss area = 26-49%)patients are relatively peaceful and balanced.Patients with S4(alopecia area = 75-99%)are negative,with good balance and persistence,while patients with S5(total hair loss with partial body hair loss)are positive with low reaction intensity.7.The overall characteristics of TCM five-state personality of patients with alopecia areata are negative,good balance and good persistence.The five-state personality characteristics of alopecia areata patients with deficiency of both qi and blood and blood-heat and wind syndrome are no different from those of ordinary people,while the five-state personality characteristics of alopecia areata patients with blood stasis syndrome and liver and kidney deficiency syndrome are negative.Generally speaking,patients with alopecia areata are not good at words,can not express their emotions well,and there may be no suitable way to venttheir emotions.Therefore,according to the different psychological problems of patients,psychological counseling methods can be adopted to make them open their hearts and alleviate psychological pressure.8.The scores of anxiety and depression of all syndrome types of alopecia areata were higher than those of the norm.Among them,the anxiety score of blood-heat wind syndrome was the highest,and the depression score of qi-blood deficiency syndrome was the highest.The coping styles of patients with various syndrome types are mainly negative,and the degree of social support is acceptable.In clinical diagnosis and treatment,according to different syndrome types,mainly regulating qi,soothing the liver and relieving depression,nourishing the heart and mind,it can not only alleviate the bad mood,but also help the viscera to recuperate.At the same time,carrying on the corresponding psychological intervention to the patients,trying to change the negative coping style and improving the degree of social support will help to improve the curative effect. |
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