| Objective:To explore the related factors of depression degree and the characteristics of TCM syndrome in community patients with post-stroke depression,to provide reference for the prevention and treatment of post-stroke depression and a theoretical basis for Chinese medicine to interfere with the depression state of stroke patients.Methods:According to the inclusion criteria,357 patients with post-stroke depression were selected from January 2018 to January 2019 in Beijing healthy rural demonstration communi ty.They were investigated the general conditions,including basic information,education level,marital status,smoking history,drinking history,personality,hobbies and other information,and the diagnosis and treatment of stroke disease,including the time and the type of the first stroke,the confirmed location of the diagnosis,course of disease,whether there is recurrence,regular infusion to prevent recurrence and combined with other chronic diseases;The Hamilton’s depression scale,the NIHSS,the Barthel index and the social support scale was used to evaluate the patients.At the same time,the four diagnostic information of the main symptoms of patients in traditional Chinese medicine,tongue and vein were collected.SPSS20.0 software was used to conduct descriptive statistics on all the data,univariate analysis and multivariate stepwise Logistic regression analysis were conducted on the relevant factors,and cluster analysis was conducted on the four diagnostic information to draw conclusions.Results:1.Among the 357 patients with PSD in the community,201(56.3%)were mildly depression,80(22.4%)were moderately depression,and 51(14.3%)were severely depression.2.Univariate analysis showed that the depression degree and gender,exercise frequency,duration of stroke,the number of chronic diseases(P<0.05),age,marital status,living conditions,personality,social interaction,interests and hobbies,exercise frequency,NIHSS score,BI score,the degree of social support(P<0.01)were correlated,while BMI index,smoking,drinking,stroke location,stroke type,occupation,education level and medical type were significantly correlated(P>0.05).In patients with chronic diseases,hypertension,coronary heart disease and hyperlipidemia were significantly correlated with the degree of depression(P<0.05),while diabetes were not statistically significant(P>0.05).3.Multiple stepwise Logistic regression analysis showed that young age,stroke course,social support and self-care ability were the protective factors for PSD patients’ depression degree(OR<1),while the degree of neurological impairment,multiple chronic diseases complicated with other diseases,introversion and living alone were risk factors for PSD patients’depression degree(OR>1).4.Cluster analysis of TCM syndromes showed that the TCM syndromes of PSD patients in the community can be divided into five categories:qi deficiency and blood stasis,liver and kidney yin deficiency,liver depression and spleen deficiency,phlegm and dampness stagnation,and qi and blood deficiency.Conclusion:PSD is a series of negative emotions,such as pessimism,sadness,anxiety,caused by the dysfunction of limb function and the decline of life ability after stroke,which is the result of multiple biological,psychological and social factors.The community undertakes the important task of secondary prevention of stroke,Therefore,perfecting community medical and nursing team,improving medical rehabilitation system,increasing social support and mental health service ability,early identification,diagnosis,and treatment of post-stroke depression patients,to promote the recovery of neurological function of patients,improve the negative mood and the quality of life of patients has a positive effect.The active use of TCM in the prevention and treatment of PSD during the rehabilitation of stroke patients is of great significance in alleviating mental symptoms of patients,improving neurological functions and promoting the rehabilitation of social functions. |
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