| Objective: To explore the distribution characteristics of traditional Chinese medicine constitution type,psychological state distribution and its correlation in elderly patients with coronary heart disease,analyze and identify the influencing factors of psychological problems in elderly patients with coronary heart disease,in order to provide clinical basis and reference for the development of personalized TCM prevention and treatment and psychological care comprehensive intervention program.Materials and METHODS: This cross-sectional study has passed the review of the Ethics Committee of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.A total of 150 elderly patients with coronary heart disease were enrolled in this study from December 2021 to December 2022 through questionnaire survey.The subjects were mainly from the elderly patients with coronary heart disease aged 60 or above in the geriatrics and cardiology wards of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.Questionnaire was developed to collect general information of patients.Symptom Check List 90(SCL-90)and TCM physique classification and evaluation scale were filled in by self-filling or question-and-answer method to determine TCM physique and psychological state of patients.Data were summarized and analyzed by Excel.Statistical software SPSS 26.0 was used for statistical analysis.Results:1.In a total of 150 elderly patients with coronary heart disease included in this study,the accumulated frequency of various constitutions was 346 times,among which the frequency of Yang deficiency was the highest in 84 cases(56.00%),followed by qi deficiency in 70 cases(46.67%),blood stasis in 60 cases(40.00%)and phlegm-dampness in 55 cases(36.67%).2.Among 150 elderly patients with coronary heart disease,31 cases had a single constitution,accounting for 20.67%.The top three were Qi deficiency(29.03%),Yang deficiency(25.80%)and blood stasis(19.35%).There were 119 cases of complex constitutions,accounting for79.33%,among which two types of complex constitutions(63.02%)> three types of complex constitutions(21.85%)> four types of complex constitutions(7.56%)> five types of complex constitutions(5.88%)> six types of complex constitutions(1.68%).3.In the elderly patients with coronary heart disease,the two types of complex constitution were mainly 75 cases,accounting for 63.02%,among which the top three frequency from high to low were Qi deficiency + Yang deficiency(20.00%),qi deficiency + blood stasis(16.00%),phlegm-dampness + blood stasis(13.33%).4.The frequency distribution from high to low was as follows: 39 cases of Yang deficiency(26.00%),35 cases of blood stasis(23.33%),33 cases of Qi deficiency(22.00%),15 cases of phlegm-dampness(10.00%),12 cases of qi stagnation(8.00%),10 cases of Yin deficiency(6.67%),and 6 cases of dampness-heat(4.00%).5.In the 150 elderly patients with coronary heart disease in this study,there were 125 people with abnormal mental state,accounting for 83.33%.Among the various factors of SCL-90,the scores of somatization,anxiety,depression,obsessive-compulsive symptoms and terror were significantly higher than the domestic norm(P<0.001).From high to low,the distribution frequency of positive mental states assessed by SCL-90 scale was: 87 cases of somatization symptoms(58.00%)> 74 cases of depression(49.30%)> 65 cases of anxiety(43.30%)> 55 cases of obsessive-compulsive symptoms(36.70%)> 49 cases of terror(32.70%)> 25 cases of interpersonal sensitivity(16.70%)> Hostility 22 cases(14.70%)>paranoia 20 cases(13.30%)> psychosis 6 cases(4.00%).6.Binary logistic regression analysis showed that age,pre-retirement occupation and the number of chronic diseases were the main influencing factors of somatization symptoms in elderly patients with coronary heart disease(P<0.05).Cardiac arrhythmia,stent or balloon history and the number of chronic diseases were the main influencing factors of depression in elderly patients with coronary heart disease(P<0.05).Cardiac arrhythmia,gender and marital status were the main influencing factors for anxiety in elderly patients with coronary heart disease(P<0.05).Combined arrhythmia and gender were the main influencing factors of obsessive symptoms in elderly patients with coronary heart disease(P<0.05).The course of disease,surgical history and hypertension were the main influencing factors of terror symptoms in elderly patients with coronary heart disease(P<0.05).7.There is a certain correlation between TCM constitution and mental state in elderly patients with coronary heart disease: TCM constitution has a certain correlation with somatization symptoms.The somatization symptoms of blood stasis are the highest(77.1%),followed by Qi-stagnation(69.2%)and Yang-deficiency(61.5%).There was a certain correlation between TCM constitution and depressive state.The depression state of Qi stagnation was the highest(76.9%),followed by Yang deficiency(71.8%).There was a certain correlation between TCM constitution and anxiety state.Yang deficiency syndrome had the highest anxiety state(69.2%),followed by Qi deficiency syndrome(57.6).TCM constitution has a certain correlation with the terror state.The terror state of dampness-heat substance is the highest(66.7%),followed by Qi-stagnation substance(58.3%).Conclusion:1.Elderly patients with coronary heart disease mostly have Yang deficiency constitution or compound constitution with Yang deficiency constitution.2.Most elderly patients with coronary heart disease have psychological problems,led by somatic symptoms,followed by depression and anxiety.3.The related factors affecting psychological problems in elderly patients with coronary heart disease include age,gender,marital status,pre-retirement occupation,number of chronic diseases,course of disease,combined with arrhythmia,combined with hypertension,history of stent or drug balloon and surgical history.These related factors should be combined in clinical diagnosis and treatment to strengthen targeted intervention measures.4.There is a certain correlation between TCM constitution and psychological state in elderly patients with coronary heart disease. |
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