基于中医辨证分型的子宫内膜异位症患者焦虑、抑郁影响因素分析OA

Objective To investigate the current status of depression and anxiety and their influencing factors in patients with endometriosis(EM)based on traditional Chinese medicine(TCM)syndrome differentiation.Methods A cross-sectional survey was conducted among EM patients treated at Guang'anmen Hospital,China Academy of Chinese Medical Sciences,from January 2019 to April 2024.Questionnaires were administered,and anxiety and depression were assessed using standardized scales including the Self-Rating Anxiety Scale(SAS)and the Self-Rating Depression Scale(SDS).Univariate and multivariate Logistic regression analysis were performed to identify relevant influencing factors.Results(1)A total of 974 EM patients were enrolled.According to SDS and SAS scores,305 patients(31.31%)were classified as having depression,and 206 patients(21.15%)were classified as having anxiety,with mild depression and mild anxiety being the predominant types.Regarding the distribution of TCM syndromes,the qi stagnation and blood stasis syndrome was the most prevalent,accounting for 491 cases(50.41%),followed by qi deficiency and blood stasis syndrome(255 cases,26.18%),cold coagulation and blood stasis syndrome(131 cases,13.45%),and other syndromes(97 cases,9.96%).The highest average scores of SDS and SAS were observed in patients with qi stagnation and blood stasis syndrome.(2)Univariate Logistic regression analysis revealed that body mass index(BMI),chronic pelvic pain,Visual Analogue Scale(VAS)score for dysmenorrhea,clinical types of endometriosis(ovarian,peritoneal,deep infiltrating),American Society for Reproductive Medicine(ASRM)stage Ⅲ-Ⅳ,recurrence,treatment with gonadotropin-releasing hormone agonist(GnRH-a),and TCM syndromes(qi stagnation and blood stasis syndrome and other syndromes)were potential influencing factors for depression in EM patients(P＜0.05 or P＜0.01).VAS score for dysmenorrhea,clinical types of endometriosis(ovarian and deep infiltrating),surgery,ASRM stage Ⅲ-Ⅳ,recurrence,treatment with GnRH-a,treatment with Chinese herbal decoction,and TCM syndromes(qi stagnation and blood stasis syndrome and other syndromes)were potential influencing factors for anxiety in EM patients(P＜0.05 or P＜0.01).(3)Multivariate Logistic regression analysis identified VAS score for dysmenorrhea(OR:1.081,95%CI:1.033-1.130,P=0.001),recurrence(OR:1.761,95%CI:1.203-2.579,P=0.004),and qi stagnation and blood stasis syndrome(OR:1.676,95%CI:1.238-2.268,P=0.001)as risk factors for depression in EM patients.Risk factors for anxiety included VAS score for dysmenorrhea(OR:1.059,95%CI:1.008-1.113,P=0.022),surgery(OR:2.160,95%CI:1.398-3.337,P=0.001),recurrence(OR:2.160,95%CI:1.398-3.337,P=0.001),presence of other chronic diseases(OR:1.724,95%CI:1.140-2.605,P=0.010),and qi stagnation and blood stasis syndrome(OR:1.429,95%CI:1.022-1.998,P=0.037).Conclusion VAS score for dysmenorrhea,recurrence,and qi stagnation and blood stasis syndrome are independent risk factors for both anxiety and depression in EM patients,while surgery and the presence of other chronic diseases are risk factors for anxiety.