创伤后应激障碍症状学特征与眼动脱敏再加工疗效关系探讨

发布时间：2018-04-10 13:05

本文选题：创伤后应激障碍 + 眼动脱敏和再加工治疗　；参考：《石河子大学》2015年硕士论文

【摘要】：目的1.通过对国外已发表的随机对照试验(Randomized Controlled Trial,RCT)进行Meta分析,比较眼动脱敏治疗和再加工(Eye Movement Desensitization and Reprocessing,EMDR)对创伤后应激障碍(Post Traumatic Stress Disorder,PTSD)患者的疗效。2.探讨EMDR对PTSD的应激症状、焦虑、抑郁情绪改善情况,为国内PTSD患者的治疗提供参考依据。方法1.检索了数据库Medline,Pubmed,EBSCO,Pro Quest和Cochrane,时间跨度从1989年至2013年,以EMDR治疗PTSD的RCT为研究对象,对纳入的文献进行质量评价及相关数据提取,Meta分析使用Cochrane提供的Revman 5.0软件及Stata 12.0完成。2.目标人群为2013年1月至2013年12月期间新疆某医院经历创伤事件的住院或门诊患者,及目睹亲人经历重大创伤或突然亡故的家属,且满足PTSD诊断标准者。知情同意后将研究对象随机分为EMDR组和对照组,治疗开始前及结束后评价两组患者PTSD症状、焦虑和抑郁症状。结果1.Meta分析纳入10项RCT,共400人。结果显示,在改善PTSD患者总体应激症状上,EMDR优于对照组(SMD=-0.98,95%CI:-1.31~-0.66),从PTSD三个核心症状的改善情况上来看,EMDR能有效地减少PTSD再体验(SMD=-1.17,95%CI:-1.59~-0.76)、回避(SMD=-1.65,95%CI:-2.10~-1.21)和易激惹症状(SMD=-1.58,95%CI:-2.02~-1.14)。2.本试验共纳入54名研究对象,两组各27人。2×2重复测量方差分析表明,在CAPS再体验、CAPS回避、CAPS易激惹、CAPS总分、PCL-C再体验方面,分组效应、时间效应以及分组和时间的交互效应均有统计学意义(P0.05),在排除药物因素对治疗效果的干扰后,EMDR组较对照组在CAPS易激惹和CAPS总分下降明显,差异有统计学意义(分别为P=0.005;P=0.021)。结论1.EMDR可以有效缓解PTSD患者的总体PTSD症状,再体验、回避、易激惹三大核心症状;2.无任何心理干预措施的对照组PTSD患者,其PTSD症状及焦虑、抑郁情绪并未随时间延长而减轻。
[Abstract]:Objective 1.By Meta analysis of Randomized Controlled Trialator (RCT), a randomized controlled trial published abroad, the efficacy of ophthalmodynamic desensitization and reprocessing Movement Desensitization and reprocessing was compared in patients with post-traumatic stress disorder (PTSD).To explore the improvement of stress symptoms, anxiety and depression in patients with PTSD by EMDR, and to provide reference for the treatment of PTSD patients in China.Method 1.A database named Medlinea Pubmedus Quest and Cochrane was retrieved from 1989 to 2013. The RCT of EMDR treatment for PTSD was used as the research object. The quality evaluation and data extraction of the included literature were carried out. Meta-analysis was completed by Revman 5.0 software provided by Cochrane and Stata 12.0.The target group is the inpatient or outpatient patient who experienced traumatic events in a hospital in Xinjiang from January 2013 to December 2013, and the family members who have seen their relatives experience major trauma or sudden death, and who meet the diagnostic criteria of PTSD.After informed consent, the subjects were randomly divided into EMDR group and control group. The symptoms of PTSD, anxiety and depression were evaluated before and after treatment.Results 1.Meta analysis included 10 items of RCTs, a total of 400 people.A total of 54 subjects were enrolled in the study. The variance analysis of repeated measurement of 2. 2 in each group of 27 people showed that the group effect was found in the CAPS reexperience of caps, the total score of caps easily irritated and the total score of caps.The time effect and the interaction effect of group and time were statistically significant (P 0.05). The total scores of CAPS irritable and CAPS in the EMDR group were significantly lower than those in the control group (P 0. 005, P 0. 021, respectively) after the elimination of the interference of drug factors on the therapeutic effect, and the total score of CAPS in the EMDR group was significantly lower than that in the control group (P 0. 005, P 0. 021).Conclusion 1.EMDR can effectively relieve the overall PTSD symptoms of patients with PTSD, reexperience, avoid, and easily irritate the three core symptoms.The PTSD symptoms, anxiety and depression of PTSD patients without any psychological intervention did not decrease with time.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.74

【参考文献】