中药配合心理干预方案提高肿瘤患者生活质量的初步研究
发布时间：2018-10-21 07:48
【摘要】： 目的:综合治疗是目前治疗恶性肿瘤的主要方法,其中中医药在综合治疗中的地位日显凸出。虽然中医心理干预治疗恶性肿瘤有一定疗效,然而缺乏规范化治疗方案及疗效标准,尚未在临床中得到广泛应用。本课题旨在客观评价中药配合中医心理干预方案在改善肿瘤患者心理状态、调节免疫功能及提高生活质量等方面的临床疗效,并试图为完善恶性肿瘤综合治疗,并形成初步的规范化心理治疗方案提供临床依据。 方法:通过前瞻性随机对照临床研究,以心理状态评分(Hamilton抑郁自评量表计分)、免疫功能(NK、T细胞亚群)检测指标和生活质量计分(EORTC QLQ-C30(version 3)生活质量调查问卷)为重点研究指标,在北京中医药大学东直门医院和中国医学科学院肿瘤医院观察了符合纳入病例标准的53例恶性肿瘤患者,按不平衡指数最小的分配原则,随机分配到治疗组及对照组,两组比例为1:1。对照组:采用常规治疗,包括化疗、对症治疗和支持治疗等。治疗组:在对照组治疗基础上,增加中药配合中医心理干预疗法。全部病例均连续治疗14天为一个治疗周期。每组分别观察治疗1个周期。统计分析采用SPSS11.0统计分析软件进行计算。组间资料两两比较采用t检验。治疗前后比较用配对t检验。 结果:中医心理干预方案对于改善肿瘤患者的心理状态、生活质量具有明显作用,在情感关系、免疫指标等方面的改善较对照组均有统计学意义。①中医心理干预治疗组第8天测评,与疗前比较,Hamilton评分有所上升,但无统计学意义(P0.05);第15天测评,Hamilton评分明显下降,与疗前相比有统计学意义(P0.01)。而常规治疗对照组中,疗后两次测评与治疗前比较,Hamilton评分略有上升,无统计学意义。②中医心理干预治疗组第8天测评,8例QOL明显改善,与对照组(仅1例改善)比较,具有统计学意义(P0.01);第15天测评,治疗组QOL评分明显上升,生活质量明显提高者达到22例,与常规治疗对照组(QOL改善者仅有2例)相比,有效率分别为75.9%和8.3%,具有统计学意义(P0.001)。③中医心理干预治疗组第15天测评免疫功能,治疗组与对照组相比,CD3+、CD4+、CD4+/CD8+均上升,CD8+下降,具有统计学意义(P0.05),治疗组NK细胞疗后虽比对照组上升,但无统计学意义(P0.05);治疗组治疗前、疗后相比,CD3+、CD4+、CD4+/CD8+均上升,CD8+下降,具有统计学意义(P0.05)。 结论:以调畅情志为主的中医心理干预治疗可以作为肿瘤综合治疗的一部分,对提高肿瘤患者生活质量方面大有裨益,反映出中药配合心理治疗方案在一定程度上调节机体免疫功能的一种趋势。本课题的研究结果显示中医心理治疗可以使肿瘤患者心理状态改善,生活质量提高,免疫指标好转,三者之间存在直接相关性。提示在肿瘤患者综合治疗中,中药配合心理干预疗法不但有助于控制肿瘤的发展,还具有一定的社会和经济效应,该方案值得进一步探索与完善。
[Abstract]:Objective: Comprehensive treatment is the main method for the treatment of malignant tumor, in which the status date of traditional Chinese medicine is prominent. Although traditional Chinese medicine psychological intervention is effective in treating malignant tumor, there is a lack of standardized treatment plan and curative effect standard, which has not been widely used in clinic. The objective of this study is to objectively evaluate the clinical efficacy of traditional Chinese medicine combined with traditional Chinese medicine psychological intervention program in improving the mental state of tumor patients, regulating the immune function and improving the quality of life, and try to improve the comprehensive treatment of malignant tumor. and forms a preliminary standardized psychotherapy scheme to provide a clinical basis. Methods: A prospective randomized controlled clinical study was conducted to evaluate the mental state score (Hamilton depression self-rating scale), immune function (NK, T cell subgroup) and quality of life (EORTC QLQ-C30 (version 3)). In order to study the indexes, 53 patients with malignant tumor were randomly assigned to the treatment group and the control group according to the principle of the minimum balance index in the East-direct-Door Hospital of Beijing University of Traditional Chinese Medicine and the Cancer Hospital of Chinese Academy of Medical Sciences. The proportion of the groups was 1: 1. The control group: routine treatment, including chemotherapy, symptomatic treatment, Therapy and support therapy, etc. Treatment group: on the basis of control group treatment, increase the coordination of traditional Chinese medicine Medical psychological intervention therapy. All cases were continuously treated for 14 days For a treatment cycle, each group views For 1 period of treatment, SPSS 11.0 was used for statistical analysis. The software is calculated. The inter-group data are two t-test was used to compare the treatment before and after treatment. Results: The psychological intervention program of traditional Chinese medicine has obvious effect on improving the mental state and quality of life of patients with tumor. Compared with the control group, the improvement of the surface was statistically significant. Compared with the control group, the Hamilton score increased, but there was no statistical significance (P0.05). There was statistical significance (P0.01). Compared with the conventional treatment group, the two tests were compared with the pre-treatment, and Hamilt On the 8th day of the treatment group, 8 cases of QOL were significantly improved, compared with the control group (1 case only). The score of QOL of the treatment group was significantly higher than that in the control group (P <0.01). The effective rate was 75.9% and 80.3%, respectively. Compared with the control group, CD3 +, CD4 +, CD4 +/ CD8 + both increased and CD8 + decreased in the treatment group compared with the control group. But there was no statistical significance (P0.05). CD3 +, CD4 +, CD4 +/ CD8 + both increased and CD8 + decreased before and after treatment. Conclusion: Traditional Chinese medicine psychological intervention can be used as a part of the comprehensive treatment of tumor, which can improve the quality of life of patients with tumor, and reflect the matching psychology of traditional Chinese medicine. The research result shows that the psychological state of the tumor patients can be improved and the life of the patients can be improved. It is suggested that traditional Chinese medicine combined with psychological intervention therapy not only can help control the development of tumor, but also has one.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R273;R395.5
本文编号：2284432
[Abstract]:Objective: Comprehensive treatment is the main method for the treatment of malignant tumor, in which the status date of traditional Chinese medicine is prominent. Although traditional Chinese medicine psychological intervention is effective in treating malignant tumor, there is a lack of standardized treatment plan and curative effect standard, which has not been widely used in clinic. The objective of this study is to objectively evaluate the clinical efficacy of traditional Chinese medicine combined with traditional Chinese medicine psychological intervention program in improving the mental state of tumor patients, regulating the immune function and improving the quality of life, and try to improve the comprehensive treatment of malignant tumor. and forms a preliminary standardized psychotherapy scheme to provide a clinical basis. Methods: A prospective randomized controlled clinical study was conducted to evaluate the mental state score (Hamilton depression self-rating scale), immune function (NK, T cell subgroup) and quality of life (EORTC QLQ-C30 (version 3)). In order to study the indexes, 53 patients with malignant tumor were randomly assigned to the treatment group and the control group according to the principle of the minimum balance index in the East-direct-Door Hospital of Beijing University of Traditional Chinese Medicine and the Cancer Hospital of Chinese Academy of Medical Sciences. The proportion of the groups was 1: 1. The control group: routine treatment, including chemotherapy, symptomatic treatment, Therapy and support therapy, etc. Treatment group: on the basis of control group treatment, increase the coordination of traditional Chinese medicine Medical psychological intervention therapy. All cases were continuously treated for 14 days For a treatment cycle, each group views For 1 period of treatment, SPSS 11.0 was used for statistical analysis. The software is calculated. The inter-group data are two t-test was used to compare the treatment before and after treatment. Results: The psychological intervention program of traditional Chinese medicine has obvious effect on improving the mental state and quality of life of patients with tumor. Compared with the control group, the improvement of the surface was statistically significant. Compared with the control group, the Hamilton score increased, but there was no statistical significance (P0.05). There was statistical significance (P0.01). Compared with the conventional treatment group, the two tests were compared with the pre-treatment, and Hamilt On the 8th day of the treatment group, 8 cases of QOL were significantly improved, compared with the control group (1 case only). The score of QOL of the treatment group was significantly higher than that in the control group (P <0.01). The effective rate was 75.9% and 80.3%, respectively. Compared with the control group, CD3 +, CD4 +, CD4 +/ CD8 + both increased and CD8 + decreased in the treatment group compared with the control group. But there was no statistical significance (P0.05). CD3 +, CD4 +, CD4 +/ CD8 + both increased and CD8 + decreased before and after treatment. Conclusion: Traditional Chinese medicine psychological intervention can be used as a part of the comprehensive treatment of tumor, which can improve the quality of life of patients with tumor, and reflect the matching psychology of traditional Chinese medicine. The research result shows that the psychological state of the tumor patients can be improved and the life of the patients can be improved. It is suggested that traditional Chinese medicine combined with psychological intervention therapy not only can help control the development of tumor, but also has one.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R273;R395.5
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