神经语言程式学法治疗外伤所致创伤后应激障碍的临床疗效和先天性小耳畸形患者术前、术后的心理状态调查

发布时间：2018-03-09 03:01

本文选题：创伤后应激障碍　切入点：神经语言程式学　出处：《宁夏医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的探索观察神经语言程式学（Neuro Linguistic Programming，NLP）对外伤所致创伤后应激障碍（Post Traumatic Stress Disorder，PTSD）者的治疗方法。统一治疗方法，对PTSD患者进行心理干预，观察NLP治疗外伤所致PTSD治疗效果与单纯手术而不进行心理干预组有无差别。方法2012年5月至2012年11月在西京医院整形外科对重大外伤后容貌毁损的术前住院病人进行调查，由精神科医生根据美国精神障碍诊断与统计手册第四版（DSM-IV）和心理创伤后应激障碍自评量表筛选36名PTSD患者。用单双顺序法随机分为NLP干预组和单纯手术组，各18例。NLP干预组术前用改变经验元素法、消除恐惧法、四步改变法等进行2-4小时心理干预，单纯手术组不进行心理干预。结果（1）2个月后随访,NLP干预组的PTSD症状明显缓解，干预后的反复再现体验和回避症状2个因子得分[分别为（12.67±4.29）分，（16.67±6.47）分]低于干预前[分别为（22.00±5.10）分，（20.40±4.88）分](反复再现体验P0.001,回避症状P0.05),NLP干预组干预前、后差异有统计学意义。（2）单纯手术组PTSD症状无明显变化。结论运用NLP中的改变经验元素法、消除恐惧法、四步改变法等能明显改善外伤所致PTSD，单纯整形手术对PTSD无明显影响。用NLP治疗外伤所致PTSD的方法简便、快速、有效，值得推广。目的通过人际关系综合诊断量表和SCL-90症状自评量表（symptom checklist90,SCL-90）调查先天性小耳畸形患者耳再造手术治疗前和治疗后的心理状况。方法通过人际关系综合诊断量表和SCL-90症状自评量表，使用统一的指导语对耳再造手术前的先天性小耳畸形患者进行调查问卷，耳再造手术完成3个月后再次对先天性小耳畸形患者进行随访，观察患者治疗前和治疗后的心理状态。结果先天性小耳畸形患者人际关系综合诊断量表总分从治疗前的（11.69±5.47）分降至治疗后的（6.22±4.24）分，，其中，以交际与交友方面的能力改善程度较明显。治疗前人际关系轻度困扰者占28%，中度困扰者占31%，重度困扰者占41%。治疗后人际关系轻度困扰者占63%，中度困扰者占34%，重度困扰者占3%。SCL-90症状自评量表将所有的因子与全国常模对比发现：9项因子分均低于全国常模，差异有统计学意义。治疗后与治疗前相比，除恐怖因子外，其余8项的因子分均明显降低，差异有统计学意义。结论人际关系综合诊断量表调查结果示先天性小耳畸形行耳再造的患者术后的人际关系较术前明显改善，以交际与交友方面的能力改善最为明显。SCL-90症状自评量表调查结果显示先天性小耳畸形患者耳再造治疗后与治疗前相比，除恐怖因子外，其余8项的因子分均明显降低，差异有统计学意义。
[Abstract]:Objective to investigate the treatment of post Traumatic Stress disorder (PTSD) patients with post-traumatic stress disorder (PTSD) by Neuro Linguistic programming. Objective: to observe the effect of NLP on traumatic PTSD and whether there is any difference between the simple operation and the psychological intervention group. Methods from May 2012 to November 2012 in Xijing Hospital plastic surgery was conducted to investigate the patients with major post-traumatic disfigurement before operation. A total of 36 patients with PTSD were selected by psychiatrists according to the 4th edition DSM-IVof the American Handbook for the diagnosis and Statistics of Mental Disorders and the Self-Rating scale of Post-traumatic stress Disorder (PTSD). The patients were randomly divided into two groups: NLP intervention group and simple operation group. 18 cases of NLP intervention group were treated with change experience element method, fear elimination method, four-step change method and so on for 2-4 hours before operation, but no psychological intervention was carried out in the simple operation group. Results after 2 months of follow-up, the symptoms of PTSD in NLP-treated group were significantly alleviated. After intervention, the scores of repeated reappearance experience and avoidance symptoms [12.67 卤4.29) and 16.67 卤6.47] were lower than those before intervention [22.00 卤5.10) and 20.40 卤4.88]. The difference was statistically significant (P < 0.05). There was no significant change in PTSD symptoms in the simple operation group. Conclusion the method of changing experience element in NLP, eliminating fear and four-step change method can obviously improve PTSD caused by trauma, but simple plastic surgery has no obvious effect on PTSD. NLP is a simple, rapid and effective method for the treatment of PTSD caused by trauma. It is worth popularizing. Objective to investigate the psychological status of patients with congenital microauricular malformation before and after ear reconstruction by using the interpersonal relationship comprehensive diagnosis scale and the SCL-90 symptom Checklist 90 (SCL-90). Methods by using the interpersonal Comprehensive Diagnostic scale and the SCL-90 symptom Checklist, the patients with congenital microauricular malformation before ear reconstruction were investigated by using the uniform guidance language. The patients with congenital microauricular malformation were followed up for 3 months after otoplasty. The psychological status of the patients before and after treatment was observed. Results the total score of interpersonal relationship comprehensive diagnosis scale in patients with congenital microauricular malformation decreased from 11.69 卤5.47 before treatment to 6.22 卤4.24 after treatment. The degree of improvement in communication and making friends was more obvious. Before treatment, 28 cases had mild disturbance in interpersonal relationship, 31 had moderate disturbance, 41 had severe disturbance. After treatment, 63 had slight disturbance in interpersonal relationship, 34 had moderate disturbance and 34 had severe disturbance. The SCL-90 symptom Checklist (SCL-90) compared all the factors with the national norm and found that the score of 9 factors was lower than that of the national norm. The difference was statistically significant. After treatment, the factor scores of the other 8 items were significantly lower than those before treatment, except for phobic factors, and the difference was statistically significant. Conclusion the results of the comprehensive diagnostic scale of interpersonal relationship showed that the interpersonal relationship of the patients with congenital microauricular malformation after ear reconstruction was significantly improved than that of the patients before operation. The results of SCL-90 symptom Checklist (SCL-90) showed that the scores of the other eight factors except phobia were significantly lower after ear reconstruction in patients with congenital microauricular malformation than before treatment. The difference is statistically significant.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.5;R622

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