生物反馈放松疗法治疗寻常型银屑病临床研究
发布时间：2018-11-03 13:11
【摘要】： 目的：银屑病是一种常见的免疫性、炎症性慢性皮肤病。目前银屑病的病因和发病机制尚未得出定论,研究表明心理因素在银屑病的诱发、加重、缓解、治愈中起着重要的作用,并有其一定的物质基础,是典型的心身疾病。焦虑、紧张、抑郁等负性情绪使银屑病患者长期处于一系列生理和心理反应的应激状态。本研究拟通过探讨生物反馈放松疗法对寻常型银屑病患者临床疗效、生活质量、情绪状态的影响,为银屑病的发生发展与社会心理因素的关系寻找理论依据,并为银屑病的临床心理治疗提供科学依据。方法：(1)病例分组及治疗方法：采用随机病例对照研究方法将纳入的60例寻常型银屑病患者随机分为常规治疗组(共30人,其中5人脱失,实际为25人)和生物反馈放松治疗组(共30人,其中3人脱失,实际为27人)。常规治疗组给予口服复方氨肽素片、外用冰霜治疗,生物反馈放松治疗组除进行药物治疗(与常规治疗组相同)外,另加入生物反馈放松训练治疗,每周1次,共治疗8周。(2)肌电、皮电参数基础值测定：测量20例一般健康人员的平静状态下10分钟内肌电、皮电平均值作为参数基础值。(3)临床疗效评价采用PASI评分法。(4)生活质量评价采用生活质量指数量表(DLQI)。(5)情绪状态评价采用焦虑自评量表(SAS)及抑郁自评量表(SDS)。(6)统计方法：应用SPSS11.5软件包对资料进行统计分析。结果：临床疗效：生物反馈放松治疗组和常规治疗组患者治疗前PASI评分分别为：13.57±3.85,13.12±4.23,两组相比差异无统计学意义(p0.05)；治疗后两组评分均下降,分别为：3.99±2.04,6.20±3.34,放松治疗组明显低于常规治疗组(p0.05)。治疗后两组总有效率分别为：70%和32%,放松治疗组明显高于常规治疗组(p0.05)。生活质量评价：放松治疗组和常规治疗组患者治疗前DLQI评分分别为：13.22±3.13,13.60±2.71,两组相比差异无统计学意义(p0.05)；治疗后两组DLQI评分分别为：10.33±2.71,13.52±2.91,放松治疗组明显低于常规治疗组(p0.05)。焦虑状态评价：放松治疗组和常规治疗组患者治疗前SAS评分分别为：40.96±4.73,42.20±4.33,两组相比差异无统计学意义(p0.05)；治疗后SAS评分分别为：36.81±5.39,42.24±4.76,放松治疗组明显低于常规治疗组(p0.05)。抑郁状态评价：放松治疗组和常规治疗组患者治疗前SDS评分分别为：47.44±1.02,49.24±1.15,两组相比差异无统计学意义(p0.05)；治疗后评分分别为：42.48±5.37,49.04±5.36,放松治疗组显著低于常规治疗组(p0.05)。肌电、皮电参数评价：(1)肌电：肌电参数基础值为4.94±0.91μV,治疗前放松治疗组及常规治疗组肌电参数10分钟平均值分别为：6.47±0.76μV,6.58±0.93μV,均高于参数基础值且两组相比差异无统计学意义(p0.05)；治疗后放松治疗组和常规治疗组肌电参数10分钟平均值分别为：5.65±0.73μV,6.33±0.68μV,放松治疗组与常规治疗组相比治疗后肌电值显著下降(p0.05)。(2)皮电：皮电参数基础值为1.72±0.49μs/cm2,治疗前放松治疗组及常规治疗组皮电参数10分钟平均值分别为：2.53±0.58μs/cm2,2.87±0.68μs/cm.2均高于参数基础值且两组相比差异无统计学意义(p0.05)；治疗后放松治疗组和常规治疗组肌电参数10分钟平均值分别为：2.15±0.50μs/cm2,2.72±0.71μs/cm2,放松治疗组与常规治疗组相比治疗后皮电参数水平显著下降(p0.05)。结论：本研究采用随机病例对照试验方法研究了生物反馈放松疗法对寻常型银屑病患者的临床疗效、生活质量、情绪状态的影响。研究结果初步揭示生物反馈放松疗法对寻常型银屑病患者的临床疗效、生活质量、情绪状态均产生了不同程度的影响。 1、生物反馈放松疗法能有效提高寻常型银屑病患者的临床疗效； 2、生物反馈放松疗法能有效改善寻常型银屑病患者的生活质量 3、生物反馈放松疗法能有效改善寻常型银屑病患者的情绪状态； 4、生物反馈放松疗法可能通过降低患者的肌电、皮电参数水平,使其趋于基础值水平,有效的改善患者的机体紧张状态以及自主神经调节功能而发挥治疗作用。
[Abstract]:Objective: Psoriasis is a common immune and inflammatory chronic skin disease. The pathogenesis and pathogenesis of psoriasis has not been decided yet. The study shows that psychological factors play an important role in the induction, exacerbation, remission and cure of psoriasis, and have a certain material base. It is a typical heart disease. Anxiety, stress, depression, etc. negative emotion causes psoriasis patients to be in a series of physiological and psychological reactions for a long time. The purpose of this study was to explore the effect of biofeedback on the clinical efficacy, quality of life and emotional state of psoriasis patients, to find the theoretical basis for the development of psoriasis and social psychological factors, and to provide scientific basis for the clinical psychotherapy of psoriasis. Methods: (1) Case grouping and treatment: 60 patients with psoriasis vulgaris were randomly divided into routine treatment group (30 persons, 5 out of 5, 25 in practice) and biofeedback relaxation treatment group (30 in total). Three of them were out of order, actually 27). In the conventional treatment group, the oral compound ammonia peptide tablet, the external drug therapy group and the biofeedback relaxation treatment group were treated with the biofeedback relaxation training group except for the drug therapy (the same as the conventional treatment group), and the biofeedback relaxation treatment group was added to the biofeedback relaxation training treatment once a week for 8 weeks. (2) Basic value measurement of myoelectric and skin electric parameters: measure the muscle electricity and skin electric average value as parameter base value within 10 minutes under the calm state of 20 general health personnel. (3) The PASI score method was adopted for clinical efficacy evaluation. (4) Quality of life evaluation adopts quality index (DLQI). (5) Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used for emotional state evaluation. (6) Statistical method: SPSS 11.5 software package was used to analyze the data. Results: The PASI scores of the biofeedback relaxation treatment group and the conventional treatment group were 13.57, 3.85, 13.12 and 4.23, respectively. There was no significant difference between the two groups (P0.05). The relaxing treatment group was significantly lower than that of the conventional treatment group (P0.05). The total effective rates of the two groups were: 70% and 32% respectively, and the relaxation treatment group was significantly higher than that in the conventional treatment group (P0.05). The evaluation of quality of life: The DLQI scores were 13. 22, 3. 13, 13. 60 and 2.71 respectively in the relaxed treatment group and the conventional treatment group. There was no significant difference between the two groups (P0.05). The DLQI scores of the two groups were 10.33, 2.71, 13.52 and 2.91, respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). Anxiety status evaluation: SAS scores were 40. 96, 4.73, 42. 20 and 4.33 respectively in the relaxed treatment group and the conventional treatment group. The SAS scores of the two groups were 36. 81, 5.39, 42. 24 and 4.76, respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). Depression status evaluation: The pre-treatment SDS scores of the relaxed treatment group and the conventional treatment group were 47. 44, 1. 02, 49. 24 and 1. 15, respectively. There was no significant difference in the two groups (P0.05). The post-treatment scores were: 42. 48, 5.37, 49. 04, and 5.36 respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). The electrical parameters of muscle and skin were evaluated as follows: (1) Muscle electricity: The basic value of myoelectric parameters was 4. 94% 0. 91. V, the average value of 10 minutes for the treatment group and the conventional treatment group was 6.47, 0.076. V, 6.58, 0.093. mu.V, respectively. Both groups were higher than the basic values of the parameters and no significant difference was found between the two groups (P0.05). The average value of 10 minutes of the electric parameters of the relaxing treatment group and the conventional treatment group after the treatment was 5. 65% 0. 73. mu.V, 6. 33, 0. 68. mu.V, respectively. Compared with the conventional treatment group, the electric value of the myoelectric muscle decreased significantly compared with the conventional treatment group (P0.05). (2) Skin electricity: The basic value of skin electric parameter was 1. 72% 0. 49. mu.s/ cm2, and the average value of 10 minutes of skin electric parameters of the pre-treatment group and the conventional treatment group were: 2.53, 0.058. mu.s/ cm2, 2.87, 0.068. mu.s/ cm. Both were higher than those of the parameter base, and the difference was not statistically significant compared with that of the two groups (P0.05). After treatment, the average values of the electrical parameters of the relaxing treatment group and the conventional treatment group were: 2. 15% 0. 50. mu.s/ cm2, 2.72, 0. 71. mu.s/ cm2, and the relaxation treatment group had a significant decrease in the level of electrical parameters after treatment compared with the conventional treatment group (P0.05). Conclusion: The clinical efficacy, quality of life and emotional state of patients with psoriasis vulgaris treated by biofeedback chemotherapy were studied in this study. The results showed that biofeedback release therapy had a different effect on the clinical efficacy, quality of life and emotional state of patients with psoriasis vulgaris. 1. Biofeedback release therapy can effectively improve patients with psoriasis vulgaris Clinical curative effect; biofeedback release therapy can effectively improve the common type The quality of life of patients with psoriasis is 3, biofeedback relaxation therapy can be changed effectively. The emotional state of patients with psoriasis vulgaris; 4. biofeedback release therapy may reduce the level of basal value by reducing the level of muscle and skin electrical parameters of the patient, so as to effectively improve the patient's body tension.
【学位授予单位】：泸州医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.63
本文编号：2307886
[Abstract]:Objective: Psoriasis is a common immune and inflammatory chronic skin disease. The pathogenesis and pathogenesis of psoriasis has not been decided yet. The study shows that psychological factors play an important role in the induction, exacerbation, remission and cure of psoriasis, and have a certain material base. It is a typical heart disease. Anxiety, stress, depression, etc. negative emotion causes psoriasis patients to be in a series of physiological and psychological reactions for a long time. The purpose of this study was to explore the effect of biofeedback on the clinical efficacy, quality of life and emotional state of psoriasis patients, to find the theoretical basis for the development of psoriasis and social psychological factors, and to provide scientific basis for the clinical psychotherapy of psoriasis. Methods: (1) Case grouping and treatment: 60 patients with psoriasis vulgaris were randomly divided into routine treatment group (30 persons, 5 out of 5, 25 in practice) and biofeedback relaxation treatment group (30 in total). Three of them were out of order, actually 27). In the conventional treatment group, the oral compound ammonia peptide tablet, the external drug therapy group and the biofeedback relaxation treatment group were treated with the biofeedback relaxation training group except for the drug therapy (the same as the conventional treatment group), and the biofeedback relaxation treatment group was added to the biofeedback relaxation training treatment once a week for 8 weeks. (2) Basic value measurement of myoelectric and skin electric parameters: measure the muscle electricity and skin electric average value as parameter base value within 10 minutes under the calm state of 20 general health personnel. (3) The PASI score method was adopted for clinical efficacy evaluation. (4) Quality of life evaluation adopts quality index (DLQI). (5) Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used for emotional state evaluation. (6) Statistical method: SPSS 11.5 software package was used to analyze the data. Results: The PASI scores of the biofeedback relaxation treatment group and the conventional treatment group were 13.57, 3.85, 13.12 and 4.23, respectively. There was no significant difference between the two groups (P0.05). The relaxing treatment group was significantly lower than that of the conventional treatment group (P0.05). The total effective rates of the two groups were: 70% and 32% respectively, and the relaxation treatment group was significantly higher than that in the conventional treatment group (P0.05). The evaluation of quality of life: The DLQI scores were 13. 22, 3. 13, 13. 60 and 2.71 respectively in the relaxed treatment group and the conventional treatment group. There was no significant difference between the two groups (P0.05). The DLQI scores of the two groups were 10.33, 2.71, 13.52 and 2.91, respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). Anxiety status evaluation: SAS scores were 40. 96, 4.73, 42. 20 and 4.33 respectively in the relaxed treatment group and the conventional treatment group. The SAS scores of the two groups were 36. 81, 5.39, 42. 24 and 4.76, respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). Depression status evaluation: The pre-treatment SDS scores of the relaxed treatment group and the conventional treatment group were 47. 44, 1. 02, 49. 24 and 1. 15, respectively. There was no significant difference in the two groups (P0.05). The post-treatment scores were: 42. 48, 5.37, 49. 04, and 5.36 respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). The electrical parameters of muscle and skin were evaluated as follows: (1) Muscle electricity: The basic value of myoelectric parameters was 4. 94% 0. 91. V, the average value of 10 minutes for the treatment group and the conventional treatment group was 6.47, 0.076. V, 6.58, 0.093. mu.V, respectively. Both groups were higher than the basic values of the parameters and no significant difference was found between the two groups (P0.05). The average value of 10 minutes of the electric parameters of the relaxing treatment group and the conventional treatment group after the treatment was 5. 65% 0. 73. mu.V, 6. 33, 0. 68. mu.V, respectively. Compared with the conventional treatment group, the electric value of the myoelectric muscle decreased significantly compared with the conventional treatment group (P0.05). (2) Skin electricity: The basic value of skin electric parameter was 1. 72% 0. 49. mu.s/ cm2, and the average value of 10 minutes of skin electric parameters of the pre-treatment group and the conventional treatment group were: 2.53, 0.058. mu.s/ cm2, 2.87, 0.068. mu.s/ cm. Both were higher than those of the parameter base, and the difference was not statistically significant compared with that of the two groups (P0.05). After treatment, the average values of the electrical parameters of the relaxing treatment group and the conventional treatment group were: 2. 15% 0. 50. mu.s/ cm2, 2.72, 0. 71. mu.s/ cm2, and the relaxation treatment group had a significant decrease in the level of electrical parameters after treatment compared with the conventional treatment group (P0.05). Conclusion: The clinical efficacy, quality of life and emotional state of patients with psoriasis vulgaris treated by biofeedback chemotherapy were studied in this study. The results showed that biofeedback release therapy had a different effect on the clinical efficacy, quality of life and emotional state of patients with psoriasis vulgaris. 1. Biofeedback release therapy can effectively improve patients with psoriasis vulgaris Clinical curative effect; biofeedback release therapy can effectively improve the common type The quality of life of patients with psoriasis is 3, biofeedback relaxation therapy can be changed effectively. The emotional state of patients with psoriasis vulgaris; 4. biofeedback release therapy may reduce the level of basal value by reducing the level of muscle and skin electrical parameters of the patient, so as to effectively improve the patient's body tension.
【学位授予单位】：泸州医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.63
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