斑秃患者的心理健康状况评估及干预治疗
发布时间：2018-11-16 07:47
【摘要】： 斑秃被认为是一种身心疾病,其发病与遗传因素、自身免疫功能紊乱、精神因素等相互作用有关。斑秃全球均可发病,可以在任何年龄发病,无性别、种族差异。现在,越来越多的学者关注心理因素对斑秃发病的影响,并运用各种心理评估量表对斑秃患者的心理因素及治疗疗效进行评估。但是在心理健康状况方面,哪项心理因子与斑秃发病的相关性最高,还不得而知。目前,斑秃的治疗多种多样。但是,在国内针对斑秃患者的心理治疗几乎空白,这已经满足不了斑秃患者的需求。 本研究采用问卷调查对185例成人斑秃病患者及健康人对照组(采取1：1对照)进行流行病学调查及SCL-90评估,同时将斑秃组SCL-90评估阳性的患者,按随机化的原则进行分组,斑秃对照组进行常规中西医结合治疗,斑秃治疗组加用多虑平对斑秃患者的心理障碍进行干预治疗,并于治疗后对治疗组和对照组进行SCL-90评估,应用Microsoft Office Excel 2003, SPSS11.0软件进行统计学处理分析,以了解斑秃的一般特征、观察哪一项心理因子与斑秃发病的相关性最高,判断加用多虑平对斑秃患者的心理障碍治疗的疗效。 本研究结果显示：①研究期间纳入观察的斑秃患者为185例,占同期皮肤科门诊量的0.01%,男女发病比例为1.3：1,发病年龄从10岁到66岁,男性患者平均发病年龄为34.45±11.95岁,女性患者平均发病年龄为34.05±11.97岁,各年龄段男、女发病年龄比较无显著性差异(t=0.156,p0.05)。斑秃发病大部分集中在21-50岁之间,病程从1周到11年不等,有阳性家族史的占11.35%。②斑秃组患者有心理诱因的有137例,占74.05%,除了因工作、学习、生活(家事)引起的以外,突发应激事件、长时间上网玩游戏、长期熬夜打牌等应引起重视。③斑秃组和健康对照组SCL-90评估的总分和阳性项目数的差异有统计学意义(t=3.43和5.08,p0.05),说明心理因素对斑秃的发病有影响。④斑秃组的躯体化(t=2.43,p0.05)、强迫症状(t=5.17,p0.05)、人际关系敏感(t=4.64,p0.05)、抑郁(t=3.17,p0.05)、焦虑(t=2.97,p0.05)、敌对(t=3.25,p0.05)和偏执(t=2.31,p0.05)7项因子与健康对照组相比有显著性统计学差异,说明躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对和偏执7项因子对斑秃的发病有影响；而恐怖(t=0.00025,p0.05)、精神病性(t=1.72,p0.05)及其他(t=1.03,p0.05)3项因子则无显著性统计学差异(p0.05),说明恐怖、精神病性及其他3项因子对斑秃的发病无影响。⑤在这7项因子中,它们出现的频率从高到低依次为强迫症状因子、敌对因子、抑郁因子、人际关系敏感因子、焦虑因子、偏执因子、躯体化因子。说明强迫症状因子与斑秃发病的相关性最高,然后依次为敌对因子、抑郁因子、人际关系敏感因子、焦虑因子、偏执因子和躯体化因子。⑥40例斑秃对照组患者在治疗前后SCL-90评估结果比较均无显著性统计学差异(p0.05),其结果表明常规中西医结合治疗对斑秃患者的心理障碍无治疗作用。39例斑秃治疗组患者在治疗前后总分和阳性项目数有显著性统计学差异(t=8.44和4.62,p0.05),其结果表明加用多虑平治疗对斑秃患者的心理障碍治疗有效,能明显改善斑秃患者的心理状态。39例斑秃治疗组患者在治疗前后,对斑秃发病有影响的7项因子中,强迫症状(t=5.06,p0.05)、人际关系敏感(t=9.17,p0.05)、抑郁(t=3.14,p0.05)、焦虑(t=8.36,p0.05)、敌对(t=9.34,p0.05)这5项因子有显著性统计学差异,说明加用多虑平治疗可以改善斑秃患者的强迫症状、人际关系敏感、抑郁、焦虑、敌对这5项心理因子；而躯体化(t=0.0003,p0.05)和偏执(t=0.0042,p0.05)这2项因子无显著性统计学差异,说明在本研究中加用多虑平治疗对躯体化和偏执因子无治疗作用。
[Abstract]:Alopecia is considered to be a kind of physical and mental illness, its incidence is related to the genetic factors, the self-immune function disorder, the mental factor and so on. The alopecia areata in the whole world can be developed, and can be developed at any age, without sex and ethnic difference. Now, more and more scholars pay attention to the influence of psychological factors on the incidence of alopecia areata, and evaluate the psychological factors and curative effect of the patients with alopecia areata with various psychological evaluation scales. However, in terms of mental health, which psychological factor is the highest in the incidence of alopecia areunknown. At present, the treatment of alopecia areata is various. However, the treatment of alopecia arealmost blank in the country, which has not been able to meet the needs of the patients with alopecia areata. In this study, the epidemiological investigation and the SCL-90 evaluation of 185 adult patients with alopecia areata and the control group (1: 1 control) were carried out in the control group (1: 1 control). In the treatment group and control group, the psychological disorder of the patients with alopecia areata was treated with conventional traditional Chinese and western medicine, and the SCL-90 evaluation was performed on the treatment group and the control group after the treatment, and the statistics of the software of Microsoft Office Excel 2003 and SPSS11.0 were applied. To study the general characteristics of alopecia areata, the correlation between the mental factors and the incidence of alopecia arethe highest. The results of this study showed that 185 patients with alopecia areata were included in the study, accounting for 0.01% of the outpatients in the same period. The incidence of the male and female patients was 1. 3: 1. The age of the disease was from 10 to 66 years. The average age of the male patients was 34. 45. The average age of the female patients was 34. 05 to 11. 97, and there was no significant difference in the age of male and female in all ages (t = 0.156). The incidence of alopecia aremost concentrated between 21 and 50 years, the course of course was from 1 to 11 years, and there was a positive family history. accounting for 11.35%. There were 137 cases of psychological inducement in the alopecia areata group, accounting for 74.05%. In addition to the cause of work, study and life (family), the sudden stress event, long-time online game play, and long-term stay up The difference of the total score and the number of positive items assessed by the SCL-90 in the bald and healthy controls was statistically significant (t = 3.43 and 5.08, p0.05), indicating the psychological factors to the spot. The somatization of alopecia areata (t = 2.43, p0.05), forced symptom (t = 5.17, p0.05), interpersonal sensitivity (t = 4.64, p0.05), depression (t = 3.17, p0.05), anxiety (t = 2.97, p0.05), hostility (t = 3.25, p0.05) and paranoia (t = 2.31, p0.05) There was no significant difference in the relationship between somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility and paranoia on the incidence of alopecia areata (t = 0.00025, p0.05), psychotic (t = 1.72, p0.05) and others (t = 1.03, p0.05). (p0.05), describing the effects of terror, psychosis, and other three factors on the spot There is no effect on the incidence of alopecia areata. In these seven factors, the frequency of their occurrence is from high to low in order of the forced symptom factor, the hostility factor, the depression factor, the interpersonal sensitivity factor, the anxiety factor, the paranoia. The correlation of obsessive-compulsive symptoms and alopecia arethe highest, and then the factors of hostility, depression, interpersonal sensitivity, anxiety and paranoia. Sub-and somatization factors. There was no significant difference in the results of SCL-90 evaluation before and after treatment in 40 patients with alopecia areata. (p0.05), the results indicated that the traditional Chinese and Western medicine combined treatment had no treatment effect on the psychological barrier of the patients with alopecia areata. (p0.05), the results indicated that the treatment of the psychological disorder of the patients with alopecia areata was effective in the treatment of alopecia areata with the treatment of the treatment of the alopecia areata, and the psychological status of the patients with alopecia areobviously improved. In the treatment group, the symptoms (t = 5.06, p0.05) and the sensitivity of the interpersonal relationship were found in the 7 factors that affected the incidence of alopecia areata before and after the treatment. (t = 9.17, p0.05), depression (t = 3.14, p0.05), anxiety (t = 8.36, p0.05), and hostility (t = 9.34, p0.05). There was no significant difference in the two factors of somatization (t = 0.0003, p0.05) and paranoia (t = 0. 0042, p0.05).
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.71
本文编号：2334904
[Abstract]:Alopecia is considered to be a kind of physical and mental illness, its incidence is related to the genetic factors, the self-immune function disorder, the mental factor and so on. The alopecia areata in the whole world can be developed, and can be developed at any age, without sex and ethnic difference. Now, more and more scholars pay attention to the influence of psychological factors on the incidence of alopecia areata, and evaluate the psychological factors and curative effect of the patients with alopecia areata with various psychological evaluation scales. However, in terms of mental health, which psychological factor is the highest in the incidence of alopecia areunknown. At present, the treatment of alopecia areata is various. However, the treatment of alopecia arealmost blank in the country, which has not been able to meet the needs of the patients with alopecia areata. In this study, the epidemiological investigation and the SCL-90 evaluation of 185 adult patients with alopecia areata and the control group (1: 1 control) were carried out in the control group (1: 1 control). In the treatment group and control group, the psychological disorder of the patients with alopecia areata was treated with conventional traditional Chinese and western medicine, and the SCL-90 evaluation was performed on the treatment group and the control group after the treatment, and the statistics of the software of Microsoft Office Excel 2003 and SPSS11.0 were applied. To study the general characteristics of alopecia areata, the correlation between the mental factors and the incidence of alopecia arethe highest. The results of this study showed that 185 patients with alopecia areata were included in the study, accounting for 0.01% of the outpatients in the same period. The incidence of the male and female patients was 1. 3: 1. The age of the disease was from 10 to 66 years. The average age of the male patients was 34. 45. The average age of the female patients was 34. 05 to 11. 97, and there was no significant difference in the age of male and female in all ages (t = 0.156). The incidence of alopecia aremost concentrated between 21 and 50 years, the course of course was from 1 to 11 years, and there was a positive family history. accounting for 11.35%. There were 137 cases of psychological inducement in the alopecia areata group, accounting for 74.05%. In addition to the cause of work, study and life (family), the sudden stress event, long-time online game play, and long-term stay up The difference of the total score and the number of positive items assessed by the SCL-90 in the bald and healthy controls was statistically significant (t = 3.43 and 5.08, p0.05), indicating the psychological factors to the spot. The somatization of alopecia areata (t = 2.43, p0.05), forced symptom (t = 5.17, p0.05), interpersonal sensitivity (t = 4.64, p0.05), depression (t = 3.17, p0.05), anxiety (t = 2.97, p0.05), hostility (t = 3.25, p0.05) and paranoia (t = 2.31, p0.05) There was no significant difference in the relationship between somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility and paranoia on the incidence of alopecia areata (t = 0.00025, p0.05), psychotic (t = 1.72, p0.05) and others (t = 1.03, p0.05). (p0.05), describing the effects of terror, psychosis, and other three factors on the spot There is no effect on the incidence of alopecia areata. In these seven factors, the frequency of their occurrence is from high to low in order of the forced symptom factor, the hostility factor, the depression factor, the interpersonal sensitivity factor, the anxiety factor, the paranoia. The correlation of obsessive-compulsive symptoms and alopecia arethe highest, and then the factors of hostility, depression, interpersonal sensitivity, anxiety and paranoia. Sub-and somatization factors. There was no significant difference in the results of SCL-90 evaluation before and after treatment in 40 patients with alopecia areata. (p0.05), the results indicated that the traditional Chinese and Western medicine combined treatment had no treatment effect on the psychological barrier of the patients with alopecia areata. (p0.05), the results indicated that the treatment of the psychological disorder of the patients with alopecia areata was effective in the treatment of alopecia areata with the treatment of the treatment of the alopecia areata, and the psychological status of the patients with alopecia areobviously improved. In the treatment group, the symptoms (t = 5.06, p0.05) and the sensitivity of the interpersonal relationship were found in the 7 factors that affected the incidence of alopecia areata before and after the treatment. (t = 9.17, p0.05), depression (t = 3.14, p0.05), anxiety (t = 8.36, p0.05), and hostility (t = 9.34, p0.05). There was no significant difference in the two factors of somatization (t = 0.0003, p0.05) and paranoia (t = 0. 0042, p0.05).
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.71
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