慢性乙型病毒性肝炎患者的心理状态与生存质量评价

发布时间：2018-03-07 20:17

本文选题：慢性乙型病毒性肝炎　切入点：生存质量　出处：《广州中医药大学》2009年硕士论文　论文类型：学位论文

【摘要】： 背景:随着社会的发展和现代医学模式的日趋完善,社会和心理因素与各类疾病的关系逐渐引起人们的重视。生存质量是人们顺应医学模式向生物、心理、社会医学模式转变而产生的一种新的健康指标,测定疾病患者的生活质量有助于全面评价其生命活动及医疗效果。慢性乙型病毒性肝炎是我国发病率较高的一种疾病,目前尚无特效疗法治愈,随着人们对慢性乙型病毒性肝炎这个群体的关注,如何提高慢性乙型病毒性肝炎患者的生存质量正越来越受到我国医务工作者及全社会的重视。目的:通过对慢性乙型病毒性肝炎患者未经治疗时及经过中医药干预后的两种心理状态的调查,探讨慢性乙型病毒性肝炎患者的心理特征及中医药干预对其心理状态的影响,进一步评价中医药干预对慢性乙型病毒性肝炎患者心理状态与生存质量的影响,为建立中医药干预慢性乙型病毒性肝炎患者心理状态的模型及安全有效的中医药干预慢性乙型病毒性肝炎患者生存质量的方案提供参考依据。方法:采用横断面研究,选择20008年2月至20009年4月期间广东省中医院肝病科200例慢性乙型病毒性肝炎患者及健康人80例,分别以一般健康状况问卷、健康状况问卷(SF-36量表)、自评抑郁量表和自评焦虑量表进行问卷调查,资料采用t检验、卡方检验。结果:中药干预前慢性乙型病毒性肝炎患者的生存质量和心理状态与健康对照组相比,SF-36量表的全部领域得分均明显低于正常人,自评抑郁量表和自评焦虑量表得分均明显高于健康对照组,以上两组差异均有统计学意义;中药干预后慢性乙型病毒性肝炎患者的生存质量和心理状态与健康对照组相比,SF-36量表里,在生理机能、身体疼痛、情感职能的平均分高于健康对照组,而在精神健康和SF总分两个方面二者基本相等,评抑郁量表平均分及自评焦虑量表平均分接近于正常人,经t检验,自评焦虑量表、自评抑郁量表差异均有统计学意义。以上两组经t检验差异均有统计学意义(P0.05), 结论:慢性乙型病毒性肝炎患者普遍存在着抑郁、焦虑等心理问题,生存质量较低。本研究结果提示中药在整体观和辨证论治的基础上,能够从不同方面提高慢性乙型病毒性肝炎患者的心理状态和生存质量,且中药具有副作用少,价格低廉,值得临床推广。生存质量可以作为临床疗效评价的参考依据,指导慢性乙型病毒性肝炎治疗方案的决策。
[Abstract]:Background: with the development of society and the improvement of modern medical model, people pay more attention to the relationship between social and psychological factors and various diseases. A new kind of health index produced by the transformation of social medical model, the quality of life of patients with diseases is helpful to evaluate their life activities and medical effects. Chronic viral hepatitis B is a disease with high incidence in China. At present, there is no special therapy to cure. With the attention of people to the group of chronic viral hepatitis B, how to improve the quality of life of patients with chronic viral hepatitis B is being paid more and more attention by medical workers and the whole society in our country. Objective: to investigate the psychological characteristics of patients with chronic viral hepatitis B (CHB) and the influence of TCM intervention on their mental state by investigating the two psychological states of patients with chronic viral hepatitis B (CHB) when they were not treated and after the intervention of traditional Chinese medicine (TCM). To further evaluate the influence of Chinese medicine intervention on the psychological state and quality of life of patients with chronic viral hepatitis B. To establish the model of Chinese medicine intervention chronic viral hepatitis B patients psychological state and the safe and effective Chinese medicine intervention chronic virus hepatitis patients quality of life plan to provide the reference basis. Methods: a cross-sectional study was conducted on 200 patients with chronic viral hepatitis B and 80 healthy persons from February to April in Guangdong Provincial Hospital of traditional Chinese Medicine. The health status questionnaire included SF-36, self-rating depression and self-rating anxiety. T test and chi-square test were used. Results: the scores of quality of life and psychological state of patients with chronic viral hepatitis B before the intervention of traditional Chinese medicine were significantly lower than those of healthy controls. The scores of self-rating depression scale and self-rating anxiety scale were significantly higher than those of healthy control group. Compared with the healthy control group, the average scores of physiological function, physical pain and emotional function of the patients with chronic viral hepatitis B were higher than those of the healthy control group in the SF-36 scale. The average scores of depression rating scale and self-rating anxiety scale were similar to those of normal people, and the average score of self-rating anxiety scale was similar to that of normal person. The difference of self-rating depression scale was statistically significant, and the difference between the above two groups by t test was statistically significant (P 0.05). Conclusion: depression, anxiety and other psychological problems are common in patients with chronic viral hepatitis B, and the quality of life is low. The results of this study suggest that Chinese traditional medicine is based on holistic view and treatment based on differentiation of symptoms and signs. It can improve the psychological state and quality of life of the patients with chronic hepatitis B from different aspects, and the traditional Chinese medicine has few side effects and low price, so it is worth popularizing in clinic. The quality of life can be used as a reference for the evaluation of clinical curative effect. To guide the treatment of chronic hepatitis B decision-making.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R395;R259

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