“思胜恐”疗法改善围手术期乳腺癌患者心理应激的临床研究

发布时间：2018-04-14 23:09

本文选题：思胜恐 + 围手术期　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:探析思胜恐疗法对围手术期乳腺癌患者心理应激的影响,从而进一步探索完善围手术期乳腺癌患者心理治疗的方法,以促进其术后恢复,改善预后。方法:选择30例符合纳入标准的需行乳腺癌改良根治术治疗的患者,按随机原则分成2组:对照组15例,只实施常规治疗;实验组15例,在常规治疗的同时加以思胜恐疗法,对两组患者进行临床观察。分别在治疗前后通过观察症状学指标:症状自评量表(SCL-90)、应激症状临床评分的改善情况,以及治疗前、术后第1天、第4天、第7天进行比较,观察血液学指标:血清皮质醇(Cor)、一氧化氮(NO)、超氧化物歧化酶(SOD)的变化,来评估临床疗效。结果:1.实验组在治疗后与对照组相比,总体心理状况(总分)均明显改善,在其他各项得分方面(总均分、阳性项目数、躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神及其他因子得分)均显著降低,有统计学意义(P0.05)。2.实验组与对照组心理应激症状临床评分在治疗后总分及各项目得分(饮食、睡眠,皮肤,肌肉关节,注意力,生活、精神质量)比较,两组有统计学意义(P0.05)。3.实验组与对照组相比,手术后第1、4天NO、SOD无统计学意义(P0.05),而在术后第7天二者均有显著性差异(P0.05)。实验组和对照组在手术后第1天的Cor比较无明显统计学差异,而在手术后4、7天Cor的比较均有差异性(P0.05)。结论:1.思胜恐疗法对于围手术期乳腺癌患者不良情绪有着改善作用,但术后短时间内与手术、麻醉等刺激相比,可能影响程度仍不及此类因素。需要改进治疗的实施方法,有待更进一步的探究。2.围手术期乳腺癌患者常规治疗期间加以思胜恐疗法,能够进一步的加强心理治疗效果,具有一定的临床价值。同时思胜恐疗法通过改善患者的心理应激水平后,能提高患者的免疫力,为围手术期乳腺癌患者心理干预方法提供了新的实践方向。
[Abstract]:Objective: to explore the effect of Sisheng terrorism therapy on psychological stress in patients with perioperative breast cancer, so as to improve the psychological treatment of perioperative breast cancer patients, so as to promote the postoperative recovery and improve the prognosis of patients with breast cancer.Methods: thirty patients who met the inclusion criteria were divided into two groups: control group (n = 15), control group (n = 15), control group (n = 15), and experimental group (n = 15).Two groups of patients were observed.The symptom indexes were observed before and after treatment: symptom Checklist-90 (SCL-90), the improvement of clinical score of stress symptoms, and the comparison before and after treatment on the 1st, 4th and 7th day after treatment.The changes of serum cortisol Corn, nitric oxide (no) and superoxide dismutase (SOD) were observed to evaluate the clinical efficacy.The result is 1: 1.Compared with the control group, the total psychological status (total score) of the experimental group was significantly improved, and the other scores (total mean score, positive items, somatization, obsessive symptoms, interpersonal relationships, depression, anxiety, hostility, terror) were significantly improved after treatment.The scores of paranoid ideation, mental and other factors were significantly lower than that of P0. 05 and 2. 2.The clinical scores of psychological stress symptoms in the experimental group and the control group were significantly higher than those in the control group (P 0.05) and the scores of each item (diet, sleep, skin, muscle and joint, attention, life, mental quality) were significantly higher than those in the control group (P < 0.05).Compared with the control group, there was no significant difference between the experimental group and the control group on the 4th day after operation (P 0.05), but there was a significant difference between the two groups on the 7th day after operation (P 0.05).There was no significant difference in Cor between the experimental group and the control group on the first day after operation, but there was significant difference in the comparison of Cor between the experimental group and the control group on the 7th day after operation (P 0.05).Conclusion 1.Sisheng terrorism therapy can improve the bad mood of breast cancer patients in perioperative period, but the influence degree of these factors is still lower than that of surgery, anesthesia and other stimuli in a short period of time after operation.Need to improve the treatment of the implementation of the method, to be further explored. 2.During the routine treatment of breast cancer patients in perioperative period, it can further strengthen the effect of psychotherapy and has certain clinical value.At the same time, Shisheng terrorism therapy can improve the immunity of patients with breast cancer by improving the level of psychological stress, which provides a new practical direction for the psychological intervention of patients with breast cancer during perioperative period.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9

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