基于辨证施乐调理乳腺癌术后肝郁患者的心身康复研究

发布时间：2018-03-26 20:46

本文选题：乳腺癌　切入点：音乐治疗　出处：《广州中医药大学》2017年硕士论文

【摘要】：目的:乳腺癌是女性最常见的恶性肿瘤之一,手术治疗是乳腺癌患者的最主要治疗手段。然而,手术不仅使女性的躯体形象损毁,同时术后心身失衡状态常常困扰患者,使之产生不同程度的生理和心理痛苦。本研究旨在中医辨证论治的理论指导下运用中医音乐治疗改善乳腺癌术后患者肝郁状态,观察辨证施乐对乳腺癌术后肝郁的临床疗效,初步探讨中医辨证施乐对乳腺癌术后肝郁的影响及优势,并揭示其在临床上运用的意义。方法:本研究采用前瞻性随机对照试验将64例符合纳入标准的术后乳腺癌肝郁患者按1:1的比例随机分为治疗组和对照组,即辨证施乐组和健康教育组,每组32例。治疗组每天接受个体音乐疗法至少30分钟,每3周接受一次集体音乐疗法。对照组每3周进行健康教育宣讲。共观察3个月。分别评价治疗前后乳腺癌患者的自我评定抑郁量表(SDS)评分,自我评定焦虑量表(SAS)评分和乳腺癌患者生命质量测定表(FACT-B中文版4.0)评分。以SPSS17.0软件处理数据,分析实验结果,得出结论。结果:一、基线比较:辨证施乐组和健康教育组患者的一般资料及治疗前SDS、SAS、FACT-B三个量表评分与健康宣讲组无显著性差异。(乃0.05)二、同组治疗前后疗效对比:经治疗,两组患者的抑郁、焦虑自评量表评分以及生命质量测定评分均有改善,与治疗前比较差异均有统计学意义。(P0.05)三、组间治疗后疗效比较:辨证施乐组的SDS评分明显降低,与对照组相比差异具有统计学意义(P0.05)。辨证施乐组的SAS评分及乳腺癌生命质量测定量表(FACT-B)评分明显升高,但对比对照组无统计学意义。(P0.05)四、分层比较:在FACT-B各项成分评定方面,两组治疗前后对比差异存在统计学意义。FACT-B各项数据表明治疗组与对照组治疗后,各项评分均升高,在生理状况、情感状况、功能状况、附加关注这四项中具有明显的统计学意义(P0.05),而在社会/家庭状况无显著统计学差异(P0.05)。说明辨证音乐治疗和健康教育在改善患者的生理状况、情感状况、功能状况及附加关注均有明显疗效,且辨证音乐治疗效果更佳。五、整个研究过程中两组没有不良反应出现。结论:一、中医辨证论治的理论指导下的个体和团体音乐治疗相结合的方式,能够有效地缓解手术后的乳腺恶性肿瘤患者的抑郁、焦虑情绪,并有效提高其生命质量。二、中医辨证音乐治疗对乳腺癌术后肝郁状态的患者具有良好的调整作用,效果优于健康教育宣讲,值得推广。三、中医辨证音乐治疗能有效提高乳腺癌术后患者的生命质量,尤其是在生理状况、功能状况、心理状况及乳腺癌附加关注这四个方面。
[Abstract]:Objective: breast cancer is one of the most common malignant tumors in women. Surgical treatment is the main treatment for breast cancer patients. The purpose of this study was to improve the state of liver depression in patients with breast cancer by using music therapy under the guidance of the theory of syndrome differentiation and treatment, and to observe the clinical effect of syndrome differentiation Xerox on liver depression after breast cancer operation. To explore the effect and advantage of Xerox on liver depression after operation of breast cancer. Methods: in this study, 64 patients with postoperative breast cancer liver depression were randomly divided into treatment group and control group according to 1:1 ratio by prospective randomized controlled trial. That is, the syndrome differentiation Xerox group and the health education group, 32 cases in each group. The treatment group received individual music therapy for at least 30 minutes per day. Group music therapy was given every 3 weeks. The control group was given health education every 3 weeks and observed for 3 months. The self-rated depression scale (SDS) scores of breast cancer patients were evaluated before and after treatment. Self-rating anxiety scale (SAS) score and quality of life (FACT-B) score of breast cancer patients. The data were processed with SPSS17.0 software, and the results were analyzed, and the results were as follows: 1. Baseline comparison: the general data of patients in Xerox syndrome differentiation group and health education group and the scores of SDSSASFACT-B before treatment were not significantly different from those in health education group (0.05). The curative effect of the same group was compared before and after treatment: after treatment, depression was found in the two groups. The scores of self-rating anxiety scale and quality of life test were improved, and the difference was statistically significant compared with that before treatment (P 0.05). Compared with the treatment group, the SDS score of the syndrome differentiation Xerox group was significantly lower than that of the control group. Compared with the control group, the difference was statistically significant (P 0.05). The SAS score and the FACT-B score of the syndrome differentiation Xerox group were significantly higher than those of the control group, but there was no significant difference between the control group and the control group (P 0.05). There were significant differences between the two groups before and after treatment. The data of FACT-B showed that the scores of the treatment group and the control group were increased after treatment. Additional attention to these four items has significant statistical significance (P 0.05), but there is no significant difference in social / family status (P 0.05). It shows that music therapy based on syndrome differentiation and health education can improve the physiological and emotional status of patients. Functional status and additional attention have obvious curative effect, and the effect of music treatment based on syndrome differentiation is better. Fifthly, there were no adverse reactions in the two groups during the whole study. Conclusion: 1. The combination of individual and group music therapy under the guidance of the theory of TCM differentiation of symptoms and signs can effectively relieve the depression and anxiety of patients with breast cancer after surgery, and effectively improve their quality of life. Music therapy based on TCM syndrome differentiation has a good adjusting effect on patients with liver depression after operation of breast cancer, and the effect is better than that of health education, which is worth popularizing. Thirdly, music therapy based on syndrome differentiation of TCM can effectively improve the quality of life of patients with breast cancer after operation. Especially in the physical condition, the function condition, the psychological condition and the breast cancer additional attention these four aspects.
【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】：2017
【分类号】：R248.9

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