目的:探讨氟西汀联合心理干预治疗心血管疾病患者伴焦虑抑郁症状的临床疗效。方法:选择伴有抑郁、焦虑情绪障碍的85例冠心病患者(心功能Ⅱ、Ⅲ级),并将其随机分成研究组和对照组。观察6w,对照组患者仅给予常规的治疗,研究组患者在常规治疗基础上给予氟西汀联合心理干预治疗。观察治疗前后两组患者采用汉密顿焦虑量表( Hamilton Anxiety Scale,HAMA) 评定焦虑症状,汉密顿抑郁量表( Hamilton Depression Scale,HAMD) 评定抑郁症状;并对治疗后心功能分级(NYHA)恢复到Ⅰ级的例数及左室射血分数进行分析评价。结果:治疗6 周 后,研究组均较对照组的汉密顿焦虑量表及汉密顿抑郁量表评分下降显著( P lt;0.01),研究组抗焦虑显效率为87.16%、抗抑郁显效率为82.26%,对照组分别为43.75%、45.36%,研究组均显著高于对照组( P lt;0.01);研究组患者的左室射血分数显著高于对照组 ( P lt;0.05),心功能分级(NYHA)恢复到Ⅰ级的例数显著高于对照组 ( P lt;0.05)。结论:氟西汀联合心理干预治疗不仅能改善心血管疾病伴焦虑抑郁患者的焦虑、抑郁情绪障碍,还能改善患者的心功能,疗效显著优于单用心血管药物治疗。
Objective To assess the effectiveness of psychological intervention on post-stoke depression. Methods Such databases as the JBI Database of Systematic Review (1980 to June, 2010), The Cochrane Library (1980 to June, 2010), PubMed (1966 to 2010), CINAHL(1982 to May, 2000), CBM (1978 to 2010), and CNKI (1979 to 2010) were searched to collect randomized controlled trials (RCTs). In accordance with the predefined inclusion and exclusion criteria, the quality of included studies was evaluated, and then meta-analyses were performed by using RevMan 5.0 software. Results A total of 33 RCTs were included. The results of meta-analyses showed: (1) Compared with the control group, the short-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analysis showed that the intervention effects at the time of four weeks, six weeks, eight weeks, and 12 weeks were better than those of the control group. (2) The long-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analyses showed that the intervention effects at the interval of eight weeks, 24 weeks, and 48 weeks were better than those of the control group. (3) The combined or single application of either cognitive-behavioral psychotherapy or supportive psychotherapy was more effective in decreasing depression score than the control group. However, there was no significant difference between the general psychological treatment group and the control group. (4) The subgroup analyses showed that the different qualities of the included studies were more effective than those of the control group. Conclusion Various psychological intervention is effective in decreasing the patient’s depression score, and cognitive-behavioral therapy and supportive psychotherapy, especially, can significantly improve the depression state and promote recovery.
肿瘤患者常常具有不适应情绪和行为反应,如焦虑、抑郁、悲伤、愤怒、恐惧等。针对这类患者的特征,我们对肿瘤科查房模式进行探讨,旨在缓解患者的不良情绪,提高肿瘤患者的治疗疗效,降低医疗风险。
ObjectiveTo explore the effects of mental intervention on elderly patients with chronic atrophic gastritis. MethodsFifty elderly patients with chronic atrophic gastritis treated from May 2011 to June 2012 were divided into two groups randomly. The control group (n=25) received conventional therapy, and individual mental intervention was applied only to patients in the treatment group (n=25). Difference of clinical effects between the two groups was observed. Change of SCL-90 symptoms index before and after the treatment in each group was analyzed too. ResultsThe treatment group showed better effects than the control group (total efficiency:80%, 48%; P<0.05), and SCL-90 symptoms index in the treatment group decreased significantly after treatment. ConclusionReasonable mental intervention helps to rehabilitate elderly patients with chronic atrophic gastritis and improve their life quality.
ObjectiveTo study the influence of psychological intervention on the immune function and psychological state in patients undergoing chemotherapy after radical operation of colorectal cancer. MethodSixty-four patients who underwent chemotherapy after eradicative resection of rectal cancer between August 2008 and August 2013 were randomly divided into control group and intervention group. Both the two groups of patients accepted conventional chemotherapy and nursing, while patients in the intervention group were also given psychological intervention. At the beginning of and 8 weeks after the therapy, self-evaluation of anxiety scale and depression self-rating scale were used to determine the psychological state (anxiety and depression) of patients in the two groups, and we evaluated the effect of psychological intervention. At the same time, the immune index and inflammatory cytokines were determined and compared between the two groups. ResultsBefore treatment, patients in both the two groups were accompanied by mild anxiety and depression. After psychological intervention, compared with the control group, anxiety and depression of patients in the intervention group were significantly alleviated (P<0.05). Before chemotherapy, patients in the two groups were not statistically different in the immune factor index (P>0.05). After chemotherapy, compared with the control group, natural killer cells, CD3+, CD4+, CD4+/CD8+, C-reactive protein, immunoglobulin (Ig) G, interleukin (IL)-10 level of the intervention group significantly increased (P<0.05), and IL-6 and tumor necrosis factor alpha expression decreased (P<0.05). CD8+, IgA and IgM were not significantly changed (P>0.05). ConclusionsPsychological intervention can alleviate anxiety and depression and improve the immune function in patients who undergo chemotherapy after radical operation of colorectal cancer, which is an effective auxiliary treatment.
In the hospital where centralized treatment was applied for the victims after Yiliang earthquake (on 7th September, 2012), a holistic rehabilitation service mode which centred on supportive psychological intervention promoting was developed by the Yiliang psychological crisis intervention team designated by the National Health and Family Planning Commision of the People’s Republic of China. The pattern takes psychological nurses as liaison, bases on the integrity and continuity of medical service, roots in comprehensive health assessment and key assessment of mental trauma stress, emphasizes on solving realistic problems for patients and their caregivers, provides supportive psychological intervention, and encourages psychological nurses to offer psychological support for earthquake victims with the help of quantitative self-assessment of social psychological support service. In practice, the mode of psychological services, which could be contiuously conducted, is welcomed by hospital managers, work staff, and earthquake victims and their caregivers.