中藥配合心理干預(yù)方案提高腫瘤患者生活質(zhì)量的初步研究
發(fā)布時間：2018-10-21 07:48
【摘要】： 目的:綜合治療是目前治療惡性腫瘤的主要方法,其中中醫(yī)藥在綜合治療中的地位日顯凸出。雖然中醫(yī)心理干預(yù)治療惡性腫瘤有一定療效,然而缺乏規(guī)范化治療方案及療效標(biāo)準(zhǔn),尚未在臨床中得到廣泛應(yīng)用。本課題旨在客觀評價中藥配合中醫(yī)心理干預(yù)方案在改善腫瘤患者心理狀態(tài)、調(diào)節(jié)免疫功能及提高生活質(zhì)量等方面的臨床療效,并試圖為完善惡性腫瘤綜合治療,并形成初步的規(guī)范化心理治療方案提供臨床依據(jù)。 方法:通過前瞻性隨機對照臨床研究,以心理狀態(tài)評分(Hamilton抑郁自評量表計分)、免疫功能(NK、T細胞亞群)檢測指標(biāo)和生活質(zhì)量計分(EORTC QLQ-C30(version 3)生活質(zhì)量調(diào)查問卷)為重點研究指標(biāo),在北京中醫(yī)藥大學(xué)東直門醫(yī)院和中國醫(yī)學(xué)科學(xué)院腫瘤醫(yī)院觀察了符合納入病例標(biāo)準(zhǔn)的53例惡性腫瘤患者,按不平衡指數(shù)最小的分配原則,隨機分配到治療組及對照組,兩組比例為1:1。對照組:采用常規(guī)治療,包括化療、對癥治療和支持治療等。治療組:在對照組治療基礎(chǔ)上,增加中藥配合中醫(yī)心理干預(yù)療法。全部病例均連續(xù)治療14天為一個治療周期。每組分別觀察治療1個周期。統(tǒng)計分析采用SPSS11.0統(tǒng)計分析軟件進行計算。組間資料兩兩比較采用t檢驗。治療前后比較用配對t檢驗。 結(jié)果:中醫(yī)心理干預(yù)方案對于改善腫瘤患者的心理狀態(tài)、生活質(zhì)量具有明顯作用,在情感關(guān)系、免疫指標(biāo)等方面的改善較對照組均有統(tǒng)計學(xué)意義。①中醫(yī)心理干預(yù)治療組第8天測評,與療前比較,Hamilton評分有所上升,但無統(tǒng)計學(xué)意義(P0.05);第15天測評,Hamilton評分明顯下降,與療前相比有統(tǒng)計學(xué)意義(P0.01)。而常規(guī)治療對照組中,療后兩次測評與治療前比較,Hamilton評分略有上升,無統(tǒng)計學(xué)意義。②中醫(yī)心理干預(yù)治療組第8天測評,8例QOL明顯改善,與對照組(僅1例改善)比較,具有統(tǒng)計學(xué)意義(P0.01);第15天測評,治療組QOL評分明顯上升,生活質(zhì)量明顯提高者達到22例,與常規(guī)治療對照組(QOL改善者僅有2例)相比,有效率分別為75.9%和8.3%,具有統(tǒng)計學(xué)意義(P0.001)。③中醫(yī)心理干預(yù)治療組第15天測評免疫功能,治療組與對照組相比,CD3+、CD4+、CD4+/CD8+均上升,CD8+下降,具有統(tǒng)計學(xué)意義(P0.05),治療組NK細胞療后雖比對照組上升,但無統(tǒng)計學(xué)意義(P0.05);治療組治療前、療后相比,CD3+、CD4+、CD4+/CD8+均上升,CD8+下降,具有統(tǒng)計學(xué)意義(P0.05)。 結(jié)論:以調(diào)暢情志為主的中醫(yī)心理干預(yù)治療可以作為腫瘤綜合治療的一部分,對提高腫瘤患者生活質(zhì)量方面大有裨益,反映出中藥配合心理治療方案在一定程度上調(diào)節(jié)機體免疫功能的一種趨勢。本課題的研究結(jié)果顯示中醫(yī)心理治療可以使腫瘤患者心理狀態(tài)改善,生活質(zhì)量提高,免疫指標(biāo)好轉(zhuǎn),三者之間存在直接相關(guān)性。提示在腫瘤患者綜合治療中,中藥配合心理干預(yù)療法不但有助于控制腫瘤的發(fā)展,還具有一定的社會和經(jīng)濟效應(yīng),該方案值得進一步探索與完善。
[Abstract]:Objective: Comprehensive treatment is the main method for the treatment of malignant tumor, in which the status date of traditional Chinese medicine is prominent. Although traditional Chinese medicine psychological intervention is effective in treating malignant tumor, there is a lack of standardized treatment plan and curative effect standard, which has not been widely used in clinic. The objective of this study is to objectively evaluate the clinical efficacy of traditional Chinese medicine combined with traditional Chinese medicine psychological intervention program in improving the mental state of tumor patients, regulating the immune function and improving the quality of life, and try to improve the comprehensive treatment of malignant tumor. and forms a preliminary standardized psychotherapy scheme to provide a clinical basis. Methods: A prospective randomized controlled clinical study was conducted to evaluate the mental state score (Hamilton depression self-rating scale), immune function (NK, T cell subgroup) and quality of life (EORTC QLQ-C30 (version 3)). In order to study the indexes, 53 patients with malignant tumor were randomly assigned to the treatment group and the control group according to the principle of the minimum balance index in the East-direct-Door Hospital of Beijing University of Traditional Chinese Medicine and the Cancer Hospital of Chinese Academy of Medical Sciences. The proportion of the groups was 1: 1. The control group: routine treatment, including chemotherapy, symptomatic treatment, Therapy and support therapy, etc. Treatment group: on the basis of control group treatment, increase the coordination of traditional Chinese medicine Medical psychological intervention therapy. All cases were continuously treated for 14 days For a treatment cycle, each group views For 1 period of treatment, SPSS 11.0 was used for statistical analysis. The software is calculated. The inter-group data are two t-test was used to compare the treatment before and after treatment. Results: The psychological intervention program of traditional Chinese medicine has obvious effect on improving the mental state and quality of life of patients with tumor. Compared with the control group, the improvement of the surface was statistically significant. Compared with the control group, the Hamilton score increased, but there was no statistical significance (P0.05). There was statistical significance (P0.01). Compared with the conventional treatment group, the two tests were compared with the pre-treatment, and Hamilt On the 8th day of the treatment group, 8 cases of QOL were significantly improved, compared with the control group (1 case only). The score of QOL of the treatment group was significantly higher than that in the control group (P <0.01). The effective rate was 75.9% and 80.3%, respectively. Compared with the control group, CD3 +, CD4 +, CD4 +/ CD8 + both increased and CD8 + decreased in the treatment group compared with the control group. But there was no statistical significance (P0.05). CD3 +, CD4 +, CD4 +/ CD8 + both increased and CD8 + decreased before and after treatment. Conclusion: Traditional Chinese medicine psychological intervention can be used as a part of the comprehensive treatment of tumor, which can improve the quality of life of patients with tumor, and reflect the matching psychology of traditional Chinese medicine. The research result shows that the psychological state of the tumor patients can be improved and the life of the patients can be improved. It is suggested that traditional Chinese medicine combined with psychological intervention therapy not only can help control the development of tumor, but also has one.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2007
【分類號】：R273;R395.5
本文編號：2284432
[Abstract]:Objective: Comprehensive treatment is the main method for the treatment of malignant tumor, in which the status date of traditional Chinese medicine is prominent. Although traditional Chinese medicine psychological intervention is effective in treating malignant tumor, there is a lack of standardized treatment plan and curative effect standard, which has not been widely used in clinic. The objective of this study is to objectively evaluate the clinical efficacy of traditional Chinese medicine combined with traditional Chinese medicine psychological intervention program in improving the mental state of tumor patients, regulating the immune function and improving the quality of life, and try to improve the comprehensive treatment of malignant tumor. and forms a preliminary standardized psychotherapy scheme to provide a clinical basis. Methods: A prospective randomized controlled clinical study was conducted to evaluate the mental state score (Hamilton depression self-rating scale), immune function (NK, T cell subgroup) and quality of life (EORTC QLQ-C30 (version 3)). In order to study the indexes, 53 patients with malignant tumor were randomly assigned to the treatment group and the control group according to the principle of the minimum balance index in the East-direct-Door Hospital of Beijing University of Traditional Chinese Medicine and the Cancer Hospital of Chinese Academy of Medical Sciences. The proportion of the groups was 1: 1. The control group: routine treatment, including chemotherapy, symptomatic treatment, Therapy and support therapy, etc. Treatment group: on the basis of control group treatment, increase the coordination of traditional Chinese medicine Medical psychological intervention therapy. All cases were continuously treated for 14 days For a treatment cycle, each group views For 1 period of treatment, SPSS 11.0 was used for statistical analysis. The software is calculated. The inter-group data are two t-test was used to compare the treatment before and after treatment. Results: The psychological intervention program of traditional Chinese medicine has obvious effect on improving the mental state and quality of life of patients with tumor. Compared with the control group, the improvement of the surface was statistically significant. Compared with the control group, the Hamilton score increased, but there was no statistical significance (P0.05). There was statistical significance (P0.01). Compared with the conventional treatment group, the two tests were compared with the pre-treatment, and Hamilt On the 8th day of the treatment group, 8 cases of QOL were significantly improved, compared with the control group (1 case only). The score of QOL of the treatment group was significantly higher than that in the control group (P <0.01). The effective rate was 75.9% and 80.3%, respectively. Compared with the control group, CD3 +, CD4 +, CD4 +/ CD8 + both increased and CD8 + decreased in the treatment group compared with the control group. But there was no statistical significance (P0.05). CD3 +, CD4 +, CD4 +/ CD8 + both increased and CD8 + decreased before and after treatment. Conclusion: Traditional Chinese medicine psychological intervention can be used as a part of the comprehensive treatment of tumor, which can improve the quality of life of patients with tumor, and reflect the matching psychology of traditional Chinese medicine. The research result shows that the psychological state of the tumor patients can be improved and the life of the patients can be improved. It is suggested that traditional Chinese medicine combined with psychological intervention therapy not only can help control the development of tumor, but also has one.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2007
【分類號】：R273;R395.5
【參考文獻】
相關(guān)期刊論文 前10條
1 胡隨瑜,張宏耕,鄭林,張海男,陳澤奇,陳昌華,趙志付,王新本,劉發(fā)榮,李順民,黃信初,俸建林,張捷;1977例抑郁癥患者中醫(yī)不同證候構(gòu)成比分析[J];中國醫(yī)師雜志;2003年10期
2 陳華江,肖建如,賈連順;不同抑郁程度對脊柱轉(zhuǎn)移癌患者臨床癥狀及生存的影響[J];第二軍醫(yī)大學(xué)學(xué)報;2003年09期
3 王榕平,王瑩;原發(fā)性肝癌病機傳變規(guī)律的初步研究[J];福建中醫(yī)藥;1998年01期
4 南克俊,魏永長,周芙玲,高成閣;心理社會因素與腫瘤細胞免疫研究進展[J];國外醫(yī)學(xué)(社會醫(yī)學(xué)分冊);2002年04期
5 曾瑩,胡超英;癌癥患者心理障礙分析與護理干預(yù)[J];護理學(xué)雜志;2000年10期
6 張美娟;癌癥患者心理障礙的臨床表現(xiàn)及心理干預(yù)[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2004年20期
7 范春香;負性心理因素與晚期癌癥患者預(yù)后的關(guān)系[J];中國臨床康復(fù);2003年27期
8 郭慶秋,顏軍,孫開宏;運動訓(xùn)練對心理應(yīng)激機體腫瘤壞死因子α的影響[J];中國臨床康復(fù);2005年08期
9 秦鳳華,謝蜀生,龍振洲;雷公藤總甙免疫抑制作用的機制[J];中國藥理學(xué)通報;1991年06期
10 周愛武，葛志東，梁君山，，王斌，鄭富林，李常玉，陳敏珠;香菇多糖的免疫調(diào)節(jié)作用[J];中國藥理學(xué)通報;1995年02期
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