生物反饋放松療法治療尋常型銀屑病臨床研究
發(fā)布時間：2018-11-03 13:11
【摘要】： 目的：銀屑病是一種常見的免疫性、炎癥性慢性皮膚病。目前銀屑病的病因和發(fā)病機(jī)制尚未得出定論,研究表明心理因素在銀屑病的誘發(fā)、加重、緩解、治愈中起著重要的作用,并有其一定的物質(zhì)基礎(chǔ),是典型的心身疾病。焦慮、緊張、抑郁等負(fù)性情緒使銀屑病患者長期處于一系列生理和心理反應(yīng)的應(yīng)激狀態(tài)。本研究擬通過探討生物反饋放松療法對尋常型銀屑病患者臨床療效、生活質(zhì)量、情緒狀態(tài)的影響,為銀屑病的發(fā)生發(fā)展與社會心理因素的關(guān)系尋找理論依據(jù),并為銀屑病的臨床心理治療提供科學(xué)依據(jù)。方法：(1)病例分組及治療方法：采用隨機(jī)病例對照研究方法將納入的60例尋常型銀屑病患者隨機(jī)分為常規(guī)治療組(共30人,其中5人脫失,實際為25人)和生物反饋放松治療組(共30人,其中3人脫失,實際為27人)。常規(guī)治療組給予口服復(fù)方氨肽素片、外用冰霜治療,生物反饋放松治療組除進(jìn)行藥物治療(與常規(guī)治療組相同)外,另加入生物反饋放松訓(xùn)練治療,每周1次,共治療8周。(2)肌電、皮電參數(shù)基礎(chǔ)值測定：測量20例一般健康人員的平靜狀態(tài)下10分鐘內(nèi)肌電、皮電平均值作為參數(shù)基礎(chǔ)值。(3)臨床療效評價采用PASI評分法。(4)生活質(zhì)量評價采用生活質(zhì)量指數(shù)量表(DLQI)。(5)情緒狀態(tài)評價采用焦慮自評量表(SAS)及抑郁自評量表(SDS)。(6)統(tǒng)計方法：應(yīng)用SPSS11.5軟件包對資料進(jìn)行統(tǒng)計分析。結(jié)果：臨床療效：生物反饋放松治療組和常規(guī)治療組患者治療前PASI評分分別為：13.57±3.85,13.12±4.23,兩組相比差異無統(tǒng)計學(xué)意義(p0.05)；治療后兩組評分均下降,分別為：3.99±2.04,6.20±3.34,放松治療組明顯低于常規(guī)治療組(p0.05)。治療后兩組總有效率分別為：70%和32%,放松治療組明顯高于常規(guī)治療組(p0.05)。生活質(zhì)量評價：放松治療組和常規(guī)治療組患者治療前DLQI評分分別為：13.22±3.13,13.60±2.71,兩組相比差異無統(tǒng)計學(xué)意義(p0.05)；治療后兩組DLQI評分分別為：10.33±2.71,13.52±2.91,放松治療組明顯低于常規(guī)治療組(p0.05)。焦慮狀態(tài)評價：放松治療組和常規(guī)治療組患者治療前SAS評分分別為：40.96±4.73,42.20±4.33,兩組相比差異無統(tǒng)計學(xué)意義(p0.05)；治療后SAS評分分別為：36.81±5.39,42.24±4.76,放松治療組明顯低于常規(guī)治療組(p0.05)。抑郁狀態(tài)評價：放松治療組和常規(guī)治療組患者治療前SDS評分分別為：47.44±1.02,49.24±1.15,兩組相比差異無統(tǒng)計學(xué)意義(p0.05)；治療后評分分別為：42.48±5.37,49.04±5.36,放松治療組顯著低于常規(guī)治療組(p0.05)。肌電、皮電參數(shù)評價：(1)肌電：肌電參數(shù)基礎(chǔ)值為4.94±0.91μV,治療前放松治療組及常規(guī)治療組肌電參數(shù)10分鐘平均值分別為：6.47±0.76μV,6.58±0.93μV,均高于參數(shù)基礎(chǔ)值且兩組相比差異無統(tǒng)計學(xué)意義(p0.05)；治療后放松治療組和常規(guī)治療組肌電參數(shù)10分鐘平均值分別為：5.65±0.73μV,6.33±0.68μV,放松治療組與常規(guī)治療組相比治療后肌電值顯著下降(p0.05)。(2)皮電：皮電參數(shù)基礎(chǔ)值為1.72±0.49μs/cm2,治療前放松治療組及常規(guī)治療組皮電參數(shù)10分鐘平均值分別為：2.53±0.58μs/cm2,2.87±0.68μs/cm.2均高于參數(shù)基礎(chǔ)值且兩組相比差異無統(tǒng)計學(xué)意義(p0.05)；治療后放松治療組和常規(guī)治療組肌電參數(shù)10分鐘平均值分別為：2.15±0.50μs/cm2,2.72±0.71μs/cm2,放松治療組與常規(guī)治療組相比治療后皮電參數(shù)水平顯著下降(p0.05)。結(jié)論：本研究采用隨機(jī)病例對照試驗方法研究了生物反饋放松療法對尋常型銀屑病患者的臨床療效、生活質(zhì)量、情緒狀態(tài)的影響。研究結(jié)果初步揭示生物反饋放松療法對尋常型銀屑病患者的臨床療效、生活質(zhì)量、情緒狀態(tài)均產(chǎn)生了不同程度的影響。 1、生物反饋放松療法能有效提高尋常型銀屑病患者的臨床療效； 2、生物反饋放松療法能有效改善尋常型銀屑病患者的生活質(zhì)量 3、生物反饋放松療法能有效改善尋常型銀屑病患者的情緒狀態(tài)； 4、生物反饋放松療法可能通過降低患者的肌電、皮電參數(shù)水平,使其趨于基礎(chǔ)值水平,有效的改善患者的機(jī)體緊張狀態(tài)以及自主神經(jīng)調(diào)節(jié)功能而發(fā)揮治療作用。
[Abstract]:Objective: Psoriasis is a common immune and inflammatory chronic skin disease. The pathogenesis and pathogenesis of psoriasis has not been decided yet. The study shows that psychological factors play an important role in the induction, exacerbation, remission and cure of psoriasis, and have a certain material base. It is a typical heart disease. Anxiety, stress, depression, etc. negative emotion causes psoriasis patients to be in a series of physiological and psychological reactions for a long time. The purpose of this study was to explore the effect of biofeedback on the clinical efficacy, quality of life and emotional state of psoriasis patients, to find the theoretical basis for the development of psoriasis and social psychological factors, and to provide scientific basis for the clinical psychotherapy of psoriasis. Methods: (1) Case grouping and treatment: 60 patients with psoriasis vulgaris were randomly divided into routine treatment group (30 persons, 5 out of 5, 25 in practice) and biofeedback relaxation treatment group (30 in total). Three of them were out of order, actually 27). In the conventional treatment group, the oral compound ammonia peptide tablet, the external drug therapy group and the biofeedback relaxation treatment group were treated with the biofeedback relaxation training group except for the drug therapy (the same as the conventional treatment group), and the biofeedback relaxation treatment group was added to the biofeedback relaxation training treatment once a week for 8 weeks. (2) Basic value measurement of myoelectric and skin electric parameters: measure the muscle electricity and skin electric average value as parameter base value within 10 minutes under the calm state of 20 general health personnel. (3) The PASI score method was adopted for clinical efficacy evaluation. (4) Quality of life evaluation adopts quality index (DLQI). (5) Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used for emotional state evaluation. (6) Statistical method: SPSS 11.5 software package was used to analyze the data. Results: The PASI scores of the biofeedback relaxation treatment group and the conventional treatment group were 13.57, 3.85, 13.12 and 4.23, respectively. There was no significant difference between the two groups (P0.05). The relaxing treatment group was significantly lower than that of the conventional treatment group (P0.05). The total effective rates of the two groups were: 70% and 32% respectively, and the relaxation treatment group was significantly higher than that in the conventional treatment group (P0.05). The evaluation of quality of life: The DLQI scores were 13. 22, 3. 13, 13. 60 and 2.71 respectively in the relaxed treatment group and the conventional treatment group. There was no significant difference between the two groups (P0.05). The DLQI scores of the two groups were 10.33, 2.71, 13.52 and 2.91, respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). Anxiety status evaluation: SAS scores were 40. 96, 4.73, 42. 20 and 4.33 respectively in the relaxed treatment group and the conventional treatment group. The SAS scores of the two groups were 36. 81, 5.39, 42. 24 and 4.76, respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). Depression status evaluation: The pre-treatment SDS scores of the relaxed treatment group and the conventional treatment group were 47. 44, 1. 02, 49. 24 and 1. 15, respectively. There was no significant difference in the two groups (P0.05). The post-treatment scores were: 42. 48, 5.37, 49. 04, and 5.36 respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). The electrical parameters of muscle and skin were evaluated as follows: (1) Muscle electricity: The basic value of myoelectric parameters was 4. 94% 0. 91. V, the average value of 10 minutes for the treatment group and the conventional treatment group was 6.47, 0.076. V, 6.58, 0.093. mu.V, respectively. Both groups were higher than the basic values of the parameters and no significant difference was found between the two groups (P0.05). The average value of 10 minutes of the electric parameters of the relaxing treatment group and the conventional treatment group after the treatment was 5. 65% 0. 73. mu.V, 6. 33, 0. 68. mu.V, respectively. Compared with the conventional treatment group, the electric value of the myoelectric muscle decreased significantly compared with the conventional treatment group (P0.05). (2) Skin electricity: The basic value of skin electric parameter was 1. 72% 0. 49. mu.s/ cm2, and the average value of 10 minutes of skin electric parameters of the pre-treatment group and the conventional treatment group were: 2.53, 0.058. mu.s/ cm2, 2.87, 0.068. mu.s/ cm. Both were higher than those of the parameter base, and the difference was not statistically significant compared with that of the two groups (P0.05). After treatment, the average values of the electrical parameters of the relaxing treatment group and the conventional treatment group were: 2. 15% 0. 50. mu.s/ cm2, 2.72, 0. 71. mu.s/ cm2, and the relaxation treatment group had a significant decrease in the level of electrical parameters after treatment compared with the conventional treatment group (P0.05). Conclusion: The clinical efficacy, quality of life and emotional state of patients with psoriasis vulgaris treated by biofeedback chemotherapy were studied in this study. The results showed that biofeedback release therapy had a different effect on the clinical efficacy, quality of life and emotional state of patients with psoriasis vulgaris. 1. Biofeedback release therapy can effectively improve patients with psoriasis vulgaris Clinical curative effect; biofeedback release therapy can effectively improve the common type The quality of life of patients with psoriasis is 3, biofeedback relaxation therapy can be changed effectively. The emotional state of patients with psoriasis vulgaris; 4. biofeedback release therapy may reduce the level of basal value by reducing the level of muscle and skin electrical parameters of the patient, so as to effectively improve the patient's body tension.
【學(xué)位授予單位】：瀘州醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R758.63
本文編號：2307886
[Abstract]:Objective: Psoriasis is a common immune and inflammatory chronic skin disease. The pathogenesis and pathogenesis of psoriasis has not been decided yet. The study shows that psychological factors play an important role in the induction, exacerbation, remission and cure of psoriasis, and have a certain material base. It is a typical heart disease. Anxiety, stress, depression, etc. negative emotion causes psoriasis patients to be in a series of physiological and psychological reactions for a long time. The purpose of this study was to explore the effect of biofeedback on the clinical efficacy, quality of life and emotional state of psoriasis patients, to find the theoretical basis for the development of psoriasis and social psychological factors, and to provide scientific basis for the clinical psychotherapy of psoriasis. Methods: (1) Case grouping and treatment: 60 patients with psoriasis vulgaris were randomly divided into routine treatment group (30 persons, 5 out of 5, 25 in practice) and biofeedback relaxation treatment group (30 in total). Three of them were out of order, actually 27). In the conventional treatment group, the oral compound ammonia peptide tablet, the external drug therapy group and the biofeedback relaxation treatment group were treated with the biofeedback relaxation training group except for the drug therapy (the same as the conventional treatment group), and the biofeedback relaxation treatment group was added to the biofeedback relaxation training treatment once a week for 8 weeks. (2) Basic value measurement of myoelectric and skin electric parameters: measure the muscle electricity and skin electric average value as parameter base value within 10 minutes under the calm state of 20 general health personnel. (3) The PASI score method was adopted for clinical efficacy evaluation. (4) Quality of life evaluation adopts quality index (DLQI). (5) Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used for emotional state evaluation. (6) Statistical method: SPSS 11.5 software package was used to analyze the data. Results: The PASI scores of the biofeedback relaxation treatment group and the conventional treatment group were 13.57, 3.85, 13.12 and 4.23, respectively. There was no significant difference between the two groups (P0.05). The relaxing treatment group was significantly lower than that of the conventional treatment group (P0.05). The total effective rates of the two groups were: 70% and 32% respectively, and the relaxation treatment group was significantly higher than that in the conventional treatment group (P0.05). The evaluation of quality of life: The DLQI scores were 13. 22, 3. 13, 13. 60 and 2.71 respectively in the relaxed treatment group and the conventional treatment group. There was no significant difference between the two groups (P0.05). The DLQI scores of the two groups were 10.33, 2.71, 13.52 and 2.91, respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). Anxiety status evaluation: SAS scores were 40. 96, 4.73, 42. 20 and 4.33 respectively in the relaxed treatment group and the conventional treatment group. The SAS scores of the two groups were 36. 81, 5.39, 42. 24 and 4.76, respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). Depression status evaluation: The pre-treatment SDS scores of the relaxed treatment group and the conventional treatment group were 47. 44, 1. 02, 49. 24 and 1. 15, respectively. There was no significant difference in the two groups (P0.05). The post-treatment scores were: 42. 48, 5.37, 49. 04, and 5.36 respectively, and the relaxation treatment group was significantly lower than that of the conventional treatment group (P0.05). The electrical parameters of muscle and skin were evaluated as follows: (1) Muscle electricity: The basic value of myoelectric parameters was 4. 94% 0. 91. V, the average value of 10 minutes for the treatment group and the conventional treatment group was 6.47, 0.076. V, 6.58, 0.093. mu.V, respectively. Both groups were higher than the basic values of the parameters and no significant difference was found between the two groups (P0.05). The average value of 10 minutes of the electric parameters of the relaxing treatment group and the conventional treatment group after the treatment was 5. 65% 0. 73. mu.V, 6. 33, 0. 68. mu.V, respectively. Compared with the conventional treatment group, the electric value of the myoelectric muscle decreased significantly compared with the conventional treatment group (P0.05). (2) Skin electricity: The basic value of skin electric parameter was 1. 72% 0. 49. mu.s/ cm2, and the average value of 10 minutes of skin electric parameters of the pre-treatment group and the conventional treatment group were: 2.53, 0.058. mu.s/ cm2, 2.87, 0.068. mu.s/ cm. Both were higher than those of the parameter base, and the difference was not statistically significant compared with that of the two groups (P0.05). After treatment, the average values of the electrical parameters of the relaxing treatment group and the conventional treatment group were: 2. 15% 0. 50. mu.s/ cm2, 2.72, 0. 71. mu.s/ cm2, and the relaxation treatment group had a significant decrease in the level of electrical parameters after treatment compared with the conventional treatment group (P0.05). Conclusion: The clinical efficacy, quality of life and emotional state of patients with psoriasis vulgaris treated by biofeedback chemotherapy were studied in this study. The results showed that biofeedback release therapy had a different effect on the clinical efficacy, quality of life and emotional state of patients with psoriasis vulgaris. 1. Biofeedback release therapy can effectively improve patients with psoriasis vulgaris Clinical curative effect; biofeedback release therapy can effectively improve the common type The quality of life of patients with psoriasis is 3, biofeedback relaxation therapy can be changed effectively. The emotional state of patients with psoriasis vulgaris; 4. biofeedback release therapy may reduce the level of basal value by reducing the level of muscle and skin electrical parameters of the patient, so as to effectively improve the patient's body tension.
【學(xué)位授予單位】：瀘州醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R758.63
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