【摘要】： 斑禿被認為是一種身心疾病,其發(fā)病與遺傳因素、自身免疫功能紊亂、精神因素等相互作用有關(guān)。斑禿全球均可發(fā)病,可以在任何年齡發(fā)病,無性別、種族差異�，F(xiàn)在,越來越多的學(xué)者關(guān)注心理因素對斑禿發(fā)病的影響,并運用各種心理評估量表對斑禿患者的心理因素及治療療效進行評估。但是在心理健康狀況方面,哪項心理因子與斑禿發(fā)病的相關(guān)性最高,還不得而知。目前,斑禿的治療多種多樣。但是,在國內(nèi)針對斑禿患者的心理治療幾乎空白,這已經(jīng)滿足不了斑禿患者的需求。 本研究采用問卷調(diào)查對185例成人斑禿病患者及健康人對照組(采取1：1對照)進行流行病學(xué)調(diào)查及SCL-90評估,同時將斑禿組SCL-90評估陽性的患者,按隨機化的原則進行分組,斑禿對照組進行常規(guī)中西醫(yī)結(jié)合治療,斑禿治療組加用多慮平對斑禿患者的心理障礙進行干預(yù)治療,并于治療后對治療組和對照組進行SCL-90評估,應(yīng)用Microsoft Office Excel 2003, SPSS11.0軟件進行統(tǒng)計學(xué)處理分析,以了解斑禿的一般特征、觀察哪一項心理因子與斑禿發(fā)病的相關(guān)性最高,判斷加用多慮平對斑禿患者的心理障礙治療的療效。 本研究結(jié)果顯示：①研究期間納入觀察的斑禿患者為185例,占同期皮膚科門診量的0.01%,男女發(fā)病比例為1.3：1,發(fā)病年齡從10歲到66歲,男性患者平均發(fā)病年齡為34.45±11.95歲,女性患者平均發(fā)病年齡為34.05±11.97歲,各年齡段男、女發(fā)病年齡比較無顯著性差異(t=0.156,p0.05)。斑禿發(fā)病大部分集中在21-50歲之間,病程從1周到11年不等,有陽性家族史的占11.35%。②斑禿組患者有心理誘因的有137例,占74.05%,除了因工作、學(xué)習(xí)、生活(家事)引起的以外,突發(fā)應(yīng)激事件、長時間上網(wǎng)玩游戲、長期熬夜打牌等應(yīng)引起重視。③斑禿組和健康對照組SCL-90評估的總分和陽性項目數(shù)的差異有統(tǒng)計學(xué)意義(t=3.43和5.08,p0.05),說明心理因素對斑禿的發(fā)病有影響。④斑禿組的軀體化(t=2.43,p0.05)、強迫癥狀(t=5.17,p0.05)、人際關(guān)系敏感(t=4.64,p0.05)、抑郁(t=3.17,p0.05)、焦慮(t=2.97,p0.05)、敵對(t=3.25,p0.05)和偏執(zhí)(t=2.31,p0.05)7項因子與健康對照組相比有顯著性統(tǒng)計學(xué)差異,說明軀體化、強迫癥狀、人際關(guān)系敏感、抑郁、焦慮、敵對和偏執(zhí)7項因子對斑禿的發(fā)病有影響；而恐怖(t=0.00025,p0.05)、精神病性(t=1.72,p0.05)及其他(t=1.03,p0.05)3項因子則無顯著性統(tǒng)計學(xué)差異(p0.05),說明恐怖、精神病性及其他3項因子對斑禿的發(fā)病無影響。⑤在這7項因子中,它們出現(xiàn)的頻率從高到低依次為強迫癥狀因子、敵對因子、抑郁因子、人際關(guān)系敏感因子、焦慮因子、偏執(zhí)因子、軀體化因子。說明強迫癥狀因子與斑禿發(fā)病的相關(guān)性最高,然后依次為敵對因子、抑郁因子、人際關(guān)系敏感因子、焦慮因子、偏執(zhí)因子和軀體化因子。⑥40例斑禿對照組患者在治療前后SCL-90評估結(jié)果比較均無顯著性統(tǒng)計學(xué)差異(p0.05),其結(jié)果表明常規(guī)中西醫(yī)結(jié)合治療對斑禿患者的心理障礙無治療作用。39例斑禿治療組患者在治療前后總分和陽性項目數(shù)有顯著性統(tǒng)計學(xué)差異(t=8.44和4.62,p0.05),其結(jié)果表明加用多慮平治療對斑禿患者的心理障礙治療有效,能明顯改善斑禿患者的心理狀態(tài)。39例斑禿治療組患者在治療前后,對斑禿發(fā)病有影響的7項因子中,強迫癥狀(t=5.06,p0.05)、人際關(guān)系敏感(t=9.17,p0.05)、抑郁(t=3.14,p0.05)、焦慮(t=8.36,p0.05)、敵對(t=9.34,p0.05)這5項因子有顯著性統(tǒng)計學(xué)差異,說明加用多慮平治療可以改善斑禿患者的強迫癥狀、人際關(guān)系敏感、抑郁、焦慮、敵對這5項心理因子；而軀體化(t=0.0003,p0.05)和偏執(zhí)(t=0.0042,p0.05)這2項因子無顯著性統(tǒng)計學(xué)差異,說明在本研究中加用多慮平治療對軀體化和偏執(zhí)因子無治療作用。
[Abstract]:Alopecia is considered to be a kind of physical and mental illness, its incidence is related to the genetic factors, the self-immune function disorder, the mental factor and so on. The alopecia areata in the whole world can be developed, and can be developed at any age, without sex and ethnic difference. Now, more and more scholars pay attention to the influence of psychological factors on the incidence of alopecia areata, and evaluate the psychological factors and curative effect of the patients with alopecia areata with various psychological evaluation scales. However, in terms of mental health, which psychological factor is the highest in the incidence of alopecia areunknown. At present, the treatment of alopecia areata is various. However, the treatment of alopecia arealmost blank in the country, which has not been able to meet the needs of the patients with alopecia areata. In this study, the epidemiological investigation and the SCL-90 evaluation of 185 adult patients with alopecia areata and the control group (1: 1 control) were carried out in the control group (1: 1 control). In the treatment group and control group, the psychological disorder of the patients with alopecia areata was treated with conventional traditional Chinese and western medicine, and the SCL-90 evaluation was performed on the treatment group and the control group after the treatment, and the statistics of the software of Microsoft Office Excel 2003 and SPSS11.0 were applied. To study the general characteristics of alopecia areata, the correlation between the mental factors and the incidence of alopecia arethe highest. The results of this study showed that 185 patients with alopecia areata were included in the study, accounting for 0.01% of the outpatients in the same period. The incidence of the male and female patients was 1. 3: 1. The age of the disease was from 10 to 66 years. The average age of the male patients was 34. 45. The average age of the female patients was 34. 05 to 11. 97, and there was no significant difference in the age of male and female in all ages (t = 0.156). The incidence of alopecia aremost concentrated between 21 and 50 years, the course of course was from 1 to 11 years, and there was a positive family history. accounting for 11.35%. There were 137 cases of psychological inducement in the alopecia areata group, accounting for 74.05%. In addition to the cause of work, study and life (family), the sudden stress event, long-time online game play, and long-term stay up The difference of the total score and the number of positive items assessed by the SCL-90 in the bald and healthy controls was statistically significant (t = 3.43 and 5.08, p0.05), indicating the psychological factors to the spot. The somatization of alopecia areata (t = 2.43, p0.05), forced symptom (t = 5.17, p0.05), interpersonal sensitivity (t = 4.64, p0.05), depression (t = 3.17, p0.05), anxiety (t = 2.97, p0.05), hostility (t = 3.25, p0.05) and paranoia (t = 2.31, p0.05) There was no significant difference in the relationship between somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility and paranoia on the incidence of alopecia areata (t = 0.00025, p0.05), psychotic (t = 1.72, p0.05) and others (t = 1.03, p0.05). (p0.05), describing the effects of terror, psychosis, and other three factors on the spot There is no effect on the incidence of alopecia areata. In these seven factors, the frequency of their occurrence is from high to low in order of the forced symptom factor, the hostility factor, the depression factor, the interpersonal sensitivity factor, the anxiety factor, the paranoia. The correlation of obsessive-compulsive symptoms and alopecia arethe highest, and then the factors of hostility, depression, interpersonal sensitivity, anxiety and paranoia. Sub-and somatization factors. There was no significant difference in the results of SCL-90 evaluation before and after treatment in 40 patients with alopecia areata. (p0.05), the results indicated that the traditional Chinese and Western medicine combined treatment had no treatment effect on the psychological barrier of the patients with alopecia areata. (p0.05), the results indicated that the treatment of the psychological disorder of the patients with alopecia areata was effective in the treatment of alopecia areata with the treatment of the treatment of the alopecia areata, and the psychological status of the patients with alopecia areobviously improved. In the treatment group, the symptoms (t = 5.06, p0.05) and the sensitivity of the interpersonal relationship were found in the 7 factors that affected the incidence of alopecia areata before and after the treatment. (t = 9.17, p0.05), depression (t = 3.14, p0.05), anxiety (t = 8.36, p0.05), and hostility (t = 9.34, p0.05). There was no significant difference in the two factors of somatization (t = 0.0003, p0.05) and paranoia (t = 0. 0042, p0.05).
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R758.71

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