本文選題：慢性乙型病毒性肝炎　切入點(diǎn)：生存質(zhì)量　出處：《廣州中醫(yī)藥大學(xué)》2009年碩士論文　論文類型：學(xué)位論文

【摘要】： 背景:隨著社會(huì)的發(fā)展和現(xiàn)代醫(yī)學(xué)模式的日趨完善,社會(huì)和心理因素與各類疾病的關(guān)系逐漸引起人們的重視。生存質(zhì)量是人們順應(yīng)醫(yī)學(xué)模式向生物、心理、社會(huì)醫(yī)學(xué)模式轉(zhuǎn)變而產(chǎn)生的一種新的健康指標(biāo),測(cè)定疾病患者的生活質(zhì)量有助于全面評(píng)價(jià)其生命活動(dòng)及醫(yī)療效果。慢性乙型病毒性肝炎是我國(guó)發(fā)病率較高的一種疾病,目前尚無(wú)特效療法治愈,隨著人們對(duì)慢性乙型病毒性肝炎這個(gè)群體的關(guān)注,如何提高慢性乙型病毒性肝炎患者的生存質(zhì)量正越來(lái)越受到我國(guó)醫(yī)務(wù)工作者及全社會(huì)的重視。 目的:通過(guò)對(duì)慢性乙型病毒性肝炎患者未經(jīng)治療時(shí)及經(jīng)過(guò)中醫(yī)藥干預(yù)后的兩種心理狀態(tài)的調(diào)查,探討慢性乙型病毒性肝炎患者的心理特征及中醫(yī)藥干預(yù)對(duì)其心理狀態(tài)的影響,進(jìn)一步評(píng)價(jià)中醫(yī)藥干預(yù)對(duì)慢性乙型病毒性肝炎患者心理狀態(tài)與生存質(zhì)量的影響,為建立中醫(yī)藥干預(yù)慢性乙型病毒性肝炎患者心理狀態(tài)的模型及安全有效的中醫(yī)藥干預(yù)慢性乙型病毒性肝炎患者生存質(zhì)量的方案提供參考依據(jù)。 方法:采用橫斷面研究,選擇20008年2月至20009年4月期間廣東省中醫(yī)院肝病科200例慢性乙型病毒性肝炎患者及健康人80例,分別以一般健康狀況問(wèn)卷、健康狀況問(wèn)卷(SF-36量表)、自評(píng)抑郁量表和自評(píng)焦慮量表進(jìn)行問(wèn)卷調(diào)查,資料采用t檢驗(yàn)、卡方檢驗(yàn)。 結(jié)果:中藥干預(yù)前慢性乙型病毒性肝炎患者的生存質(zhì)量和心理狀態(tài)與健康對(duì)照組相比,SF-36量表的全部領(lǐng)域得分均明顯低于正常人,自評(píng)抑郁量表和自評(píng)焦慮量表得分均明顯高于健康對(duì)照組,以上兩組差異均有統(tǒng)計(jì)學(xué)意義;中藥干預(yù)后慢性乙型病毒性肝炎患者的生存質(zhì)量和心理狀態(tài)與健康對(duì)照組相比,SF-36量表里,在生理機(jī)能、身體疼痛、情感職能的平均分高于健康對(duì)照組,而在精神健康和SF總分兩個(gè)方面二者基本相等,評(píng)抑郁量表平均分及自評(píng)焦慮量表平均分接近于正常人,經(jīng)t檢驗(yàn),自評(píng)焦慮量表、自評(píng)抑郁量表差異均有統(tǒng)計(jì)學(xué)意義。以上兩組經(jīng)t檢驗(yàn)差異均有統(tǒng)計(jì)學(xué)意義(P0.05), 結(jié)論:慢性乙型病毒性肝炎患者普遍存在著抑郁、焦慮等心理問(wèn)題,生存質(zhì)量較低。本研究結(jié)果提示中藥在整體觀和辨證論治的基礎(chǔ)上,能夠從不同方面提高慢性乙型病毒性肝炎患者的心理狀態(tài)和生存質(zhì)量,且中藥具有副作用少,價(jià)格低廉,值得臨床推廣。生存質(zhì)量可以作為臨床療效評(píng)價(jià)的參考依據(jù),指導(dǎo)慢性乙型病毒性肝炎治療方案的決策。
[Abstract]:Background: with the development of society and the improvement of modern medical model, people pay more attention to the relationship between social and psychological factors and various diseases. A new kind of health index produced by the transformation of social medical model, the quality of life of patients with diseases is helpful to evaluate their life activities and medical effects. Chronic viral hepatitis B is a disease with high incidence in China. At present, there is no special therapy to cure. With the attention of people to the group of chronic viral hepatitis B, how to improve the quality of life of patients with chronic viral hepatitis B is being paid more and more attention by medical workers and the whole society in our country. Objective: to investigate the psychological characteristics of patients with chronic viral hepatitis B (CHB) and the influence of TCM intervention on their mental state by investigating the two psychological states of patients with chronic viral hepatitis B (CHB) when they were not treated and after the intervention of traditional Chinese medicine (TCM). To further evaluate the influence of Chinese medicine intervention on the psychological state and quality of life of patients with chronic viral hepatitis B. To establish the model of Chinese medicine intervention chronic viral hepatitis B patients psychological state and the safe and effective Chinese medicine intervention chronic virus hepatitis patients quality of life plan to provide the reference basis. Methods: a cross-sectional study was conducted on 200 patients with chronic viral hepatitis B and 80 healthy persons from February to April in Guangdong Provincial Hospital of traditional Chinese Medicine. The health status questionnaire included SF-36, self-rating depression and self-rating anxiety. T test and chi-square test were used. Results: the scores of quality of life and psychological state of patients with chronic viral hepatitis B before the intervention of traditional Chinese medicine were significantly lower than those of healthy controls. The scores of self-rating depression scale and self-rating anxiety scale were significantly higher than those of healthy control group. Compared with the healthy control group, the average scores of physiological function, physical pain and emotional function of the patients with chronic viral hepatitis B were higher than those of the healthy control group in the SF-36 scale. The average scores of depression rating scale and self-rating anxiety scale were similar to those of normal people, and the average score of self-rating anxiety scale was similar to that of normal person. The difference of self-rating depression scale was statistically significant, and the difference between the above two groups by t test was statistically significant (P 0.05). Conclusion: depression, anxiety and other psychological problems are common in patients with chronic viral hepatitis B, and the quality of life is low. The results of this study suggest that Chinese traditional medicine is based on holistic view and treatment based on differentiation of symptoms and signs. It can improve the psychological state and quality of life of the patients with chronic hepatitis B from different aspects, and the traditional Chinese medicine has few side effects and low price, so it is worth popularizing in clinic. The quality of life can be used as a reference for the evaluation of clinical curative effect. To guide the treatment of chronic hepatitis B decision-making.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2009
【分類號(hào)】：R395;R259

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