【摘要】：背景:肺癌的死亡率居高不下,是惡性腫瘤中發(fā)病率最高的腫瘤之一。因其發(fā)病較為隱匿,早期常常無明顯癥狀,絕大多數(shù)患者一經(jīng)診斷即為中晚期肺癌。被確診為肺癌后,多數(shù)患者會(huì)出現(xiàn)焦慮不安、抑郁、消極等情緒,再加上治療中產(chǎn)生的強(qiáng)烈的不良反應(yīng)以及讓人無法忍受的癌性疼痛,就會(huì)使絕望悲觀的情緒更為嚴(yán)重,這種不良心理惡性循環(huán)使肺癌臨床常規(guī)治療更為困難,因此如何減輕中晚期肺癌患者消極情緒,改善心身狀態(tài),輔助臨床治療,提高他們的生存質(zhì)量,成為當(dāng)今研究的熱點(diǎn)。目的:研究制作改良版?zhèn)�體電腦游戲版豁達(dá)治療,探討個(gè)體電腦游戲版豁達(dá)治療在心理、生理以及社會(huì)等方面對(duì)中晚期肺癌患者臨床療效的影響,為促進(jìn)中晚期肺癌患者身心康復(fù)提供理論方法和實(shí)證依據(jù)。方法:1、研究制作改良版?zhèn)�體電腦游戲版豁達(dá)治療(Individual Computer Game-version Magnanimous Therapy,ICGMT),選取生動(dòng)有趣、貼近生活、富有哲理的8個(gè)小故事,并將其編輯成Flash動(dòng)畫形式;隨著情節(jié)的發(fā)展會(huì)穿插相關(guān)的問題,伴隨“積極”“消極”的選項(xiàng);每次作出不同的選擇,故事將會(huì)沿不同的方向發(fā)展,最終得出不同的結(jié)果;每完成一次視頻游戲后,系統(tǒng)會(huì)自動(dòng)記分。2、將60例中晚期肺癌住院患者依照匹配分組原則,分為ICGMT組和對(duì)照組各30人。ICGMT組除常規(guī)治療外,并在電腦上進(jìn)行一對(duì)一的個(gè)體電腦游戲版豁達(dá)治療2周,一周4次,一次約40分鐘;對(duì)照組僅用腫瘤臨床常規(guī)治療,不給予豁達(dá)治療。兩組患者在治療前后分別采用癌癥心身狀態(tài)問卷、T型心理量表、癌癥患者心理調(diào)節(jié)量表、癌癥應(yīng)對(duì)問卷、進(jìn)取豁達(dá)問卷、癌癥病人生活功能指標(biāo)量表、醫(yī)院焦慮抑郁量表和潛意識(shí)繪畫房-樹-人測(cè)驗(yàn)作為患者心理、社會(huì)指標(biāo)評(píng)價(jià);所有參與者兩周前后用生物反饋治療儀記錄腦電波、血壓、心率和呼吸各值,采集靜脈血檢查免疫細(xì)胞Ig A、Ig G、Ig M、NK值作為患者生理指標(biāo)評(píng)價(jià);觀察比較兩組在實(shí)驗(yàn)前后心身狀況、心理應(yīng)對(duì)、調(diào)節(jié)方式、生活質(zhì)量和生理指標(biāo)等多方面的變化情況,以評(píng)估療效。結(jié)果:1.研制而成改良版?zhèn)�體電腦游戲版豁達(dá)治療(ICGMT)。2.患者心理、社會(huì)指標(biāo)結(jié)果(1)癌癥心身狀態(tài)問卷評(píng)分:ICGMT組干預(yù)2周后總分、“心理”維度、“軀體”維度、“社會(huì)功能”維度、“心理行為可塑性”維度評(píng)分(30.70±3.98、8.10±1.63、7.20±1.21、8.2±1.45、7.00±1.01)均低于入院時(shí)(35.90±4.91、10.03±2.11、8.60±1.75、9.2±1.87、8.07±1.33),差異有統(tǒng)計(jì)學(xué)意義(p0.01);對(duì)照組2周后總分、“心理”、“軀體”、“社會(huì)功能”維度評(píng)分(40.08±1.11、11.94±4.38、10.22±2.13、14.01±3.78)均高于入院時(shí)(35.33±1.37、10.83±4.28、7.71±2.41、9.89±4.23),差異有顯著性(p0.01),而在“心理行為可塑性”維度評(píng)分(9.01±3.54)與入院時(shí)(8.78±1.09)相比,差異無統(tǒng)計(jì)學(xué)意義(p0.05)。(2)T型心理量表評(píng)分:ICGMT組與對(duì)照組在總均分、“個(gè)性特點(diǎn)”、“認(rèn)知習(xí)慣”、“情緒表現(xiàn)”和“潛意識(shí)”五個(gè)維度與入院時(shí)相比,差異均無統(tǒng)計(jì)學(xué)意義(p0.05)。(3)癌癥患者心理調(diào)節(jié)量表評(píng)分:ICGMT組干預(yù)后總均分、“情緒/自尊”、“主觀感覺”、“人際關(guān)系/社會(huì)生活”、“日常生活”和“其他”五個(gè)維度(3.40±0.33、3.65±0.54、3.53±0.41、3.53±0.34、2.89±0.45、3.37±0.59)均高于入院時(shí)(3.35±0.52、3.57±0.43、3.41±0.51、2.77±0.48、3.51±0.33、3.29±0.51),差異有顯著性(p0.01);對(duì)照組2周后總均分、“情緒/自尊”、“主觀感覺”、“人際關(guān)系/社會(huì)生活”、“日常生活”和“其他”五個(gè)維度(3.29±0.49、3.72±0.74、3.38±0.64、2.69±0.21、3.87±0.24、3.45±0.81)與入院時(shí)(3.31±0.64、3.73±1.49、3.39±0.52、2.71±0.42、3.89±0.32、3.47±0.49)均降低,但差異無統(tǒng)計(jì)學(xué)意義(p0.05)。(4)癌癥應(yīng)對(duì)問卷評(píng)分:ICGMT組干預(yù)后總均分、“面對(duì)”維度(2.34±0.14、2.77±0.55)高于入院時(shí)(2.29±0.23、2.48±0.52),“回避與壓抑”和“屈服”維度(1.73±0.69、2.10±0.55)低于入院時(shí)(2.00±0.51、1.73±0.69),差異有顯著性(p0.05);而在“幻想”和“發(fā)泄”維度(2.05±1.46、1.56±5.67)與入院時(shí)(2.04±0.61、1.55±0.41)相比,差異無統(tǒng)計(jì)學(xué)意義(p0.05);對(duì)照組2周后“面對(duì)”維度(2.41±0.39)低于入院時(shí)(2.56±0.41),差異有顯著性(p0.05)。而總均分、“回避與壓抑”、“屈服”、“幻想”、“發(fā)泄”四個(gè)維度維度(2.01±1.45、2.14±0.29、2.43±0.58、2.12±0.11、1.42±0.56)與入院時(shí)(1.99±1.08、2.13±0.63、2.46±0.44、2.01±0.22、1.43±0.58)相比,差異無統(tǒng)計(jì)學(xué)意義(p0.05)。(5)進(jìn)取豁達(dá)問卷評(píng)分:ICGMT組干預(yù)后總分、“積極進(jìn)取”維度(72.35±6.76、36.71±4.09)高于入院時(shí)(70.56±7.89、35.45±4.54),差異有顯著性(p0.05);而在“豁達(dá)寬容”維度(36.27±3.55)與干預(yù)前(36.01±4.06)相比,差異無統(tǒng)計(jì)學(xué)意義(p0.05);對(duì)照組2周后總分、“豁達(dá)寬容”維度(70.81±6.21、35.20±1.89)與入院時(shí)(71.11±8.30、35.09±1.21)相比,差異無統(tǒng)計(jì)學(xué)意義(p0.05);“積極進(jìn)取”維度(30.07±1.89)較2周前(34.11±2.11)降低,差異有顯著性(p0.05)。(6)癌癥病人生活功能指標(biāo)量表評(píng)分:ICGMT組干預(yù)后總均分、“軀體良好”維度、“心理良好”維度、“社會(huì)良好”維度(4.38±1.21、4.63±1.03、4.93±0.37、5.80±1.24)高于入院時(shí)(4.13±0.67、4.34±1.31、4.86±0.88、5.67±1.15),差異有顯著性(p0.05);“因癌造成的艱難”維度、“惡心”維度(3.23±1.28、4.03±1.52)低于入院時(shí)(3.72±1.54、4.78±1.82),差異有顯著性(p0.01)。對(duì)照組2周后“軀體良好”維度、“心理良好”維度(3.56±1.23、4.15±1.09)低于入院時(shí)(4.11±0.98、4.77±1.22),差異有顯著性(p0.05);“惡心”維度、“因癌造成的艱難”維度(4.47±2.01、3.33±1.29)高于入院時(shí)(4.46±3.21、3.21±1.04),總均分、“社會(huì)良好”維度(3.87±0.37、5.49±1.11)均低于入院時(shí)(3.88±0.52、5.55±1.09),但差異無顯著性(p0.05)。(7)醫(yī)院焦慮抑郁量表評(píng)分:ICGMT組干預(yù)2周后總分、焦慮評(píng)分、抑郁評(píng)分(13.23±3.12、5.99±2.13、7.87±2.24)低于入院時(shí)(16.12±3.67、6.67±2.31、9.45±2.78),差異有顯著性(p0.01);對(duì)照組2周后總分、焦慮評(píng)分、抑郁評(píng)分(19.23±3.16、8.99±4.13、10.87±2.24)高于入院時(shí)(17.13±4.57、6.98±2.39、9.85±2.18),差異有顯著性(p0.01)。(8)房-樹-人測(cè)驗(yàn):ICGMT組干預(yù)2周后,房-樹-人繪畫內(nèi)容較之前充實(shí),各部分布局完整無缺失,比例適中,線頭連續(xù)、畫面清晰、筆觸果決,無反復(fù)修改痕跡,畫面寓意更積極更陽光,消極投射點(diǎn)大幅度降低;而對(duì)照組2周后,整體畫面清晰度無明顯改善,房樹人各個(gè)部分仍不完整,畫面仍顯單調(diào),整副影像嚴(yán)重偏向圖紙一方,大小比例仍失衡,落筆無力、猶豫不決,線條彎彎曲曲,存在許多反復(fù)修改的痕跡,畫面寓意消極悲觀,積極投射點(diǎn)顯著降低。3.患者生理指標(biāo)結(jié)果(1)ICGMT組經(jīng)心理干預(yù)后,收縮壓值、舒張壓值、心率值和呼吸值(129.55±7.23、80.31±8.09、84.55±4.38、17.47±1.35)與入院時(shí)(134.78±7.57、85.77±9.23、87.11±8.22、19.56±2.11)相比,均降低,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。對(duì)照組與入院時(shí)相比,差異無統(tǒng)計(jì)學(xué)意義。(2)腦電波和皮電、皮溫值比較:ICGMT組干預(yù)2周后,α波值(35.94±0.98)高于入院時(shí)(34.85±1.69),θ波值(3.69±1.61)低于入院時(shí)(4.68±1.78),差異均有統(tǒng)計(jì)學(xué)意義(p0.01);對(duì)照組2周后,θ波(28.71±4.56)高于入院時(shí)(24.51±8.21),α波值(9.39±3.52)低于入院(11.65±4.94),差異均有顯著性(p0.01)。ICGMT組和對(duì)照組在皮電值、皮溫值、β波值和SMR波值與入院時(shí)相比,差異均無統(tǒng)計(jì)學(xué)意義(p0.05)。(3)免疫細(xì)胞Ig A、Ig G、Ig M、NK值比較:ICGMT組干預(yù)2周后,Ig A、Ig G、Ig M、NK細(xì)胞值(2.55±3.23、14.87+4.27、1.48±0.13、0.35±0.47)均高于入院時(shí)(2.29±2.10、10.43+3.14、1.01±0.88、0.21±0.23),差異有顯著性(p0.05);對(duì)照組2周后,Ig A、Ig G、Ig M、NK細(xì)胞值(1.55±1.19、9.57±5.19、1.35±0.61、0.21±0.21)均低于入院時(shí)(2.18±1.10、10.92±3.91、1.61±0.88、0.35±0.13),差異有顯著性(p0.05)。4.臨床定性評(píng)價(jià)大部分中晚期肺癌患者認(rèn)為電腦游戲版豁達(dá)治療生動(dòng)有趣、貼近生活,再現(xiàn)了患者平時(shí)內(nèi)心的糾結(jié);富有哲理,通過向患者傳遞易于理解的道理,糾正他們歪曲的認(rèn)知和消極的想法;操作簡單,適合不同年齡層次。使患者無論在心身狀況、心理應(yīng)對(duì)、調(diào)節(jié)方式、生活質(zhì)量和生理指標(biāo)等方面均有所改善,受到患者一致好評(píng)。結(jié)論:個(gè)體電腦游戲版豁達(dá)治療是一種規(guī)范、生動(dòng)、實(shí)用、有效的心理干預(yù)方式,幫助患者逐步養(yǎng)成積極樂觀的人生態(tài)度,達(dá)到豁達(dá)的人生境界。此治療對(duì)于提高中晚期肺癌患者心身狀況、心理應(yīng)對(duì)、調(diào)節(jié)方式、社會(huì)功能和生活質(zhì)量均有積極作用;對(duì)于患者生理指標(biāo)尤其是免疫功能,也有相對(duì)較大的改善。作為一種有效地心理干預(yù)方式,幫助肺癌住院患者提高生存質(zhì)量,為以后的癌癥臨床工作提供了有力的實(shí)證依據(jù)。
[Abstract]:Background: the mortality of lung cancer is high. It is one of the most malignant tumors in the malignant tumor. Because of its insidious incidence and no obvious symptoms in the early stage, most patients are diagnosed as middle and late lung cancer. After being diagnosed as lung cancer, most patients have anxiety, depression, negative emotions, combined with treatment. The strong adverse reaction and unbearable cancer pain will make the despair and pessimistic mood more serious. This bad psychological vicious circle makes the lung cancer clinical routine treatment more difficult, so how to reduce the negative emotion, improve the mental state, assist the clinical treatment and improve the quality of life of the patients with middle and late lung cancer. Objective: To study and make an improved version of the individual computer game version of the open-minded therapy, to explore the effect of the individual computer game on the clinical efficacy of the patients with middle and advanced lung cancer in the psychological, physiological and social aspects, and to provide a theoretical and empirical basis for the promotion of Shen Xinkang in the middle and late stage lung cancer patients. Method: 1, Make the improved version of Individual Computer Game-version Magnanimous Therapy (ICGMT), select 8 small stories that are lively and interesting, close to life, and be rich in philosophy, and edit them into Flash animated forms; with the development of the plot, they will be interspersed with the question of "positive" and "negative"; each time To make different choices, the story will develop in different directions and finally get different results. After each video game, the system will automatically score.2. 60 cases of advanced lung cancer patients are divided into group ICGMT and control group, each of which is divided into group ICGMT and control group.ICGMT except routine treatment, and one to one on the computer. The individual computer game edition was treated for 2 weeks, 4 times a week, and one time for about 40 minutes. The control group only used the tumor clinical routine treatment and no open-minded treatment. The two groups were treated with the cancer psychosomatic state questionnaire, the T mental scale, the cancer patient psychological adjustment scale, the cancer coping questionnaire, the enterprising and open-minded questionnaire, the cancer patient's life. The function index scale, the Hospital Anxiety Depression Scale and the subconscious painting room - tree - man test were used as the patients' psychological and social indicators. All the participants recorded brain wave, blood pressure, heart rate and respiratory value by biofeedback therapy instrument before and after two weeks, and collected venous blood to examine immuno cell Ig A, Ig G, Ig M, NK value as the evaluation of physiological indexes of patients. The two groups were compared before and after the experiment, such as psychosomatic condition, psychological response, adjustment mode, quality of life and physiological indexes, and so on to evaluate the effect. Results: 1. developed a modified version of the individual computer game version of open-minded therapy (ICGMT).2. patients' psychological, social indicators (1) cancer psychosomatic state questionnaire score: group ICGMT intervention 2 weeks later. The total score, "psychological" dimension, "body" dimension, "social function" dimension, "psychological behavior plasticity" score (30.70 + 3.98,8.10 + 1.63,7.20 + 1.21,8.2 + 1.45,7.00 + 1.01) were lower than admission (35.90 + 4.91,10.03 + 2.11,8.60 + 1.75,9.2 + 1.87,8.07 + 1.33), and the difference was statistically significant (P0.01), and the total score of the control group after 2 weeks, " The score of "psychological", "body" and "social function" (40.08 + 1.11,11.94 + 4.38,10.22 + 2.13,14.01 + 3.78) were higher than that of admission (35.33 + 1.37,10.83 + 4.28,7.71 + 2.41,9.89 + 4.23), and the difference was significant (P0.01), but there was no statistical difference between the "psychological behavior plasticity" dimension score (9.01 + 3.54) and admission (8.78 + 1.09). Learning significance (P0.05). (2) T mental scale score: ICGMT group and control group in the total average, "personality", "cognitive habit", "emotional expression" and "subconscious", compared to the admission, the difference was not statistically significant (P0.05). (3) the psychological adjustment scale score of the cancer patients: the total average score of the ICGMT group, "emotion / self-esteem" "Subjective feeling", "interpersonal relationship / social life", "daily life" and "other" five dimensions (3.40 + 0.33,3.65 + 0.54,3.53 + 0.41,3.53 + 0.34,2.89 + 0.45,3.37 + 0.59) were higher than admission (3.35 + 0.52,3.57 + 0.43,3.41 + 0.51,2.77 + 0.48,3.51 + 0.33,3.29 + 0.51), the difference was significant (P0.01); the control group was 2 weeks after the total. The five dimensions of "emotion / self-esteem", "subjective feeling", "interpersonal relationship / social life", "daily life" and "other" (3.29 + 0.49,3.72 + 0.74,3.38 + 0.64,2.69 + 0.21,3.87 + 0.24,3.45 + 0.81) were all decreased with admission (3.31 + 0.64,3.73 + 1.49,3.39 + 0.52,2.71 + 0.42,3.89 + 0.32,3.47 + 0.49), but the difference was not statistically significant Learning significance (P0.05). (4) cancer Coping Questionnaire score: the total average score of the ICGMT group, the "face" dimension (2.34 + 0.14,2.77 + 0.55) was higher than that of admission (2.29 + 0.23,2.48 + 0.52), "avoidance and depression" and "yield" dimension (1.73 + 0.69,2.10 + 0.55) were lower than that of admission (2 + 0.51,1.73 + 0.69), and the difference was significant (P0.05). There was no significant difference in the dimension (2.05 + 1.46,1.56 + 5.67) and the admission (2.04 + 0.61,1.55 + 0.41), and the control group was lower than the admission (2.41 + 0.39) after 2 weeks (2.56 + 0.41), and the difference was significant (P0.05). The total equalization, "avoidance and depression", "yield", "fantasy", and "vent" four were significant. The dimension (2.01 + 1.45,2.14 + 0.29,2.43 + 0.58,2.12 + 0.11,1.42 + 0.56) had no significant difference compared with the admission (1.99 + 1.08,2.13 + 0.63,2.46 + 0.22,1.43 + 0.58). (5) the enterprising and open-minded questionnaire score: the total score of the ICGMT group and the positive enterprising dimension (72.35 + 4.09) was higher than that of the admission (70.5). 6 + 7.89,35.45 + 4.54), the difference was significant (P0.05), but there was no significant difference between the "open-minded tolerance" dimension (36.27 + 3.55) and the intervention (36.01 + 4.06) before the intervention (P0.05), and the total score of the control group after 2 weeks (70.81 + 6.21,35.20 + 1.89) and the admission (71.11 + 8.30,35.09 + 1.21) had no statistical significance (p0.0 5); the dimension of "aggressive" (30.07 + 1.89) was lower than that of 2 weeks (34.11 + 2.11), and the difference was significant (P0.05). (6) the scale score of the life function index of cancer patients: the total average score of the ICGMT group, the "good body" dimension, the "good psychological" dimension, and the "social good" dimension (4.38 + 1.21,4.63 + 0.37,5.80 + 1.24) were higher than that of the entry. In hospital (4.13 + 0.67,4.34 + 1.31,4.86 + 0.88,5.67 + 1.15), the difference was significant (P0.05); "nausea" dimension (3.23 + 1.28,4.03 + 1.52) was lower than that of admission (3.72 + 1.54,4.78 + 1.82). The difference was significant (P0.01). In the control group, "good body" dimension and "good psychological" dimension (3.56 + 1.23,4.15) after 2 weeks. The difference was significantly lower than that of admission (4.11 + 0.98,4.77 + 1.22), and the difference was significant (P0.05); the dimension of "nausea" and "the difficulty of cancer" (4.47 + 2.01,3.33 + 1.29) were higher than that of admission (4.46 + 3.21,3.21 + 1.04), the total average, and the "good social" dimension (3.87 + 0.37,5.49 + 1.11) were lower than that of admission (3.88 + 0.52,5.55 + 4.11), but the difference was not (P0.05). (7) the hospital anxiety and Depression Scale score: the total score, the anxiety score and the depression score (13.23 + 3.12,5.99 + 2.13,7.87 + 2.24) in the group ICGMT were lower than that of the admission (16.12 + 3.67,6.67 2.31,9.45 + 2.78), and the difference was significant (P0.01); the total score, anxiety score, and depression score (19.23 + 3.16,8.99 + 4.13,10.87 + 2.24) in the control group were 2 weeks later. ) higher than the admission (17.13 + 4.57,6.98 + 2.39,9.85 + 2.18), the difference was significant (P0.01). (8) room tree man test: 2 weeks after the intervention of group ICGMT, the content of room tree man painting was more full, the layout of each part was complete and no missing, the proportion was moderate, the line head was continuous, the picture was clear, the pen touched the fruit, no repeated modification marks, the picture allegedly more active more sunshine, disappear. After 2 weeks of the control group, the overall picture clarity did not improve obviously, the whole picture was still incomplete, the picture was still monotonous, the whole image was seriously biased toward the drawing side, the size ratio was still unbalance, the pen was weak, the line was irresolute, the lines were bending, the picture implied negative sadness. The positive projection points significantly reduced the results of.3. patients' physiological index (1) group ICGMT after psychological intervention, systolic pressure, diastolic pressure, heart rate and respiratory value (129.55 + 7.23,80.31 + 8.09,84.55 + 4.38,17.47 + 1.35) were lower than those at admission (134.78 + 7.57,85.77 + 9.23,87.11 + 8.22,19.56 + 2.11), and the difference was statistically significant (P0.05). There was no significant difference between the group and the admission group. (2) the comparison of brain wave and skin electricity and skin temperature: after 2 weeks of ICGMT intervention, the value of alpha wave (35.94 + 0.98) was higher than that of admission (34.85 + 1.69), and the value of theta wave (3.69 + 1.61) was lower than that of admission (4.68 + 1.78) (4.68 + 1.78), and the difference was all (P0.01). After the control group, theta wave (28.71 + 4.56) was higher than the admission (24.51) after 2 weeks (24.51). 8.21), the value of alpha wave (9.39 + 3.52) was lower than admission (11.65 + 4.94). The difference was significant (P0.01) in group.ICGMT and control group, there was no significant difference in skin electrical value, skin temperature, beta wave value and SMR wave value (P0.05). (3) immune cells Ig A, Ig G, Ig M, NK comparison: 2 weeks after ICGMT group intervention (2.55 + 3.) 23,14.87+4.27,1.48 + 0.13,0.35 + 0.47) was higher than that of admission (2.29 + 2.10,10.43+3.14,1.01 + 0.88,0.21 + 0.23), and the difference was significant (P0.05). After 2 weeks in the control group, Ig A, Ig G, Ig M, and NK cell values were lower than those of the admission (2.18 + and 2.18 + 0.21), and the difference was significant 0.05).4. clinical qualitative evaluation of most patients with middle and late stage lung cancer think that the computer game version of open-minded treatment is lively and interesting, close to life, reproduces the patient's innermost inner entanglement; rich philosophic, through the transfer of easy understanding to the patient, correct their distorted cognition and extreme ideas; simple operation, suitable for different age levels. Make patients suffer from different ages. No matter in heart and body condition, psychological coping, adjustment way, quality of life and physiological index, the patient is well received. Conclusion: the individual computer game version of open-minded treatment is a standard, vivid, practical and effective psychological intervention, helping the patients develop a positive and optimistic attitude towards life and achieve an open-minded life. This treatment has a positive effect on improving the psychosomatic condition, psychological response, adjustment mode, social function and quality of life for patients with middle and advanced lung cancer, and also has relatively large improvement on the patient's physiological index, especially the immune function. As an effective psychological intervention formula, it helps the patients with lung cancer improve the quality of life. The post cancer clinical work provides a strong empirical basis.
【學(xué)位授予單位】：廣東藥科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R734.2

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