本文選題：乳腺癌　切入點(diǎn)：音樂(lè)治療　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:乳腺癌是女性最常見(jiàn)的惡性腫瘤之一,手術(shù)治療是乳腺癌患者的最主要治療手段。然而,手術(shù)不僅使女性的軀體形象損毀,同時(shí)術(shù)后心身失衡狀態(tài)常常困擾患者,使之產(chǎn)生不同程度的生理和心理痛苦。本研究旨在中醫(yī)辨證論治的理論指導(dǎo)下運(yùn)用中醫(yī)音樂(lè)治療改善乳腺癌術(shù)后患者肝郁狀態(tài),觀察辨證施樂(lè)對(duì)乳腺癌術(shù)后肝郁的臨床療效,初步探討中醫(yī)辨證施樂(lè)對(duì)乳腺癌術(shù)后肝郁的影響及優(yōu)勢(shì),并揭示其在臨床上運(yùn)用的意義。方法:本研究采用前瞻性隨機(jī)對(duì)照試驗(yàn)將64例符合納入標(biāo)準(zhǔn)的術(shù)后乳腺癌肝郁患者按1:1的比例隨機(jī)分為治療組和對(duì)照組,即辨證施樂(lè)組和健康教育組,每組32例。治療組每天接受個(gè)體音樂(lè)療法至少30分鐘,每3周接受一次集體音樂(lè)療法。對(duì)照組每3周進(jìn)行健康教育宣講。共觀察3個(gè)月。分別評(píng)價(jià)治療前后乳腺癌患者的自我評(píng)定抑郁量表(SDS)評(píng)分,自我評(píng)定焦慮量表(SAS)評(píng)分和乳腺癌患者生命質(zhì)量測(cè)定表(FACT-B中文版4.0)評(píng)分。以SPSS17.0軟件處理數(shù)據(jù),分析實(shí)驗(yàn)結(jié)果,得出結(jié)論。結(jié)果:一、基線比較:辨證施樂(lè)組和健康教育組患者的一般資料及治療前SDS、SAS、FACT-B三個(gè)量表評(píng)分與健康宣講組無(wú)顯著性差異。(乃0.05)二、同組治療前后療效對(duì)比:經(jīng)治療,兩組患者的抑郁、焦慮自評(píng)量表評(píng)分以及生命質(zhì)量測(cè)定評(píng)分均有改善,與治療前比較差異均有統(tǒng)計(jì)學(xué)意義。(P0.05)三、組間治療后療效比較:辨證施樂(lè)組的SDS評(píng)分明顯降低,與對(duì)照組相比差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。辨證施樂(lè)組的SAS評(píng)分及乳腺癌生命質(zhì)量測(cè)定量表(FACT-B)評(píng)分明顯升高,但對(duì)比對(duì)照組無(wú)統(tǒng)計(jì)學(xué)意義。(P0.05)四、分層比較:在FACT-B各項(xiàng)成分評(píng)定方面,兩組治療前后對(duì)比差異存在統(tǒng)計(jì)學(xué)意義。FACT-B各項(xiàng)數(shù)據(jù)表明治療組與對(duì)照組治療后,各項(xiàng)評(píng)分均升高,在生理狀況、情感狀況、功能狀況、附加關(guān)注這四項(xiàng)中具有明顯的統(tǒng)計(jì)學(xué)意義(P0.05),而在社會(huì)/家庭狀況無(wú)顯著統(tǒng)計(jì)學(xué)差異(P0.05)。說(shuō)明辨證音樂(lè)治療和健康教育在改善患者的生理狀況、情感狀況、功能狀況及附加關(guān)注均有明顯療效,且辨證音樂(lè)治療效果更佳。五、整個(gè)研究過(guò)程中兩組沒(méi)有不良反應(yīng)出現(xiàn)。結(jié)論:一、中醫(yī)辨證論治的理論指導(dǎo)下的個(gè)體和團(tuán)體音樂(lè)治療相結(jié)合的方式,能夠有效地緩解手術(shù)后的乳腺惡性腫瘤患者的抑郁、焦慮情緒,并有效提高其生命質(zhì)量。二、中醫(yī)辨證音樂(lè)治療對(duì)乳腺癌術(shù)后肝郁狀態(tài)的患者具有良好的調(diào)整作用,效果優(yōu)于健康教育宣講,值得推廣。三、中醫(yī)辨證音樂(lè)治療能有效提高乳腺癌術(shù)后患者的生命質(zhì)量,尤其是在生理狀況、功能狀況、心理狀況及乳腺癌附加關(guān)注這四個(gè)方面。
[Abstract]:Objective: breast cancer is one of the most common malignant tumors in women. Surgical treatment is the main treatment for breast cancer patients. The purpose of this study was to improve the state of liver depression in patients with breast cancer by using music therapy under the guidance of the theory of syndrome differentiation and treatment, and to observe the clinical effect of syndrome differentiation Xerox on liver depression after breast cancer operation. To explore the effect and advantage of Xerox on liver depression after operation of breast cancer. Methods: in this study, 64 patients with postoperative breast cancer liver depression were randomly divided into treatment group and control group according to 1:1 ratio by prospective randomized controlled trial. That is, the syndrome differentiation Xerox group and the health education group, 32 cases in each group. The treatment group received individual music therapy for at least 30 minutes per day. Group music therapy was given every 3 weeks. The control group was given health education every 3 weeks and observed for 3 months. The self-rated depression scale (SDS) scores of breast cancer patients were evaluated before and after treatment. Self-rating anxiety scale (SAS) score and quality of life (FACT-B) score of breast cancer patients. The data were processed with SPSS17.0 software, and the results were analyzed, and the results were as follows: 1. Baseline comparison: the general data of patients in Xerox syndrome differentiation group and health education group and the scores of SDSSASFACT-B before treatment were not significantly different from those in health education group (0.05). The curative effect of the same group was compared before and after treatment: after treatment, depression was found in the two groups. The scores of self-rating anxiety scale and quality of life test were improved, and the difference was statistically significant compared with that before treatment (P 0.05). Compared with the treatment group, the SDS score of the syndrome differentiation Xerox group was significantly lower than that of the control group. Compared with the control group, the difference was statistically significant (P 0.05). The SAS score and the FACT-B score of the syndrome differentiation Xerox group were significantly higher than those of the control group, but there was no significant difference between the control group and the control group (P 0.05). There were significant differences between the two groups before and after treatment. The data of FACT-B showed that the scores of the treatment group and the control group were increased after treatment. Additional attention to these four items has significant statistical significance (P 0.05), but there is no significant difference in social / family status (P 0.05). It shows that music therapy based on syndrome differentiation and health education can improve the physiological and emotional status of patients. Functional status and additional attention have obvious curative effect, and the effect of music treatment based on syndrome differentiation is better. Fifthly, there were no adverse reactions in the two groups during the whole study. Conclusion: 1. The combination of individual and group music therapy under the guidance of the theory of TCM differentiation of symptoms and signs can effectively relieve the depression and anxiety of patients with breast cancer after surgery, and effectively improve their quality of life. Music therapy based on TCM syndrome differentiation has a good adjusting effect on patients with liver depression after operation of breast cancer, and the effect is better than that of health education, which is worth popularizing. Thirdly, music therapy based on syndrome differentiation of TCM can effectively improve the quality of life of patients with breast cancer after operation. Especially in the physical condition, the function condition, the psychological condition and the breast cancer additional attention these four aspects.
【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】：2017
【分類號(hào)】：R248.9

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本文編號(hào)：1669549