心理行为干预改善肠易激综合征患者的生活质量  

Effects of psychological behavior interventions on the quality of life in patients with irritable bowel syndrome

作　　者：王玉霞[1] 许春进[1] 杨帆[1] 陈玉龙[2] 

机构地区：[1]商丘市第一人民医院消化科,河南省商丘市476100 [2]郑州大学第一附属医院消化科,河南省郑州市450052

出　　处：《中国临床康复》2005年第20期70-71,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨心理行为干预对肠易激综合征患者生活质量的影响。方法:选择2003-08/2004-04在商丘市第一人民医院消化内科门诊及住院的肠易激综合征患者59例,男25例,女34例。受试者均能读懂或经讲解理解问卷内容且自愿接受心理干预。心理干预组:在常规对症治疗的基础上给予心理干预治疗。于入组时、干预10周后采用症状自评量表(由90个陈述句构成,被测者以最近1周的实际情况分4级进行回答,1为无,2为轻度,3为较重,4为严重,以9个因子躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病)进行有关心理卫生状况的评价。以汉化的肠易激综合征生活质量调查问卷(包括34个条目,分为8个方面,既烦躁不安、冲突行为、身体角色、健康忧虑、饮食限制、社会反应、异性概念、家庭关系。每一方面得分通过转换使其值为0～100,得分越高生活质量越好)评估患者精神状况及生活质量。结果:按意向处理分析,进入结果分析肠易激综合征患者59例,均完成问卷调查。①心理干预组干预前症状自评量表各因子分及总分均明显高于中国常模(2.560～3.015,P<0.05),干预后症状自评量表总分及各因子与中国常模比较无明显差异(P>0.05)。心理干预组干预后症状自评量表除强迫因子外,其余因子分及总分均明显低于干预前(t=2.425～3.250,P<0.05)。②心理干预组干预后肠易激综合征生活质量调查问卷各因子分和总分均明显高于干预前(t=2.103～3.451,P<0.05)。结论:肠易激综合征患者存在明显精神症状;心理行为干预可改善其精神状况,提高肠易激综合征患者生活的质量。AIM：To investigate the influence of psychological behavior interventions on the quality of life in patients with irritable howel syndrome.METHODS： Fifty-nine patients with irritable bowel syndrome （25 males and 34 females） were selected from the patients treated or hospitalized in the Department of Gastroenterology, Shangqiu First People＇s Hospital between August 2003 and April 2004. All the subjects could understand the contents of the questionnaire by themselves or after instruction, they received psychological interventions voluntarily. Patients in the psychological intervention group were treated with psychological interventions on the basis of regular treatment according to the symptoms; Before intervention and 10 weeks after intervention, the mental health status of the patients were assessed with the symptom checklist-90 （consisted of 90 statements,the testees should answer the questionnaires according to the actual conditions in the latest 1 week by 4 degrees： 1 as none, 2 as mild, 3 as moderate, 4 as severe; The nine factors were somatization,obsessioncompulsion, interpersonal sensitivity, depression, anxiety, hostility,phobic anxiety, paranoid ideation and psychotieism）; The mental status and quality of life in the patients were evaluated with the Chinese assimilated quality of life inventory for irritable bowel syndrome （including 34 items,which consisted of 8 aspects：dysphoria, conflict behavior, body role, healthy apprehension, dietary restriction, society reaction, heterology concept,family relation; The score of each aspect was transferred to 0 to 100 points;The higher the score, the better their quality of life）.RESULTS： According to intention-to-treat analysis, all the 59 patients with irritable bowel syndrome finished the questionnaire investigation, and were involved in the analysis of results. ① The factor scores and the total score of symptom checklist-90 before intervention were obviously higher in the psychological intervention group than Chinese norm （t=2.560 to

关 键 词：结肠疾病 功能性/心理学 生活质量 精神病状态评定量表 患者生活质量 肠易激综合征 心理行为干预 心理干预治疗 症状自评量表 第一人民医院 心理卫生状况 

分 类 号：R459.5[医药卫生—治疗学] R574.4[医药卫生—临床医学]