恶性肿瘤患者住院期间的情绪问题及康复策略  

Emotional issues and rehabilitation strategies of malignant tumor patients during hospitalization

作　　者：石秀换[1] 邢舴[1] 曹冉华[1] 李超 李瑶[1] SHI Xiuhuan;XING Ze;CAO Ranhua;LI Chao;LI Yao(Department of Oncology,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院肿瘤内科,呼和浩特010050

出　　处：《科技导报》2023年第23期72-78,共7页Science & Technology Review

基　　金：内蒙古医科大学科技百万联合项目(YKD2018KJBW(LH)032);内蒙古医科大学研究生教育教学改革研究实践项目(YJG20191013215);内蒙古医科大学附属医院重点实验室开放基金项目(2022NYFYSYS011)。

摘　　要：恶性肿瘤患者极易出现不良情绪和心理障碍,影响其转归和预后。中医认为情志为病是肿瘤发生的原因之一,心理康复是临床工作中需重点关注的环节。以恶性肿瘤患者为研究对象,比较了常规心理干预与常规心理干预结合中医综合康复(八段锦、芳香疗法)对患者住院前后情绪、睡眠、心理健康及肿瘤免疫功能的影响,评定指标包括:蒙哥马利抑郁评分(MADRS)、焦虑自评量表(SAS)评分、匹兹堡睡眠质量指数(PSQI)、领悟社会支持量表(PSSS)评分、外周血CD4+、CD8+、CD4+CD25+T淋巴细胞计数、肿瘤坏死因子-α(TNF-α)及干扰素-γ(IFN-γ)水平。结果显示,综合康复组出院时的MADRS下降程度、CD4+CD25+T细胞计数的降低程度大于对照组,SAS及PSQI升高程度小于对照组,PSSS的提高程度显著大于对照组,外周血TNF-α的降低程度小于对照组。说明中医综合康复策略有利于改善恶性肿瘤患者抑郁、焦虑、睡眠质量、社会支持感受能力以及抗肿瘤免疫功能。Patients with malignant tumors are highly susceptible to adverse emotions and psychological disorders,which can affect their recurrence and prognosis.Traditional Chinese medicine believes that emotional illness is one of the causes of tumors and psychological rehabilitation is a key aspect that needs to be concerned in clinical work.This study compares the effects of conventional psychological intervention and traditional Chinese medicine comprehensive rehabilitation(Baduanjin,aromatherapy)combined with conventional psychological intervention on the emotions,sleep,mental health,and tumor immune function of patients with malignant tumors before and after hospitalization.The indicators include Montgomery depression scale(MADRS),self rating anxiety scale(SAS),Pittsburgh sleep quality index(PSQI),perceived social support scale(PSSS)score,peripheral blood CD4+,CD8+,CD4+CD25+T lymphocyte count,tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)level.The results show that the decreases in MADRS and CD4+CD25+T cell count at discharge in the comprehensive rehabilitation group are greater than thost in the control group,while the increases in SAS and PSQI are lower than those in the control group.The increase in PSSS is significantly greater than that in the control group,and the degree of reduction peripheral blood TNF-αis smaller than that of the control group.It is concluded that the comprehensive rehabilitation strategy of traditional Chinese medicine is beneficial for improving depression,anxiety,sleep quality,social support perception ability,and anti-tumor immune function in patients with malignant tumors.

关 键 词：心理康复 中医综合康复 八段锦 芳香疗法 不良情绪 睡眠质量 抗肿瘤免疫功能 

分 类 号：R73[医药卫生—肿瘤]