舒肝养心扶正法联合正念干预治疗肺癌术后患者抑郁状态的临床效果  

Clinical effect of the combined treatment of Shuganyangxin Fuzheng Method and mindfulness intervention in the treatment of depression after lung cancer surgery

作　　者：秦若琰 沈丽萍[1] 姜怡[1] 杨晓风 陈晓云[2] 刘苓霜[1] Qin Ruoyan;Shen Liping;Jiang Yi;Yang Xiaofeng;Chen Xiaoyun;Liu Lingshuang(Department of Oncology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Department of Rheumatology and Immunology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院肿瘤科,上海200032 [2]上海中医药大学附属龙华医院风湿免疫科,上海200032

出　　处：《中国肿瘤临床与康复》2024年第8期478-487,共10页Chinese Journal of Clinical Oncology and Rehabilitation

基　　金：上海市中医肿瘤临床医学研究中心(21MC1930500);国家中医药管理局高水平中医药重点学科建设项目(中医肿瘤病学,ZYYZDXK-2023063);上海市卫生健康委员会科研项目(20214Y0375)。

摘　　要：目的探讨舒肝养心扶正法联合正念干预治疗肺癌术后患者抑郁状态的临床疗效。方法将64例上海中医药大学附属龙华医院2018年5月至2019年3月收治的肺癌术后抑郁状态患者按随机数字表法分为治疗组和对照组,每组32例,对照组给予舒肝养心扶正法中药治疗,治疗组在舒肝养心扶正法中药治疗的基础上联合正念干预,两组疗程均为3个月,观察治疗组和对照组患者的临床疗效、中医证候积分、Zung抑郁自评量表(SDS)积分、汉密尔顿抑郁量表(HAMD)积分、肺癌治疗功能评价系统(FACT-L)积分、血清T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))指标的变化情况。结果治疗组和对照组患者的临床总有效率分别为93.8%(30/32)和75.0%(24/32),治疗组明显优于对照组(χ^(2)=13.55,P=0.001)。治疗后,治疗组和对照组患者的中医证候积分分别为(3.22±1.58)分和(5.44±1.37)分,均较治疗前明显降低(t值分别为11.38和12.90,均P<0.001);且治疗组中医证候积分明显低于对照组(t=-6.01,P<0.001)。治疗后,治疗组和对照组患者的SDS积分分别为(27.88±3.34)分和(43.88±5.86)分,均较治疗前明显降低(t值分别为14.05和7.86,均P<0.001);且治疗组SDS积分明显低于对照组(t=-13.42,P<0.001)。治疗后,治疗组和对照组患者的HAMD积分分别为(11.38±3.55)分和(18.56±2.12)分,均较治疗前明显降低(t值分别为15.64和5.74,均P<0.001);且治疗组HAMD积分明显低于对照组(t=-9.84,P<0.001)。治疗后,治疗组和对照组FACT-L总积分及身体状况、社会和家庭状况、情绪状况、功能状况、附加的关注领域积分均较治疗前明显升高(均P<0.001);且治疗组除社会和家庭状况外,FACT-L总积分及其他领域积分均明显高于对照组(均P<0.001)。治疗后,治疗组患者CD3^(+)T细胞和CD4^(+)T细胞的比例较治疗前明显升高(均P<0.05),但CD8^(+)T细胞比例、CD4^(+)/CD8^(+)T细胞与治疗前比较,差异无统计学意义(均P>0.05);对照Objective To investigate the clinical efficiency of Shuganyangxin Fuzheng method combined with mindfulness intervention on depression after lung cancer surgery.Methods From May 2018 to March 2019,a total of sixty-four patients with depression after lung cancer surgery were randomly divided into the treatment group and the control group,32 cases in each group.The control group was treated with Chinese medicine by using Shuganyangxin Fuzheng Method,the treatment group was treated with mindfulness intervention based on the treatment for the control group,with a course of 3 months.The clinical efficacy and the changes of TCM syndrome scores,Zung Depression Self-Assessment(SDS)scores,Hamilton Depression Scale(HAMD)scores,Function Assessment to Cancer Therapy-Lung(FACT-L)scores,levels of T lymphocyte subsets(CD3^(+)、CD4^(+)、CD8^(+))were observed.Results sThe overall clinical effective rates were 93.8%(30/32)in the treatment group and 75.0%(24/32)in the control group,and the clinical efficacy of the treatment group was better than that of the control group(χ^(2)=13.55,P=0.001).After treatment,the TCM syndrome scores of the treatment group and the control group were(3.22±1.58)and(5.44±1.37)points,which were significantly lower than before treatment(t=11.38,t=12.90,all P<0.001),and the TCM syndrome score of the treatment group was significantly lower than that of the control group(t=-6.01,P<0.001).After treatment,the SDS scores of the treatment group and the control group were(27.88±3.34)and(43.88±5.86)points,which were significantly lower than before treatment(t=14.05,t=7.86,all P<0.001),and the SDS score of the treatment group was significantly lower than that of the control group(t=-13.42,P<0.001).After treatment,the HAMD scores of the treatment group and the control group were(11.38±3.55)and(18.56±2.12)points,which were significantly lower than before treatment(t-15.64,t=5.74,all P<0.001),and the HAMD score of the treatment group was significantly lower than that of the control group(t=-9.84,P<0.001).After

关 键 词：肺肿瘤 抑郁 舒肝养心扶正法 正念干预 临床疗效 

分 类 号：R273[医药卫生—中西医结合]