调神治癌方联合心理干预治疗卵巢癌术后合并抑郁临床研究  

Clinical Study of Tiaoshen Zhiai Formula(调神治癌方)Combined with Psychological Intervention in Treatment of Depression After Ovarian Cancer Surgery

作　　者：姚嘉良 程玺 田建辉[1,2] 从恩朝 杨蕴 陆鑫熠[1,2] 张龙 王子良 吴彦 YAO Jialiang;CHENG Xi;TIAN Jianhui;CONGEnchao;YANG Yun;LU Xinyi;ZHANG Long;WANG Ziliang;WU Yan(Clinical Oncology Center,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Institute of Traditional Chinese Medicine Oncology,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai 200071,China;Depart-ment of Gynecological Oncology,Minhang Branch,Oncology Hospital,Fudan University,Shanghai 200240,China;Mental Health Center,College of Medicine,Shanghai Jiaotong University,Shanghai 200030,China;Scientific Research Bureau,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院肿瘤临床医学中心,上海200071 [2]上海市中医医院中医肿瘤研究所,上海200071 [3]复旦大学附属肿瘤医院闵行分院妇瘤科,上海200240 [4]上海交通大学医学院附属精神卫生中心,上海200030 [5]上海中医药大学附属市中医医院科研处,上海200071

出　　处：《山东中医杂志》2024年第11期1188-1195,共8页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:82274278);国家自然科学基金青年科学基金项目(编号:82305069);第五批全国中医临床优秀人才研修项目(批文号:国中医药人教函〔2022〕1号);上海申康医院发展中心第二轮《促进市级医院临床技能与临床创新三年行动计划》研究型医师创新转化能力培训项目(编号:SHDC2023CRD01);上海市中医神志病研究所2023年度开放科研项目(编号:SZB2023102);2023年度上海中医药大学科技发展项目(编号:23KFL096);上海市静安区卫生科研课题(编号:2023QT02)。

摘　　要：目的:观察调神治癌方联合心理干预的“调神治癌”疗法治疗卵巢癌术后合并抑郁状态患者的临床疗效。方法:采用前瞻性研究设计方法,根据纳排标准筛选入组90例卵巢癌术后合并抑郁状态的患者,按随机数字表法分为调神治癌方联合心理干预的干预组和常规调神治癌方为主的对照组,两组各45例,干预4周为1个周期,共干预3个周期。两组患者分别于0、12周评估抑郁症筛查量表(PHQ-9)、广泛性焦虑量表(GAD-7)、多维疲劳量表(MFI-20)、匹兹堡睡眠指数(PSQI)量表及Karmofsky功能状态(KPS)评分,并于干预前后检测血常规、肝肾功能、肿瘤标志物糖类抗原125(CA125)。结果:治疗后干预组患者CA125水平显著低于对照组(P<0.05)。治疗后两组患者MFI-20疲劳评分均较前有所降低:其中疲劳总分、体力疲劳评分、脑力疲劳评分、动力下降评分、活动减少评分等均较治疗前明显下降(P<0.01);治疗后,干预组患者疲劳总分、体力疲劳评分、脑力疲劳评分以及活动减少评分,均显著低于对照组(P<0.05)。治疗后两组患者PSQI睡眠评分比较,对照组患者在睡眠障碍及日间功能障碍评分两方面均较治疗前显著减少(P<0.05),干预组患者在睡眠质量、催眠药物、睡眠障碍、睡眠效率以及PSQI总分5个方面均较治疗前下降(P<0.05);与对照组相比,治疗后干预组睡眠质量、睡眠时间、催眠药物使用、睡眠障碍、睡眠效率、日间功能障碍以及PSQI总分均显著优于对照组(P<0.05)。治疗后干预组患者抑郁和焦虑以及KPS生活质量评分改善也显著优于对照组(P<0.05)。结论:调神治癌方联合心理干预的“调神治癌”疗法能够改善患者抑郁、焦虑等负性心理状态,改善失眠、疲乏等多项临床症状,提高综合疗效。Objective:To observe the clinical effect of“regulating spirit to treat cancer”therapy in which Tiaoshen Zhiai Formula(调神治癌方)is combined with psychological intervention in the treatment of ovarian cancer patients with depression after surgery.Methods:A total of 90 ovarian cancer patients with depression after surgery were included according to the inclusion and exclusion criteria,and by using a random number table were divided into the intervention group treated with Tiaoshen Zhiai Formula combined with psychological treatment and the control group treated with routine Tiaoshen Zhiai Formula treatment,45 patients in each group.One treatment course lasted for 4 weeks,and the patients were treated for 3 courses.The scores of PHQ9 depression scale,GAD-7 anxiety scale,multidimensional fatigue inventory-20(MFI-20),PSQI sleep scale and KPS scale were evaluated in both groups at the 0th and 12th weeks,and the blood routine test,liver and kidney function,and cancer antigen 125(CA125)were detected before and after the intervention.Results:After treatment,the level of CA125 in the intervention group was significantly lower than that in the control group(P<0.05).The MFI-20 fatigue scores of the two groups were lower than those before treatment,among which the total fatigue score,physical fatigue score,mental fatigue score,decreased power score,and decreased activity score were significantly decreased(P<0.01).After treatment,the total score of fatigue,physical fatigue,mental fatigue and reduced activity scores in the intervention group were significantly lower than those in the control group(P<0.05).The comparison of PSQI sleep scores between the two groups after treatment showed that the scores of sleep disorders and daytime dysfunction in the control group were significantly lower than those before treatment(P<0.05),and scores of sleep quality,hypnotic drugs,sleep disorders,sleep efficiency and PSQI total score in the intervention group were significantly lower than those before treatment(P<0.05).The improveme

关 键 词：调神治癌 抑郁 卵巢癌术后 心理治疗 失眠 临床研究 

分 类 号：R273[医药卫生—中西医结合]