基于个体化深入访谈探讨精神心理因素对针刺防治中重度季节性变应性鼻炎的影响  

Effects of psychological factors on acupuncture prevention and treatment of moderate and severe seasonal allergic rhinitis based on personalized in-depth interview

作　　者：宋婷婷 赵吉平[2] 刘新桥[1] 杜朔 谭程[2] SONG Tingting;ZHAO Jiping;LIU Xinqiao;DU Shuo;TAN Cheng(Physiotherapy Department,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Acupuncture and Moxibustion Department,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]首都医科大学附属北京安贞医院中医理疗科,北京100029 [2]北京中医药大学东直门医院针灸科,北京100700

出　　处：《中华中医药杂志》2025年第3期1416-1420,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点研发计划项目(No.2019YFC1712200)。

摘　　要：目的:了解精神心理因素对中重度季节性变应性鼻炎患者躯体症状的影响,并探讨其对针刺防治本病思路的启发。方法:采用半结构化访谈法。依据目的性抽样和动态抽样原则选取最具有代表性的受访者进行访谈,根据信息饱和原则估算样本量。最终从参与针刺预防治疗中重度季节性变应性鼻炎的临床试验中选取19名受访者,围绕患者精神情绪、针刺感受、针刺获益等方面进行个体深入访谈。应用主题分析方法对访谈稿进行编码、抽取主题并归纳结论。结果:最终生成“不良情绪与季节变化”“期待效应与医疗选择”“医患关系与疗效”3个主题。“不良情绪与季节变化”包括2个亚主题:春季与焦虑情绪、秋季与悲观情绪,“期待效应与医疗选择”包括2个亚主题:选择偏好、合理的心理预期,“医患关系与疗效”包括2个亚主题:患者受益于良性沟通、医患信任与针刺获益。结论:精神心理因素对中重度季节性过敏性鼻炎患者的影响贯穿发作始终,季节变化对患者精神情绪有不同影响,春季发作的患者情绪更偏向于焦虑,秋季发作的患者情绪则更悲观消极。关注患者的不良情绪,调整合理的医疗期待,构建和谐的医患关系,是提高针刺防治本病疗效的关键所在。Objective:To understand the influence of mental and psychological factors on somatic symptoms of patients with moderate and severe seasonal allergic rhinitis,and to explore its inspiration for acupuncture prevention and treatment of this disease.Methods:The semi-structured interview method was adopted.The most representative interviewees were selected according to the principle of purposeful sampling and dynamic sampling,and the sample size was estimated according to the principle of information saturation.Finally,19 interviewees were selected from the clinical trial of acupuncture prevention and treatment of moderate and severe seasonal allergic rhinitis,and conducted in-depth interviews around the patients'mental mood,acupuncture feelings,acupuncture benefits and other aspects.The topic analysis method is used to encode the interview manuscript,extract the topic and sum up the conclusion.Results:There were three themes:‘bad mood and seasonal change',‘expectation effect and medical choice'‘doctor-patient relationship and curative effect'.‘Bad mood and seasonal change'includes two subthemes:spring and anxiety,autumn and pessimism.‘Expectation effect and medical choice'includes two subthemes:choice preference and reasonable psychological expectation.‘Doctor-patient relationship and curative effect'includes two subthemes:patients benefit from benign communication,doctor-patient trust and acupuncture benefit.Conclusion:The influence of mental and psychological factors on patients with moderate and severe seasonal allergic rhinitis runs through the attack.Seasonal changes have different effects on patients'mental mood.Patients with spring attacks tend to be anxious,while patients with autumn attacks are more pessimistic and negative.Paying attention to the bad mood of patients,adjusting reasonable medical expectations and building a harmonious doctor-patient relationship are the key to improve the efficacy of acupuncture in the prevention and treatment of this disease.

关 键 词：定性研究 季节性变应性鼻炎 中重度 针刺 防治 心身医学 

分 类 号：R246.81[医药卫生—针灸推拿学]