本文選題：創(chuàng)傷后應(yīng)激障礙 + 眼動脫敏和再加工治療��； 參考：《石河子大學(xué)》2015年碩士論文

【摘要】：目的1.通過對國外已發(fā)表的隨機(jī)對照試驗(yàn)(Randomized Controlled Trial,RCT)進(jìn)行Meta分析,比較眼動脫敏治療和再加工(Eye Movement Desensitization and Reprocessing,EMDR)對創(chuàng)傷后應(yīng)激障礙(Post Traumatic Stress Disorder,PTSD)患者的療效。2.探討EMDR對PTSD的應(yīng)激癥狀、焦慮、抑郁情緒改善情況,為國內(nèi)PTSD患者的治療提供參考依據(jù)。方法1.檢索了數(shù)據(jù)庫Medline,Pubmed,EBSCO,Pro Quest和Cochrane,時(shí)間跨度從1989年至2013年,以EMDR治療PTSD的RCT為研究對象,對納入的文獻(xiàn)進(jìn)行質(zhì)量評價(jià)及相關(guān)數(shù)據(jù)提取,Meta分析使用Cochrane提供的Revman 5.0軟件及Stata 12.0完成。2.目標(biāo)人群為2013年1月至2013年12月期間新疆某醫(yī)院經(jīng)歷創(chuàng)傷事件的住院或門診患者,及目睹親人經(jīng)歷重大創(chuàng)傷或突然亡故的家屬,且滿足PTSD診斷標(biāo)準(zhǔn)者。知情同意后將研究對象隨機(jī)分為EMDR組和對照組,治療開始前及結(jié)束后評價(jià)兩組患者PTSD癥狀、焦慮和抑郁癥狀。結(jié)果1.Meta分析納入10項(xiàng)RCT,共400人。結(jié)果顯示,在改善PTSD患者總體應(yīng)激癥狀上,EMDR優(yōu)于對照組(SMD=-0.98,95%CI:-1.31~-0.66),從PTSD三個(gè)核心癥狀的改善情況上來看,EMDR能有效地減少PTSD再體驗(yàn)(SMD=-1.17,95%CI:-1.59~-0.76)、回避(SMD=-1.65,95%CI:-2.10~-1.21)和易激惹癥狀(SMD=-1.58,95%CI:-2.02~-1.14)。2.本試驗(yàn)共納入54名研究對象,兩組各27人。2×2重復(fù)測量方差分析表明,在CAPS再體驗(yàn)、CAPS回避、CAPS易激惹、CAPS總分、PCL-C再體驗(yàn)方面,分組效應(yīng)、時(shí)間效應(yīng)以及分組和時(shí)間的交互效應(yīng)均有統(tǒng)計(jì)學(xué)意義(P0.05),在排除藥物因素對治療效果的干擾后,EMDR組較對照組在CAPS易激惹和CAPS總分下降明顯,差異有統(tǒng)計(jì)學(xué)意義(分別為P=0.005;P=0.021)。結(jié)論1.EMDR可以有效緩解PTSD患者的總體PTSD癥狀,再體驗(yàn)、回避、易激惹三大核心癥狀;2.無任何心理干預(yù)措施的對照組PTSD患者,其PTSD癥狀及焦慮、抑郁情緒并未隨時(shí)間延長而減輕。
[Abstract]:Objective 1.By Meta analysis of Randomized Controlled Trialator (RCT), a randomized controlled trial published abroad, the efficacy of ophthalmodynamic desensitization and reprocessing Movement Desensitization and reprocessing was compared in patients with post-traumatic stress disorder (PTSD).To explore the improvement of stress symptoms, anxiety and depression in patients with PTSD by EMDR, and to provide reference for the treatment of PTSD patients in China.Method 1.A database named Medlinea Pubmedus Quest and Cochrane was retrieved from 1989 to 2013. The RCT of EMDR treatment for PTSD was used as the research object. The quality evaluation and data extraction of the included literature were carried out. Meta-analysis was completed by Revman 5.0 software provided by Cochrane and Stata 12.0.The target group is the inpatient or outpatient patient who experienced traumatic events in a hospital in Xinjiang from January 2013 to December 2013, and the family members who have seen their relatives experience major trauma or sudden death, and who meet the diagnostic criteria of PTSD.After informed consent, the subjects were randomly divided into EMDR group and control group. The symptoms of PTSD, anxiety and depression were evaluated before and after treatment.Results 1.Meta analysis included 10 items of RCTs, a total of 400 people.A total of 54 subjects were enrolled in the study. The variance analysis of repeated measurement of 2. 2 in each group of 27 people showed that the group effect was found in the CAPS reexperience of caps, the total score of caps easily irritated and the total score of caps.The time effect and the interaction effect of group and time were statistically significant (P 0.05). The total scores of CAPS irritable and CAPS in the EMDR group were significantly lower than those in the control group (P 0. 005, P 0. 021, respectively) after the elimination of the interference of drug factors on the therapeutic effect, and the total score of CAPS in the EMDR group was significantly lower than that in the control group (P 0. 005, P 0. 021).Conclusion 1.EMDR can effectively relieve the overall PTSD symptoms of patients with PTSD, reexperience, avoid, and easily irritate the three core symptoms.The PTSD symptoms, anxiety and depression of PTSD patients without any psychological intervention did not decrease with time.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R473.74

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本文編號：1731316