本文選題：思勝恐 + 圍手術(shù)期�。� 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探析思勝恐療法對圍手術(shù)期乳腺癌患者心理應(yīng)激的影響,從而進(jìn)一步探索完善圍手術(shù)期乳腺癌患者心理治療的方法,以促進(jìn)其術(shù)后恢復(fù),改善預(yù)后。方法:選擇30例符合納入標(biāo)準(zhǔn)的需行乳腺癌改良根治術(shù)治療的患者,按隨機原則分成2組:對照組15例,只實施常規(guī)治療;實驗組15例,在常規(guī)治療的同時加以思勝恐療法,對兩組患者進(jìn)行臨床觀察。分別在治療前后通過觀察癥狀學(xué)指標(biāo):癥狀自評量表(SCL-90)、應(yīng)激癥狀臨床評分的改善情況,以及治療前、術(shù)后第1天、第4天、第7天進(jìn)行比較,觀察血液學(xué)指標(biāo):血清皮質(zhì)醇(Cor)、一氧化氮(NO)、超氧化物歧化酶(SOD)的變化,來評估臨床療效。結(jié)果:1.實驗組在治療后與對照組相比,總體心理狀況(總分)均明顯改善,在其他各項得分方面(總均分、陽性項目數(shù)、軀體化、強迫癥狀、人際關(guān)系、抑郁、焦慮、敵對、恐怖、偏執(zhí)、精神及其他因子得分)均顯著降低,有統(tǒng)計學(xué)意義(P0.05)。2.實驗組與對照組心理應(yīng)激癥狀臨床評分在治療后總分及各項目得分(飲食、睡眠,皮膚,肌肉關(guān)節(jié),注意力,生活、精神質(zhì)量)比較,兩組有統(tǒng)計學(xué)意義(P0.05)。3.實驗組與對照組相比,手術(shù)后第1、4天NO、SOD無統(tǒng)計學(xué)意義(P0.05),而在術(shù)后第7天二者均有顯著性差異(P0.05)。實驗組和對照組在手術(shù)后第1天的Cor比較無明顯統(tǒng)計學(xué)差異,而在手術(shù)后4、7天Cor的比較均有差異性(P0.05)。結(jié)論:1.思勝恐療法對于圍手術(shù)期乳腺癌患者不良情緒有著改善作用,但術(shù)后短時間內(nèi)與手術(shù)、麻醉等刺激相比,可能影響程度仍不及此類因素。需要改進(jìn)治療的實施方法,有待更進(jìn)一步的探究。2.圍手術(shù)期乳腺癌患者常規(guī)治療期間加以思勝恐療法,能夠進(jìn)一步的加強心理治療效果,具有一定的臨床價值。同時思勝恐療法通過改善患者的心理應(yīng)激水平后,能提高患者的免疫力,為圍手術(shù)期乳腺癌患者心理干預(yù)方法提供了新的實踐方向。
[Abstract]:Objective: to explore the effect of Sisheng terrorism therapy on psychological stress in patients with perioperative breast cancer, so as to improve the psychological treatment of perioperative breast cancer patients, so as to promote the postoperative recovery and improve the prognosis of patients with breast cancer.Methods: thirty patients who met the inclusion criteria were divided into two groups: control group (n = 15), control group (n = 15), control group (n = 15), and experimental group (n = 15).Two groups of patients were observed.The symptom indexes were observed before and after treatment: symptom Checklist-90 (SCL-90), the improvement of clinical score of stress symptoms, and the comparison before and after treatment on the 1st, 4th and 7th day after treatment.The changes of serum cortisol Corn, nitric oxide (no) and superoxide dismutase (SOD) were observed to evaluate the clinical efficacy.The result is 1: 1.Compared with the control group, the total psychological status (total score) of the experimental group was significantly improved, and the other scores (total mean score, positive items, somatization, obsessive symptoms, interpersonal relationships, depression, anxiety, hostility, terror) were significantly improved after treatment.The scores of paranoid ideation, mental and other factors were significantly lower than that of P0. 05 and 2. 2.The clinical scores of psychological stress symptoms in the experimental group and the control group were significantly higher than those in the control group (P 0.05) and the scores of each item (diet, sleep, skin, muscle and joint, attention, life, mental quality) were significantly higher than those in the control group (P < 0.05).Compared with the control group, there was no significant difference between the experimental group and the control group on the 4th day after operation (P 0.05), but there was a significant difference between the two groups on the 7th day after operation (P 0.05).There was no significant difference in Cor between the experimental group and the control group on the first day after operation, but there was significant difference in the comparison of Cor between the experimental group and the control group on the 7th day after operation (P 0.05).Conclusion 1.Sisheng terrorism therapy can improve the bad mood of breast cancer patients in perioperative period, but the influence degree of these factors is still lower than that of surgery, anesthesia and other stimuli in a short period of time after operation.Need to improve the treatment of the implementation of the method, to be further explored. 2.During the routine treatment of breast cancer patients in perioperative period, it can further strengthen the effect of psychotherapy and has certain clinical value.At the same time, Shisheng terrorism therapy can improve the immunity of patients with breast cancer by improving the level of psychological stress, which provides a new practical direction for the psychological intervention of patients with breast cancer during perioperative period.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.9

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