专题:康复医学的时代发展与中国策略

恶性肿瘤患者住院期间的情绪问题及康复策略

  • 石秀换 ,
  • 邢舴 ,
  • 曹冉华 ,
  • 李超 ,
  • 李瑶
展开
  • 内蒙古医科大学附属医院肿瘤内科,呼和浩特 010050
石秀换,主任医师,研究方向为肿瘤内科治疗与辅助治疗,电子信箱:shixiuhuan2023@163.com

收稿日期: 2023-03-30

  修回日期: 2023-07-10

  网络出版日期: 2023-12-21

基金资助

内蒙古医科大学科技百万联合项目(YKD2018KJBW(LH)032);内蒙古医科大学研究生教育教学改革研究实践项目 (YJG20191013215);内蒙古医科大学附属医院重点实验室开放基金项目(2022NYFYSYS011)

Emotional issues and rehabilitation strategies of malignant tumor patients during hospitalization

  • SHI Xiuhuan ,
  • XING Ze ,
  • CAO Ranhua ,
  • LI Chao ,
  • LI Yao
Expand
  • Department of Oncology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

Received date: 2023-03-30

  Revised date: 2023-07-10

  Online published: 2023-12-21

摘要

恶性肿瘤患者极易出现不良情绪和心理障碍,影响其转归和预后。中医认为情志为病是肿瘤发生的原因之一,心理康复是临床工作中需重点关注的环节。以恶性肿瘤患者为研究对象,比较了常规心理干预与常规心理干预结合中医综合康复(八段锦、芳香疗法)对患者住院前后情绪、睡眠、心理健康及肿瘤免疫功能的影响,评定指标包括:蒙哥马利抑郁评分(MADRS)、焦虑自评量表(SAS)评分、匹兹堡睡眠质量指数(PSQI)、领悟社会支持量表(PSSS)评分、外周血CD4+、CD8+、CD4+CD25+T淋巴细胞计数、肿瘤坏死因子-α(TNF-α)及干扰素-γ(IFN-γ)水平。结果显示,综合康复组出院时的MADRS下降程度、CD4+CD25+T细胞计数的降低程度大于对照组,SAS及PSQI升高程度小于对照组,PSSS的提高程度显著大于对照组,外周血TNF-α的降低程度小于对照组。说明中医综合康复策略有利于改善恶性肿瘤患者抑郁、焦虑、睡眠质量、社会支持感受能力以及抗肿瘤免疫功能。

本文引用格式

石秀换 , 邢舴 , 曹冉华 , 李超 , 李瑶 . 恶性肿瘤患者住院期间的情绪问题及康复策略[J]. 科技导报, 2023 , 41(23) : 72 -78 . DOI: 10.3981/j.issn.1000-7857.2023.23.010

Abstract

Patients with malignant tumors are highly susceptible to adverse emotions and psychological disorders, which can affect their recurrence and prognosis. Traditional Chinese medicine believes that emotional illness is one of the causes of tumors and psychological rehabilitation is a key aspect that needs to be concerned in clinical work. This study compares the effects of conventional psychological intervention and traditional Chinese medicine comprehensive rehabilitation (Baduanjin, aromatherapy) combined with conventional psychological intervention on the emotions, sleep, mental health, and tumor immune function of patients with malignant tumors before and after hospitalization. The indicators include Montgomery depression scale (MADRS), self rating anxiety scale (SAS), Pittsburgh sleep quality index (PSQI), perceived social support scale (PSSS) score, peripheral blood CD4+, CD8+, CD4+CD25+T lymphocyte count, tumor necrosis factor- α(TNF- α)and interferon- γ(IFN- γ)level. The results show that the decreases in MADRS and CD4+CD25+T cell count at discharge in the comprehensive rehabilitation group are greater than thost in the control group, while the increases in SAS and PSQI are lower than those in the control group. The increase in PSSS is significantly greater than that in the control group, and the degree of reduction peripheral blood TNF- α is smaller than that of the control group. It is concluded that the comprehensive rehabilitation strategy of traditional Chinese medicine is beneficial for improving depression, anxiety, sleep quality, social support perception ability, and anti-tumor immune function in patients with malignant tumors.

参考文献

[1] 曹毛毛, 陈万青 . 中国恶性肿瘤流行情况及防控现状[J]. 中国肿瘤临床, 2019(3): 5.
[2] Zeng H, Chen W, Zheng R, et al. Changing cancer survival in China during 2003-15: A pooled analysis of 17 population-based cancer registries[J]. Lancet Glob Health, 2018, 6(5): e555-e567.
[3] 徐国君, 孙艳, 刘鸿雁, 等. 心理干预对肿瘤患者康复期的实施价值探讨[J]. 中国实用医药, 2020, 15(26): 188-190.
[4] 刘朝霞. 心理护理在恶性肿瘤患者康复过程中的应用价值[J]. 肿瘤基础与临床, 2020, 33(2): 4.
[5] 吴整军 . 中医情志为病论与肿瘤发病、康复中精神心理因素的作用[J]. 中国组织工程研究, 2004, 8(27): 5950-5951.
[6] 张皓, 黎晓静 . 中医外治法对新冠肺炎疫期公众不良情绪的调适作用[J]. 江西中医药, 2022, 53(1): 77-80.
[7] 周璇梓, 王倩 . 心理干预对恶性肿瘤术后患者心理与睡眠康复效果评价[J]. 世界睡眠医学杂志, 2021, 8(1): 87.
[8] 石小翠, 曹冬花, 李佳, 等. 三种香茅精油的化学成分及体外抗氧化和抗炎活性评价[J]. 食品工业科技, 2021, 42(21): 83-90.
[9] Soron T R. Validation of Bangla Montgomery Asberg depression rating scale(MADRSB) [J]. Asian Journal of Psychiatry, 2017, 28: 41-46.
[10] 段泉泉, 胜利 . 焦虑及抑郁自评量表的临床效度[J]. 中国心理卫生杂志, 2012, 26(9): 676-679.
[11] Nierenberg A A, Adler L A, Peselow E, et al. Trazodone for antidepressant-associated insomnia[J]. Asian Journal of Psychiatry, 1994, 151(7): 1069-1072.
[12] 张帆, 朱树贞, 邓平基. 领悟社会支持量表在国内住院病人社会支持研究中的应用评价[J]. 护理研究, 2018, 32(13): 2048-2052.
[13] Niedzwiedz C L, Knifton L, Robb K A, et al. Depression and anxiety among people living with and beyond cancer: A growing clinical and research priority[J]. BMC Cancer, 2019, 19(1): 943.
[14] 姚晚侠, 李明众, 刘孜, 等 . 肿瘤患者的情绪障碍及生活事件调查[J]. 中国康复理论与实践, 2007(5): 482-483.
[15] 王逸如, 黄华兰, 应文娟, 等 . 恶性肿瘤与良性疾病住院患者焦虑抑郁状况及影响因素[J]. 南方护理学报, 2004(4): 47-49.
[16] 尤艳, 郑晓缺, 王林, 等 . 骨肿瘤患者术后复发的心理状况及心理康复的研究分析[J]. 中华肿瘤防治杂志, 2016, 23(2): 383-384.
[17] 梁利苹 . 多种传统保健体育项目对中老年人心理情绪及免疫功能的影响[J]. 中国老年学杂志, 2018, 38(2): 418-420.
[18] 李爱军, 姚淳, 邝春燕, 等 . 耳穴压豆联合八段锦对新型冠状病毒肺炎康复期患者焦虑抑郁的影响[J]. 护理学报, 2021, 28(6): 48-52.
[19] 李慧婷, 李远辉, 任桂林, 等 . 中药挥发油防治情志疾病的研究现状及前景展望[J]. 中草药, 2019(17): 4031-4040.
[20] Ozkaraman A, Dügüm Z, zen Ylmaz H, et al. Aromatherapy: The effect of lavender on anxiety and sleep quality in patients treated with chemotherapy[J]. Clinical Journal of Oncology Nursing, 2018, 22(2): 203-210.
[21] Donelli D, Antonelli M, Bellinazzi C, et al. Effects of lavender on anxiety: A systematic review and meta-analysis[J]. Phytomedicine, 2019, 65: 153099.
[22] 郁亚波, 许丰, 马刚, 等 . 芳香治疗改善腹部手术后患者的睡眠质量以及焦虑状态的研究[J]. 中华全科医学, 2017(11): 1928-1931.
[23] 梁敏, 肖艳红, 刘艳灵, 等 . 调节性 T 细胞在抗肿瘤免疫及治疗中的研究进展[J]. 癌变·畸变·突变, 2022, 34(6): 481-484.
文章导航

/