心理行为干预与卵巢癌患者情绪及T淋巴细胞亚群的动态变化研究
|
摘要
目的:
探讨心理行为干预对卵巢癌患者情绪、T淋巴细胞亚群的动态变化规律及干预效果的影响因素,并进一步探讨心理行为干预的最佳时间。
对象与方法:
将符合要求的62名卵巢癌患者随机分为干预组和对照组,每组31名。所有患者均在干预前进行基线测评,包括汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)、简易应对方式问卷、艾森克人格问卷(EPQ)和抽取静脉血用免疫组化碱性磷酸酶桥联酶标法(APAAP)测定T淋巴细胞亚群的功能。干预组心理行为干预持续三个月。心理行为干预第一个月后测定两组患者情绪和T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/ CD8+)的数值。心理干预后第二个月、第三个月只测定两组患者的T淋巴细胞亚群的数值。
结果:
(1)干预组与对照组之间干预前均衡性比较没有显著性差异(P>0.05)(年龄、文化程度、职业、付费方式、肿瘤分期、焦虑、抑郁和T淋巴细胞亚群)。
(2)心理行为干预后,两组焦虑、抑郁总分干预前后差值的比较有显著性差别(P<0.05),干预组的焦虑和抑郁明显减轻。
(3)心理行为干预后焦虑、抑郁变化受人格因素的影响
人格特质中的神经质与干预后抑郁有正相关性,未见神经质与干预后焦虑的相关性。内外向与干预后的焦虑、抑郁得分呈负相关。未见焦虑和抑郁与精神质相关。掩饰性与干预后焦虑有相关性,未见掩饰性与干预后抑郁的相关性。
(4)心理行为干预一个月后CD3+(55.6±4.7/51.7±6.7,F=26.49)、CD4+(33.483±3.462/32.225±4.543 ,F=6.82)有显著性提高;干预2个月后各免疫参数CD3+(60.967±4.262/51.7±6.7,F=145.8)、CD4+(36.483±3.355/32.225±4.543,F=78.08)、CD8+(29.806±3.458/35.290±6.039,F=70.57)、CD4+/ CD8+(1.244±0.218/0.950±0.272,F=102.13)均有显著变化,且干预2个月与3个月相比各免疫参数变化不明显。干预组与对照组相比,不同时间点的各种免疫参数有显著性差异(P<0. 05),干预与时间点见明显的交互作用(P<0. 05),除CD8+(F=2.95,P>0. 05)外,两组患者各免疫参数存在显著性差异。
(5)心理行为干预后T淋巴细胞亚群的变化受人格因素的影响神经质与CD8+正相关,但内外向、神经质和掩饰性与T淋巴细胞亚群(CD3+、CD4+、CD8+及CD4+/ CD8+比值)的相关性不明显。
(6)影响心理行为干预效果的多元回归分析影响焦虑干预效果的因素有消极应对、掩饰性、和文化程度。影响抑郁干预效果的因素有消极应对、内外向和掩饰性。
影响CD3+变化的因素有干预后抑郁。影响CD4+变化的因素有干预前焦虑、年龄、付费方式和干预前抑郁。影响CD8+变化的因素有积极应对方式、付费方式和掩饰性。影响CD4+/ CD8+变化的因素有积极应对、掩饰性和焦虑。
结论:
(1)心理行为干预能明显改善卵巢癌患者的焦虑和抑郁情绪。
(2)心理行为干预可以提高卵巢癌患者T淋巴细胞亚群的免疫功能,且心理干预2个月后患者免疫功能维持在较高水平。
(3)心理行为干预后影响患者焦虑、抑郁及T淋巴细胞亚群的因素各不相同。
Objective:
To examine the effects of psycho-behavioral intervention including educational intervention and progressive muscle relaxation on emotional disorder and the Changes of T lymphocyte subsets in Patients with Ovarian Cancer, and influencing factor, and further explore the best time. Subjects and Methods:
62 inpatients were randomly assigned to either intervention group (n=31) or control group (n=31). All patients completed questionnaires including Hamilton Depression rating Scale(HAMD) ,Hamilton Anxiety rating Scale (HAMA), Simple Coping Style Questionnare, Eysenck Personality Questionnaire (EPQ) and immune parameter variables in both groups were measured with Alkaline Phosphatase Anti Alkaline Phosphatase ( APAAP ) technique at baseline assessment. The intervention group patients accepted psycho-behavioral intervention including educational intervention and progressive muscle relaxation for three months from the second chemotherapy. Emotion and coping style and
T lymphocyte subsets were measured in all patients one month after psycho-behavioral intervention. T lymphocyte subsets were also measured during two and three months after psycho-behavioral intervention.
Results:
(1) There were no statistical significance between the intervention group and the control group in age, culture, occupation, pay style, tumor stage and T lymphocyte subsets at baseline assessment(p>0.05).
(2) There were statistical significance between the intervention group and the control group in depression and anxiety (p<0.05), and the score in the intervention group decreased more.
(3) Impact of personality on emotion. The neuroticism had positive correlation with depression after intervention, but the neuroticism had no correlation with anxiety after intervention. Extroversion and introversion had negative correlation with anxiety and depression after intervention.
There were no correlation between anxiety, depression and psy- choticism.
Cover up had positive correlation with anxiety after intervention, but the Cover up had no correlation with depression after intervention.
(4) CD3+、CD4+ were increased significantly after psychological intervention for one month;All immune parameters were increased significantly after psychological intervention for two month,but no significant differences between two and three month. Difference between two groups were significant(P<0.05)in different time,interaction between intervention and time were also significant(P<0.05),except CD8+ ,all immune parameters were increased significantly.
(5) Impact of personality on T lymphocyte subsets. The neuroticism had positive correlation with T lymphocyte subsets (CD8+ ), but the neuroticism , Extroversion and introversion, psychoticism and cover up had no correlation with T lymphocyte subsets.
(6) Multiple stepwise regression of the influence factors of anxiety and depression after intervention. After intervention, factors of impacting anxiety were passive coping, cover up, and culture. Factors of impacting depression were passive coping, extroversion and introversion, and cover up. Factors of impacting CD3+ were depression. Factors of impacting CD4+ were age, fee sources and anxiety, depression before intervention. Factors of impacting CD8+ were active coping style, fee sources and cover up.
Factors of impacting CD4+/ CD8+ were active coping style, cover up and anxiety.
Conclusion:
(1) Psycho-behavioral intervention can obviously improve the emotion in Patients with Ovarian Cancer.
(2) Psycho-behavioral intervention can obviously improve the immunity of T lymphocyte subsets in Patients with Ovarian Cancer, which remained at a relatively high level after psychological intervention for two month.
(3) The influence factors of anxiety, depression and T lymphocyte subsets in Patients with Ovarian Cancer were different after intervention.
探讨心理行为干预对卵巢癌患者情绪、T淋巴细胞亚群的动态变化规律及干预效果的影响因素,并进一步探讨心理行为干预的最佳时间。
对象与方法:
将符合要求的62名卵巢癌患者随机分为干预组和对照组,每组31名。所有患者均在干预前进行基线测评,包括汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)、简易应对方式问卷、艾森克人格问卷(EPQ)和抽取静脉血用免疫组化碱性磷酸酶桥联酶标法(APAAP)测定T淋巴细胞亚群的功能。干预组心理行为干预持续三个月。心理行为干预第一个月后测定两组患者情绪和T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/ CD8+)的数值。心理干预后第二个月、第三个月只测定两组患者的T淋巴细胞亚群的数值。
结果:
(1)干预组与对照组之间干预前均衡性比较没有显著性差异(P>0.05)(年龄、文化程度、职业、付费方式、肿瘤分期、焦虑、抑郁和T淋巴细胞亚群)。
(2)心理行为干预后,两组焦虑、抑郁总分干预前后差值的比较有显著性差别(P<0.05),干预组的焦虑和抑郁明显减轻。
(3)心理行为干预后焦虑、抑郁变化受人格因素的影响
人格特质中的神经质与干预后抑郁有正相关性,未见神经质与干预后焦虑的相关性。内外向与干预后的焦虑、抑郁得分呈负相关。未见焦虑和抑郁与精神质相关。掩饰性与干预后焦虑有相关性,未见掩饰性与干预后抑郁的相关性。
(4)心理行为干预一个月后CD3+(55.6±4.7/51.7±6.7,F=26.49)、CD4+(33.483±3.462/32.225±4.543 ,F=6.82)有显著性提高;干预2个月后各免疫参数CD3+(60.967±4.262/51.7±6.7,F=145.8)、CD4+(36.483±3.355/32.225±4.543,F=78.08)、CD8+(29.806±3.458/35.290±6.039,F=70.57)、CD4+/ CD8+(1.244±0.218/0.950±0.272,F=102.13)均有显著变化,且干预2个月与3个月相比各免疫参数变化不明显。干预组与对照组相比,不同时间点的各种免疫参数有显著性差异(P<0. 05),干预与时间点见明显的交互作用(P<0. 05),除CD8+(F=2.95,P>0. 05)外,两组患者各免疫参数存在显著性差异。
(5)心理行为干预后T淋巴细胞亚群的变化受人格因素的影响神经质与CD8+正相关,但内外向、神经质和掩饰性与T淋巴细胞亚群(CD3+、CD4+、CD8+及CD4+/ CD8+比值)的相关性不明显。
(6)影响心理行为干预效果的多元回归分析影响焦虑干预效果的因素有消极应对、掩饰性、和文化程度。影响抑郁干预效果的因素有消极应对、内外向和掩饰性。
影响CD3+变化的因素有干预后抑郁。影响CD4+变化的因素有干预前焦虑、年龄、付费方式和干预前抑郁。影响CD8+变化的因素有积极应对方式、付费方式和掩饰性。影响CD4+/ CD8+变化的因素有积极应对、掩饰性和焦虑。
结论:
(1)心理行为干预能明显改善卵巢癌患者的焦虑和抑郁情绪。
(2)心理行为干预可以提高卵巢癌患者T淋巴细胞亚群的免疫功能,且心理干预2个月后患者免疫功能维持在较高水平。
(3)心理行为干预后影响患者焦虑、抑郁及T淋巴细胞亚群的因素各不相同。
Objective:
To examine the effects of psycho-behavioral intervention including educational intervention and progressive muscle relaxation on emotional disorder and the Changes of T lymphocyte subsets in Patients with Ovarian Cancer, and influencing factor, and further explore the best time. Subjects and Methods:
62 inpatients were randomly assigned to either intervention group (n=31) or control group (n=31). All patients completed questionnaires including Hamilton Depression rating Scale(HAMD) ,Hamilton Anxiety rating Scale (HAMA), Simple Coping Style Questionnare, Eysenck Personality Questionnaire (EPQ) and immune parameter variables in both groups were measured with Alkaline Phosphatase Anti Alkaline Phosphatase ( APAAP ) technique at baseline assessment. The intervention group patients accepted psycho-behavioral intervention including educational intervention and progressive muscle relaxation for three months from the second chemotherapy. Emotion and coping style and
T lymphocyte subsets were measured in all patients one month after psycho-behavioral intervention. T lymphocyte subsets were also measured during two and three months after psycho-behavioral intervention.
Results:
(1) There were no statistical significance between the intervention group and the control group in age, culture, occupation, pay style, tumor stage and T lymphocyte subsets at baseline assessment(p>0.05).
(2) There were statistical significance between the intervention group and the control group in depression and anxiety (p<0.05), and the score in the intervention group decreased more.
(3) Impact of personality on emotion. The neuroticism had positive correlation with depression after intervention, but the neuroticism had no correlation with anxiety after intervention. Extroversion and introversion had negative correlation with anxiety and depression after intervention.
There were no correlation between anxiety, depression and psy- choticism.
Cover up had positive correlation with anxiety after intervention, but the Cover up had no correlation with depression after intervention.
(4) CD3+、CD4+ were increased significantly after psychological intervention for one month;All immune parameters were increased significantly after psychological intervention for two month,but no significant differences between two and three month. Difference between two groups were significant(P<0.05)in different time,interaction between intervention and time were also significant(P<0.05),except CD8+ ,all immune parameters were increased significantly.
(5) Impact of personality on T lymphocyte subsets. The neuroticism had positive correlation with T lymphocyte subsets (CD8+ ), but the neuroticism , Extroversion and introversion, psychoticism and cover up had no correlation with T lymphocyte subsets.
(6) Multiple stepwise regression of the influence factors of anxiety and depression after intervention. After intervention, factors of impacting anxiety were passive coping, cover up, and culture. Factors of impacting depression were passive coping, extroversion and introversion, and cover up. Factors of impacting CD3+ were depression. Factors of impacting CD4+ were age, fee sources and anxiety, depression before intervention. Factors of impacting CD8+ were active coping style, fee sources and cover up.
Factors of impacting CD4+/ CD8+ were active coping style, cover up and anxiety.
Conclusion:
(1) Psycho-behavioral intervention can obviously improve the emotion in Patients with Ovarian Cancer.
(2) Psycho-behavioral intervention can obviously improve the immunity of T lymphocyte subsets in Patients with Ovarian Cancer, which remained at a relatively high level after psychological intervention for two month.
(3) The influence factors of anxiety, depression and T lymphocyte subsets in Patients with Ovarian Cancer were different after intervention.
引文
[1] 乐杰,谢幸,丰有吉,等.妇产科学第 6 版[M].人民卫生出版社.2004,305.
[2] 杨建华,石一复.卵巢癌的病因流行病学研究进展[J].国外医学妇幼保健分册,2004,15(6):382-384.
[3] 张淑熙,赵树雕.心理神经免疫学的研究及其新进展[J].洛阳师范学院学报,2003,2:93-96.
[4] 贾玫、陈信义.肿瘤心理神经免疫学进展[J].医学研究通讯,2005,34(10):63-65.
[5] Karin Luebbert,Bernhard Dahme,Monkia Hasenbring.The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non—surgical cancer treatment:a meta-analytical review[J].Psycho-oncology,2001,10(6):490-502.
[6] Richardson MA,Post-White J,Grimm EA,et a1.Coping life attitudes,and immune responses to imagery and group support after breast cancer treatment[J].Altern ther health Med,1997,3(5):62-70.
[7] Ferrell BR, Smith SL, Ervin KS.A qualitative analysis of social concerns of women with ovarian cancer[J]. Psycho-oncology. 2003 ,12(7):647-63.
[8] 蔡光蓉,乔宜,李佩文,等.音乐疗法在肿瘤临床的应用[J].中华心理卫生杂志,.2001,15(3):179-181.
[9] 余建芬,卢惠珍,朱慧,等.太极拳在妇科恶性肿瘤病人中临床应用效果分析[J].现代护理,2005,11(19):1630.
[10] 谢忠,黄钢,银正民,等.音乐治疗加放松内心意向法对癌症化疗病人生活质量的影响[J].中国心理卫生杂志,2001,15(3):176-178.
[11] 刘艳,林文娟,刘新帆,等. 心理行为干预对乳腺癌患者情绪反应及免疫功能的影响[J].心理学报,2001,33(5):437-441.
[12] 汪向东等编.心理卫生评定量表手册增订版[M].中国心理卫生杂志,1999,12.
[13] 陈宏.乳腺癌患者术前心理社会因素与免疫功能[J].中国心理卫生杂志,2005,19(8):557-560.
[14] 黄丽,汤水琴 . 心理行为干预与癌症患者的生活质量 [J]. 中国肿瘤,2002,11(12):711-713.
[15] 黄丽,罗健,肿瘤心理治疗[M].北京:人民卫生出版社,2000.276-452.
[16] 梁国勇,王栋,主编.医学心理学.第三版[M].吉林:科学技术出版社,1998.120-124.
[17] Schaffer SD, Yucha CB. Relaxation&pain management: the relaxation response can play a role in managing chronic and acute pain[J]. Am J Nurs, 2004,104(8):75-76,78-79, 81-82.
[18] Kerr K. Relaxation techniques: a critical review. Critical Reviews in Physical and Rehabilitation[J]. Medicine, 2000,12(1):51-89.
[19] Titlebaum HM. Relaxation[J]. Holist Nurs Pract, 1988,2(3):17-25.
[20] 唐牟尼,刘协和,等.成都地区55周年及以上人群中抑郁症患病率调查[J].中国心理卫生杂志,2001,15(2):103—106.
[21] Skírnisdóttir I, Lindborg K, Sorbe B,et al. Adjuvant chemotherapy with carboplatin and taxane compared with single drug carboplatin in early stage epithelial ovarian carcinoma[J]. Oncol Rep,2007,18(5):1249-1256.
[22] 梁宝勇,刘畅,杜桂芝,等.关于应付的一些思考与实证研究、应付方式与人格[J].中国临床心理学杂志,2000, 8 (1): 7-9.
[23] Howard FS, Dimatteo MR. Health psychology[M].Prentice-Hall Inc, 1989.
[24] Morasso G, Costantini M, Baracco G, et al. Assessing psychological distress in cancer patients: validation of a self-administered questionnaire[J]. Oncology.1996,53(4): 295-302.
[25] Iwamitsu Y, Shimoda K, Abe H, et al. Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression[J].Psychiatry Clin Neurosci, 2003, 57(3): 289-94.
[26] Classen C,Koopman C,Angell K .Coping styles associated with psychological adjustment to advanced breast cancer[J].Health Psychol, 1996,15(6): 434-7.
[27] Eysenck HJ. Biological dimensions of personality//Pervin LA. Handbook of Personality Theory and Research[M].New York: Guilford 1990. 244-76.
[28] Wilson G, Introversion/edtroversion//London H, Exner JE. Dimensions of Personality[M].New York: Wiley, 1978. 217-61.
[29] 周意丹,刘亚平.社会支持、应对方式、人格特征等因素与手术患者焦虑的关系[J].中国临床康复,8 (33): 7349-7351.
[30] Sakamoto H, Inoue K, Shimada M. Depression during interferon therapy in renal cell cancer patients--comparison with chronic hepatitis C patients[J]. Nippon-Hinyokika-Gakkai-Zasshi, 2000, 91(9): 611-7.
[31] Yamaoka K, Shigehisa T, Ogoshi K, et al. Health-related quality of life varies with personality types: a comparison among cancer patients, non-cancer patients and healthy individuals in a Japanese population[J] .Qual-Life-Res, 1998, 7(6): 535-44.
[32] Greer S, Morris T. Psychological attributes of women who develop breast cancer: A controlled study[J]. Psychosomatic Researchs, 1975, 19:147-153.
[33] Temoshok L. Personality, coping style, emotion and cancer: towards an integrative model[J] .Cancer Surv, 1987, 6(3): 545-67.
[34] 陈虹,姜潮,王中波,等.晚期癌症患者抑郁与应对方式的相关性研究[J].中国行为医科科学杂志,2002,11(2):670.
[35] Ikeda H, Chamoto K, Tsuji T,et al. The critical role of type-1 innate and acquired immunity in tumor immunotherapy[J]. Cancer Sci.2004,95(9):697-703.
[36] Oizumi S, Strbo N, Pahwa S,et al. Molecular and cellular requirements for enhanced antigen cross-presentation to CD8 cytotoxic T lymphocytes[J] .Immunol.,2007 ,179(4):2310-2317.
[37] 殷缨,张盈华,张利朝,等.恶性肿瘤患者T细胞亚群与红细胞免疫功能的变化及其相关性分析[J].实用癌症杂志,2001,16(2):l7l—l73.
[38] 蒋红飞.癌症患者的T淋巴细胞亚群免疫功能的研究[J].国际检验医学杂志,2006,27(7):660-661.
[39] 董增义. 恶性肿瘤病人手术及化疗前后T淋巴细胞亚群的变化[J].齐鲁医学杂志,2003,18(2):131-132.
[40] 贾玫,陈信义.肿瘤心理神经免疫学研究进展[J].医学研究通讯,2005,(34)10 :63-65.
[41] Caudell KA .Psychoneuroimmunology and innovative behavioral interventions inpatients with Leukemia[J].Onol Nurs Forum,1996 Apr,23(3):493—502.
[42] 王建平,林文娟,梁耀坚,等.心理干预对癌症患者免疫功能的影响[J]. 中国肿瘤临床,2002,29(12):841-844.
[43] Segerstrom SC. Individual differences, immunity, and cancer: lessons from personality psychology[J] .Brain Behav Immun, 2003,17 Suppl 1: S92-7.
[44] Jamner JD, Schwartz GE, Leigh H. The relationship between repressive and defensive coping style and defensive coping style and monocyte, eosinophil, and serum glucose levels: Support for the opioid peptide hypothesis of repression[J] .Psychosom Med, 1988, 50: 567-575.
[45] Segerstrom SC. Personality and the immune system: Models, methods, and mechanisms[J] .Ann. Behav, 2000, 22: 180-190.
[46] 李建中,吴爱勤,吴彩云.肿瘤患者的心理社会因素与免疫功能的测定[J].中国心理卫生杂志,2002,16(6):386-389.
[47] 马博,李中琦,马志敏.消化系统癌症病人抑郁情绪和细胞免疫的研究[J].中国行为医学科学,2002,11(1):49-50.
[48] Andersen BL,Farrar WB,Golden-Kreutz DM,et al .Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial[J] .J Clin Oncol, 2004, 22(17): 3570-80.
[49] McGregor B A, Antoni M H, Boyers A, et al. Cognitive-behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer[J]·J-Psychosom-Res, 2004, 56(1): 1-8.
[1] 乐杰,谢幸,丰有吉,等.妇产科学第 6 版[M].人民卫生出版社,2004,305.
[2] 杨建华,石一复.卵巢癌的病因流行病学研究进展[J].国外医学妇幼保健分册,2004,15(6):382-384.
[3] von Georgi R, Schubert K, Franke FE, et al. Effects of sociomedical risk factors on the progression of ovarian cancer. Dtsch Med Wochenschr. [J] 2002,27(39):2001-2005.
[4] 崔文姬,杜彬.卵巢癌患者与健康者的C型行为特征问卷调查[J].中国临床康复,2004,8(3):457.
[5] Canada AL, Parker PA, de Moor JS. Active coping mediates the association between religion/spirituality and quality of life in ovarian cancer[J]. Gynecol Oncol,2006,101 (1):102-107.
[6] Zabalegui A(英).晚期癌症患者的心理疾患及处理对策[J].国外医学护理学分册,2O00,19(8):382.
[7] Baltrusch HJ, Stangel W,Titze I.et al . Stress, cancer and immunity. New developments in biopsychosocial and psychoneuroimmunologic research[J]. Acta Neurologica [Acta Neurol (Napoli)], 1991 ,13 (4): 315-327.
[8] 汪向东.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:127-132.
[9] Hipkins J, Whitworth M, Tarrier N,et al.Social support, anxiety and depression after chemotherapy for ovarian cancer: a prospective study[J].Br J Health Psychol, 2004,9(4):569-581.
[10] Lutgendorf SK, Sood AK, Anderson B et al .Social support, psychological distress, and natural killer cell activity in ovarian cancer[J]. J Clin Oncol, 2005 ,23(28):7105-7113.
[11] 杨镇.肿瘤免疫学[M].武汉:湖北科学技术出版社,1998,106.
[12] 贾玫,陈信义.肿瘤心理神经免疫学研究进展[J].医学研究通讯,2005,(34)10 :63-65.
[13] 郑丽,林文娟.神经系统与免疫系统的相互作用[J].心理学动态,2000(8)1:69-74.
[14] Gendy RK,Able JA,Rainsbury RM.Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery[J].Br J Surg, 2003,90(4):433-439.
[15] 岳文浩,潘芳,张红静.医学心理学[M].北京:北京科技出版社,2001:252-256.
[16] 苏小茵,谭悦,郑美春,等.生物反馈放松训练在肿瘤病人化疗期间的应用[J].中华护理杂志,1997,10(32):627—629.
[17] 蔡光蓉,乔宜,李佩文,等.音乐疗法在肿瘤临床的应用[J].中华心理卫生杂志,.2001,15(3):179-181.
[18] 余建芬,卢惠珍,朱慧,等.太极拳在妇科恶性肿瘤病人中临床应用效果分析[J].现代护理,2005,11(19):1630.
[19] ZANKER. Looking along the track of the psycho-neuoimmunologic aris for missing links in cancer progression[J].Int Sports Med,1991,12(1):558-562.
[20] Mock K,Burke MB,Sheehan P,et a1.A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy[J].Oncol Nurs Form ,1994,21(5):899—902.
[21] 王建平,林文娟.心理神经免疫学与癌症[J].国外医学肿瘤学分册,2001,28(5):364-366.
[22] Karin Luebbert,Bernhard Dahme,Monkia Hasenbring.The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non—surgical cancer treatment:a meta-analytical review[J].Psycho-oncology,2001,10(6):490-502.
[23] Richardson MA,Post-White J,Grimm EA,et a1.Coping life attitudes,and immune responses to imagery and group support after breast cancer treatment[J].Altern ther health Med,1997,3(5):62-70.
[24] Andersen BL,Farrar WB, Golden-Kreutz DM,et al. Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial[J]. Journal Of Clinical Oncology,2004, 22 (17): 3570-3580.
[25] Ferrell B, Ervin K, Smith S,et al. Family perspectives of ovarian cancer[J]. Cancer Pract,2002,10(6):269-76.
[26] Endo E, Nitta N, Inayoshi M, et al. Pattern recognition as a caring partnership in families with cancer[J]. J Adv Nurs, 2000,32(3):603-610.
[2] 杨建华,石一复.卵巢癌的病因流行病学研究进展[J].国外医学妇幼保健分册,2004,15(6):382-384.
[3] 张淑熙,赵树雕.心理神经免疫学的研究及其新进展[J].洛阳师范学院学报,2003,2:93-96.
[4] 贾玫、陈信义.肿瘤心理神经免疫学进展[J].医学研究通讯,2005,34(10):63-65.
[5] Karin Luebbert,Bernhard Dahme,Monkia Hasenbring.The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non—surgical cancer treatment:a meta-analytical review[J].Psycho-oncology,2001,10(6):490-502.
[6] Richardson MA,Post-White J,Grimm EA,et a1.Coping life attitudes,and immune responses to imagery and group support after breast cancer treatment[J].Altern ther health Med,1997,3(5):62-70.
[7] Ferrell BR, Smith SL, Ervin KS.A qualitative analysis of social concerns of women with ovarian cancer[J]. Psycho-oncology. 2003 ,12(7):647-63.
[8] 蔡光蓉,乔宜,李佩文,等.音乐疗法在肿瘤临床的应用[J].中华心理卫生杂志,.2001,15(3):179-181.
[9] 余建芬,卢惠珍,朱慧,等.太极拳在妇科恶性肿瘤病人中临床应用效果分析[J].现代护理,2005,11(19):1630.
[10] 谢忠,黄钢,银正民,等.音乐治疗加放松内心意向法对癌症化疗病人生活质量的影响[J].中国心理卫生杂志,2001,15(3):176-178.
[11] 刘艳,林文娟,刘新帆,等. 心理行为干预对乳腺癌患者情绪反应及免疫功能的影响[J].心理学报,2001,33(5):437-441.
[12] 汪向东等编.心理卫生评定量表手册增订版[M].中国心理卫生杂志,1999,12.
[13] 陈宏.乳腺癌患者术前心理社会因素与免疫功能[J].中国心理卫生杂志,2005,19(8):557-560.
[14] 黄丽,汤水琴 . 心理行为干预与癌症患者的生活质量 [J]. 中国肿瘤,2002,11(12):711-713.
[15] 黄丽,罗健,肿瘤心理治疗[M].北京:人民卫生出版社,2000.276-452.
[16] 梁国勇,王栋,主编.医学心理学.第三版[M].吉林:科学技术出版社,1998.120-124.
[17] Schaffer SD, Yucha CB. Relaxation&pain management: the relaxation response can play a role in managing chronic and acute pain[J]. Am J Nurs, 2004,104(8):75-76,78-79, 81-82.
[18] Kerr K. Relaxation techniques: a critical review. Critical Reviews in Physical and Rehabilitation[J]. Medicine, 2000,12(1):51-89.
[19] Titlebaum HM. Relaxation[J]. Holist Nurs Pract, 1988,2(3):17-25.
[20] 唐牟尼,刘协和,等.成都地区55周年及以上人群中抑郁症患病率调查[J].中国心理卫生杂志,2001,15(2):103—106.
[21] Skírnisdóttir I, Lindborg K, Sorbe B,et al. Adjuvant chemotherapy with carboplatin and taxane compared with single drug carboplatin in early stage epithelial ovarian carcinoma[J]. Oncol Rep,2007,18(5):1249-1256.
[22] 梁宝勇,刘畅,杜桂芝,等.关于应付的一些思考与实证研究、应付方式与人格[J].中国临床心理学杂志,2000, 8 (1): 7-9.
[23] Howard FS, Dimatteo MR. Health psychology[M].Prentice-Hall Inc, 1989.
[24] Morasso G, Costantini M, Baracco G, et al. Assessing psychological distress in cancer patients: validation of a self-administered questionnaire[J]. Oncology.1996,53(4): 295-302.
[25] Iwamitsu Y, Shimoda K, Abe H, et al. Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression[J].Psychiatry Clin Neurosci, 2003, 57(3): 289-94.
[26] Classen C,Koopman C,Angell K .Coping styles associated with psychological adjustment to advanced breast cancer[J].Health Psychol, 1996,15(6): 434-7.
[27] Eysenck HJ. Biological dimensions of personality//Pervin LA. Handbook of Personality Theory and Research[M].New York: Guilford 1990. 244-76.
[28] Wilson G, Introversion/edtroversion//London H, Exner JE. Dimensions of Personality[M].New York: Wiley, 1978. 217-61.
[29] 周意丹,刘亚平.社会支持、应对方式、人格特征等因素与手术患者焦虑的关系[J].中国临床康复,8 (33): 7349-7351.
[30] Sakamoto H, Inoue K, Shimada M. Depression during interferon therapy in renal cell cancer patients--comparison with chronic hepatitis C patients[J]. Nippon-Hinyokika-Gakkai-Zasshi, 2000, 91(9): 611-7.
[31] Yamaoka K, Shigehisa T, Ogoshi K, et al. Health-related quality of life varies with personality types: a comparison among cancer patients, non-cancer patients and healthy individuals in a Japanese population[J] .Qual-Life-Res, 1998, 7(6): 535-44.
[32] Greer S, Morris T. Psychological attributes of women who develop breast cancer: A controlled study[J]. Psychosomatic Researchs, 1975, 19:147-153.
[33] Temoshok L. Personality, coping style, emotion and cancer: towards an integrative model[J] .Cancer Surv, 1987, 6(3): 545-67.
[34] 陈虹,姜潮,王中波,等.晚期癌症患者抑郁与应对方式的相关性研究[J].中国行为医科科学杂志,2002,11(2):670.
[35] Ikeda H, Chamoto K, Tsuji T,et al. The critical role of type-1 innate and acquired immunity in tumor immunotherapy[J]. Cancer Sci.2004,95(9):697-703.
[36] Oizumi S, Strbo N, Pahwa S,et al. Molecular and cellular requirements for enhanced antigen cross-presentation to CD8 cytotoxic T lymphocytes[J] .Immunol.,2007 ,179(4):2310-2317.
[37] 殷缨,张盈华,张利朝,等.恶性肿瘤患者T细胞亚群与红细胞免疫功能的变化及其相关性分析[J].实用癌症杂志,2001,16(2):l7l—l73.
[38] 蒋红飞.癌症患者的T淋巴细胞亚群免疫功能的研究[J].国际检验医学杂志,2006,27(7):660-661.
[39] 董增义. 恶性肿瘤病人手术及化疗前后T淋巴细胞亚群的变化[J].齐鲁医学杂志,2003,18(2):131-132.
[40] 贾玫,陈信义.肿瘤心理神经免疫学研究进展[J].医学研究通讯,2005,(34)10 :63-65.
[41] Caudell KA .Psychoneuroimmunology and innovative behavioral interventions inpatients with Leukemia[J].Onol Nurs Forum,1996 Apr,23(3):493—502.
[42] 王建平,林文娟,梁耀坚,等.心理干预对癌症患者免疫功能的影响[J]. 中国肿瘤临床,2002,29(12):841-844.
[43] Segerstrom SC. Individual differences, immunity, and cancer: lessons from personality psychology[J] .Brain Behav Immun, 2003,17 Suppl 1: S92-7.
[44] Jamner JD, Schwartz GE, Leigh H. The relationship between repressive and defensive coping style and defensive coping style and monocyte, eosinophil, and serum glucose levels: Support for the opioid peptide hypothesis of repression[J] .Psychosom Med, 1988, 50: 567-575.
[45] Segerstrom SC. Personality and the immune system: Models, methods, and mechanisms[J] .Ann. Behav, 2000, 22: 180-190.
[46] 李建中,吴爱勤,吴彩云.肿瘤患者的心理社会因素与免疫功能的测定[J].中国心理卫生杂志,2002,16(6):386-389.
[47] 马博,李中琦,马志敏.消化系统癌症病人抑郁情绪和细胞免疫的研究[J].中国行为医学科学,2002,11(1):49-50.
[48] Andersen BL,Farrar WB,Golden-Kreutz DM,et al .Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial[J] .J Clin Oncol, 2004, 22(17): 3570-80.
[49] McGregor B A, Antoni M H, Boyers A, et al. Cognitive-behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer[J]·J-Psychosom-Res, 2004, 56(1): 1-8.
[1] 乐杰,谢幸,丰有吉,等.妇产科学第 6 版[M].人民卫生出版社,2004,305.
[2] 杨建华,石一复.卵巢癌的病因流行病学研究进展[J].国外医学妇幼保健分册,2004,15(6):382-384.
[3] von Georgi R, Schubert K, Franke FE, et al. Effects of sociomedical risk factors on the progression of ovarian cancer. Dtsch Med Wochenschr. [J] 2002,27(39):2001-2005.
[4] 崔文姬,杜彬.卵巢癌患者与健康者的C型行为特征问卷调查[J].中国临床康复,2004,8(3):457.
[5] Canada AL, Parker PA, de Moor JS. Active coping mediates the association between religion/spirituality and quality of life in ovarian cancer[J]. Gynecol Oncol,2006,101 (1):102-107.
[6] Zabalegui A(英).晚期癌症患者的心理疾患及处理对策[J].国外医学护理学分册,2O00,19(8):382.
[7] Baltrusch HJ, Stangel W,Titze I.et al . Stress, cancer and immunity. New developments in biopsychosocial and psychoneuroimmunologic research[J]. Acta Neurologica [Acta Neurol (Napoli)], 1991 ,13 (4): 315-327.
[8] 汪向东.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:127-132.
[9] Hipkins J, Whitworth M, Tarrier N,et al.Social support, anxiety and depression after chemotherapy for ovarian cancer: a prospective study[J].Br J Health Psychol, 2004,9(4):569-581.
[10] Lutgendorf SK, Sood AK, Anderson B et al .Social support, psychological distress, and natural killer cell activity in ovarian cancer[J]. J Clin Oncol, 2005 ,23(28):7105-7113.
[11] 杨镇.肿瘤免疫学[M].武汉:湖北科学技术出版社,1998,106.
[12] 贾玫,陈信义.肿瘤心理神经免疫学研究进展[J].医学研究通讯,2005,(34)10 :63-65.
[13] 郑丽,林文娟.神经系统与免疫系统的相互作用[J].心理学动态,2000(8)1:69-74.
[14] Gendy RK,Able JA,Rainsbury RM.Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery[J].Br J Surg, 2003,90(4):433-439.
[15] 岳文浩,潘芳,张红静.医学心理学[M].北京:北京科技出版社,2001:252-256.
[16] 苏小茵,谭悦,郑美春,等.生物反馈放松训练在肿瘤病人化疗期间的应用[J].中华护理杂志,1997,10(32):627—629.
[17] 蔡光蓉,乔宜,李佩文,等.音乐疗法在肿瘤临床的应用[J].中华心理卫生杂志,.2001,15(3):179-181.
[18] 余建芬,卢惠珍,朱慧,等.太极拳在妇科恶性肿瘤病人中临床应用效果分析[J].现代护理,2005,11(19):1630.
[19] ZANKER. Looking along the track of the psycho-neuoimmunologic aris for missing links in cancer progression[J].Int Sports Med,1991,12(1):558-562.
[20] Mock K,Burke MB,Sheehan P,et a1.A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy[J].Oncol Nurs Form ,1994,21(5):899—902.
[21] 王建平,林文娟.心理神经免疫学与癌症[J].国外医学肿瘤学分册,2001,28(5):364-366.
[22] Karin Luebbert,Bernhard Dahme,Monkia Hasenbring.The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non—surgical cancer treatment:a meta-analytical review[J].Psycho-oncology,2001,10(6):490-502.
[23] Richardson MA,Post-White J,Grimm EA,et a1.Coping life attitudes,and immune responses to imagery and group support after breast cancer treatment[J].Altern ther health Med,1997,3(5):62-70.
[24] Andersen BL,Farrar WB, Golden-Kreutz DM,et al. Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial[J]. Journal Of Clinical Oncology,2004, 22 (17): 3570-3580.
[25] Ferrell B, Ervin K, Smith S,et al. Family perspectives of ovarian cancer[J]. Cancer Pract,2002,10(6):269-76.
[26] Endo E, Nitta N, Inayoshi M, et al. Pattern recognition as a caring partnership in families with cancer[J]. J Adv Nurs, 2000,32(3):603-610.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |