心理干预对地震灾害所致创伤后应激障碍并支气管哮喘急性发作期患者的影响
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摘要
目的探索心理干预对地震灾害所致创伤后应激障碍合并支气管哮喘急性发作期患者的影响。方法将来自地震灾区的符合美国精神病协会制定的创伤后应激障碍诊断标准的支气管哮喘急性发作期患者40例分为对照组及干预组,分别给予支气管哮喘常规治疗、支气管哮喘常规治疗联合心理干预,比较两组PTSD检查量表(PCL-C)、ACQ5、FEV1%pred、PEF%pred、外周血嗜酸粒细胞(EOS)的变化;分析干预组中PCL-C与ACQ5、FEV1%pred、PEF%pred、EOS之间的关系。结果干预组的PCL-C、ACQ5、FEV1%pred、PEF%pred较之对照组有明显改善,两组之间的差异有统计学意义(P<0.05);但EOS改善不明显,两组之间的差异无统计学意义(P>0.05);干预组中PCL-C与ACQ5呈正相关(r=0.61,P<0.05),与FEV1%pred、PEF%pred呈负相关(r值分别为-0.53、-0.57),与EOS无直线相关关系(P>0.05)。结论用心理干预联合支气管哮喘常规治疗的方法治疗地震灾害所致PTSD并支气管哮喘急性发作期患者的疗效优于单纯的常规治疗,但对EOS改善作用不大。
Objective To explore the effect of mental intervention on the survivors in earthquakes with post-traumatic stress disorder(PTSD)and acute bronchial asthma.Methods 40 patients with PTSD and acute bronchial asthma were divided into 2 groups,control group and experiment group.The control group was treated with conventional therapy of bronchial asthma,and the experiment group was treated with mental intervention and conventional therapy of bronchial asthma, respectively. PCL-C、ACQ5、FEV1%pred、PEF%pred、EOS in Peripheral blood of two groups were compared.Results PCL-C、ACQ5、FEV1%pred and PEF%pred of the experiment group were improvement,obviously, compared with that of the control group, respectively. The difference in two group was statistical significance (P<0.05),but the difference of EOS in Peripheral blood in two group was no noticeable difference (P>0.05). The value of PCL-C from the experiment group showed a positive correlation with the value of ACQ5 (r=0.61,P<0.05), and a negative correlation with the level of FEV1%pred and PEF%pred,respectively. (r=-0.53,r=-0.57, respectively. all P<0.05),and no correlation with the level of EOS (P>0.05).Conclusions The effect of mental intervention united conventional therapy of bronchial asthma was better than the conventional therapy,but had no obvious improvement for EOS in Peripheral blood.
Objective To explore the effect of mental intervention on the survivors in earthquakes with post-traumatic stress disorder(PTSD)and acute bronchial asthma.Methods 40 patients with PTSD and acute bronchial asthma were divided into 2 groups,control group and experiment group.The control group was treated with conventional therapy of bronchial asthma,and the experiment group was treated with mental intervention and conventional therapy of bronchial asthma, respectively. PCL-C、ACQ5、FEV1%pred、PEF%pred、EOS in Peripheral blood of two groups were compared.Results PCL-C、ACQ5、FEV1%pred and PEF%pred of the experiment group were improvement,obviously, compared with that of the control group, respectively. The difference in two group was statistical significance (P<0.05),but the difference of EOS in Peripheral blood in two group was no noticeable difference (P>0.05). The value of PCL-C from the experiment group showed a positive correlation with the value of ACQ5 (r=0.61,P<0.05), and a negative correlation with the level of FEV1%pred and PEF%pred,respectively. (r=-0.53,r=-0.57, respectively. all P<0.05),and no correlation with the level of EOS (P>0.05).Conclusions The effect of mental intervention united conventional therapy of bronchial asthma was better than the conventional therapy,but had no obvious improvement for EOS in Peripheral blood.
引文
[1]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案).中华结核和呼吸杂志,2008,31:177-185.
[2]American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition,Text Revision DSM-IV-TR.American Psychiatric Pub,2000:943.
[3]Mason JW,Giller EL,Kosten TR,et al.Urinary free-cortisol levels in post traumatic stress disorder patients.J Nerv Ment Dis,1986,174:145-149.
[4]Yehuda R,Bierer LM,Schmeidler J,et al.Low cortisol and risk for PTSD in adult offspring of holocaust survivors.Am J Psychiatry,2000,157:1252-1259.
[5]Wong CM.Post-traumatic stress disorder:advances in psychoneuroimmunology.Psychiatr Clin North Am,2002,25:369-383.
[2]American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition,Text Revision DSM-IV-TR.American Psychiatric Pub,2000:943.
[3]Mason JW,Giller EL,Kosten TR,et al.Urinary free-cortisol levels in post traumatic stress disorder patients.J Nerv Ment Dis,1986,174:145-149.
[4]Yehuda R,Bierer LM,Schmeidler J,et al.Low cortisol and risk for PTSD in adult offspring of holocaust survivors.Am J Psychiatry,2000,157:1252-1259.
[5]Wong CM.Post-traumatic stress disorder:advances in psychoneuroimmunology.Psychiatr Clin North Am,2002,25:369-383.
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