摘要
目的:评估综合性心理干预与帕罗西汀联合治疗方法对化疗期乳腺癌患者焦虑、抑郁情绪的干预疗效及安全性。方法:采用自编问卷、Herth希望量表、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)对81名已婚女性乳腺癌患者进行评估,将符合纳入标准的64例化疗期乳腺癌抑郁焦虑共病患者(HAMD评分≥8且HAMA评分≥7)随机分为干预组(32例,在常规护理的基础上接受心理干预与帕罗西汀联合治疗)和对照组(32例,给予常规护理)。采用流式细胞术(FCM)测定患者外周静脉血T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)及自然杀伤(NK)细胞水平,以不良反应发生率作为安全性评价指标。结果:两组患者化疗前Herth希望评分、HAMD评分、HAMA评分、免疫细胞水平比较差异无统计学意义(P>0.05)。化疗期干预组Herth希望评分(33.94±8.26)较对照组(24.74±6.96)显著增加,HAMD评分(15.78±5.24)较对照组(24.66±5.23)显著减少;化疗前后2组CD3+、CD4+、CD4+/CD8+、NK细胞差值比较,差异有统计学意义(P<0.01);不良反应恶心呕吐、骨髓抑制发生率差异亦有统计学意义(P<0.05)。结论:心理干预联合帕罗西汀联合治疗可改善化疗期乳腺癌患者的抑郁焦虑程度,提高希望水平和改善机体免疫功能,降低不良反应发生率。
Objective To estimate the efficacy and safety of psychotherapy combined with paroxetine on depression and anxiety of patients with breast cancer during chemotherapy.Methods A total of 81 married female patients with breast cancer were estimated with self-designed questionnaire,the Herth hope scale,Hamilton depression scale(HAMD) and Hamilton anxiety scale(HAMA).These 64 cases of breast cancer patients with depression and anxiety(HAMD≥8 and HAMA≥7) during chemotherapy were randomly divided into two groups,the intervening group was treated with psychological intervention combined with paroxetine on the base of routine nursing(n = 32) and the control group was only given routine nursing(n = 32).The levels of T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/ CD8+) and NK cells in peripheral vein blood of patients were determined by flow cytometry(FCM) and the incidence of adverse reactions was recorded as the index for security evaluation.Results There were no significant differences in the scores of Herth hope scale,HAMD,HAMA and immunocyte between the two groups before chemotherapy(P >0.05).The score of Herth hope scale in intervening group(33.94 ± 8.26) was significantly increased than that of control group(24.74 ± 6.96),while the score of HAMD(15.78 ± 5.24) was significantly decreased compared with control group(24.66 ± 5.23).The difference of CD3+,CD4+,CD4+/ CD8+,NK cells was significantly increased,respectively(P < 0.01).The incidence of adverse reactions,such as nausea,vomiting and myelosuppression,was significantly decreased(P < 0.05).Conclusion Psychotherapy combined with paroxetine could improve the levels of depression and anxiety,enhance the levels of hope and immune function and decrease the incidence of adverse reactions in patients with breast cancer during chemotherapy.
出处
《湖北医药学院学报》
CAS
2013年第4期311-316,共6页
Journal of Hubei University of Medicine
基金
湖北医药学院研究生启动基金(2010QDJ33)
关键词
心理干预
帕罗西汀
乳腺癌
抑郁
焦虑
Psychotherapy
Paroxetine
Breast cancer
Depression
Anxiety
