摘要
目的评估综合性心理干预对化疗期乳腺癌患者焦虑和抑郁的作用,并探讨化疗前后焦虑和抑郁对乳腺癌患者细胞免疫功能的影响。方法采用自行设计好问卷、Herth希望量表、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)对81例已婚女性乳腺癌患者进行调查和测评,将符合纳入标准的64例抑郁、焦虑共病患者(HAMD评分大于或等于8且HAMA评分大于或等于7分)随机分为干预组和对照组。流式细胞术检测患者外周静脉血T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)及自然杀伤细胞(NK细胞)。结果化疗后,干预组比对照组Herth评分增加37.19%,HAMD评分减少36.01%,差异有统计学意义(P<0.01);化疗前与化疗后比较,干预组Herth评分增加了(12.57±4.57)分,HAMD和HAMA评分分别下降了(9.32±1.86)分和(4.35±1.15)分,且差异均有统计学意义(P<0.01)。与对照组比较,干预组化疗前后CD3+、CD4+、CD4+/CD8+和NK细胞差值分别增加2.10±1.63、1.51±1.02、0.05±0.02和0.78±0.52,差异均有统计学意义(P<0.01),HAMD评分与CD4+/CD8+呈负相关(r=-0.554)。结论乳腺癌患者细胞免疫功能减退可能与焦虑合并抑郁程度相关,综合性心理干预模式可改善化疗期乳腺癌患者抑郁、焦虑情绪。
Objective To evaluate the effects of the comprehensive psychological intervention on anxiety and depression of the patients with breast cancer during chemotherapy, and to explore the influence of depression and anxiety before and after chemother- apy on the ce[lular immune function. Methods A total of 81 married female patients with breast cancer were surveyed and assessed with self-designed questionnaire, the Herth Hope Scale,the Hamilton Depression Scale（HAMD） and the Hamilton Anxiety Scale （HAMA）. 64 cases of breast cancer with depression and anxiety according with the included standards（ HAMD scores ~8 and HA- MA scores ~7） were randomly divided into the intervention group（n = 32） and the control group（n=32）. The levels of T lympho cyte subsets（CD3＋ ,CD4＋ ,CD8＋ ,CD4＋ / CD8＋ ） and the natural killing（NK） ceils in peripheral venous blood were determined by the flow cytometry（FCM）. Results The Herth scores after chemotherapy in the intervention group were increased by 37.19% than that of the control group, while the HAMD scores were decreased by 36.01% compared with the control group,the differences be tween them showing statistical significance（P〈0.01）. In the comparison between before and after chemotherapy, the Herth scores in the intervention group were increased by 12.57±4.57,while the HAMD and HAMA scores were declined by 9.32±1.86 and 4.35± 1.15 respectively,the differences showed the statistical significance（P〈0.01 ）. Compared with the control group, CD3＋, CD4＋ ,CD4＋/ CD8＋ ratio and NK cells before and after chemotherapy in the intervention group were increased by 2. 10 ± 1.63, 1.51--1.02,0.05±0.02 and 0. 78±0. 52 correspondingly,the differences among them had statistical signifieance（P〈0. 001）. The HAMD scores were negatively eorrelated with the CD4＋/CD8＋ ratio（r= -0. 554）. Conclusion The cellular immune hypofunction in the patients with breast cancer is probably related with anxiety and degree of depression. The comprehensive psychological inter- vention model can improve the anxiety and depression mood during chemotherapy.
出处
《重庆医学》
CAS
CSCD
北大核心
2014年第2期161-164,共4页
Chongqing medicine
基金
湖北省教育厅科学技术研究项目(Q20132107)
湖北医药学院研究生启动基金(2010QDJ33)
关键词
心理疗法
帕罗西汀
乳腺肿瘤
抑郁
焦虑
免疫功能
psychotherapy ~ paroxetine ~ breast neoplasms ~ depression ~ anxiety ~ immunologic function
