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目的 探讨支持性心理治疗和渐进性神经肌肉放松训练两种不同心理干预方法对改善慢性乙肝患者心身症状的效果。方法 将 90例慢性乙肝患者 ,随机分为 3组 ,实验组在临床治疗的同时分别采用支持性心理治疗和渐进性神经肌肉放松训练。病人入院时、入院 2周、入院 4周用症状自评量表 ( SCL-90 )、Zung焦虑自评量表 ( SAS)、Zung抑郁自评量表( SDS)分别评估实验组、对照组病人心理状况 ,进行心理干预前后、实验组之间及与对照组同期的心身症状比较。结果 支持性心理治疗组和渐进性神经肌肉放松训练组患者干预前后 SCL-90阳性总分、阳性项目、各因子得分及 SAS、SDS标准分比较 ,P<0 .0 5 ,差异有显著性。两个实验组干预后 2周、4周 SCL-90、SAS、SDS得分分别与对照组比较 ,P<0 .0 5 ,差异有显著性。渐进性神经肌肉放松训练组干预后 2周 SCL-90、SAS、SDS得分与支持性心理治疗组比较 ,差异有显著性 ;干预后 4周 SAS、SDS标准分差异有显著性。结论 支持性心理治疗和渐进性神经肌肉放松训练对改善病人的心身症状有明显效果 ,渐进性神经肌肉放松训练对改善病人焦虑、抑郁等负性情绪 ,优于支持性心理治疗
Objective To investigate the effects of supportive psychotherapy and progressive neuromuscular relaxation training on the improvement of psychosomatic symptoms in patients with chronic hepatitis B. Methods Ninety patients with chronic hepatitis B were randomly divided into three groups. The experimental group was treated with supportive psychotherapy and progressive neuromuscular relaxation training respectively. At admission, patients were admitted to hospital for 2 weeks and 4 weeks after admission. The patients in the experimental group and the control group were assessed by the SCL-90, the Zung Self-rating Anxiety Scale (SAS) and the Zung Self-rating Depression Scale (SDS) Psychological status, before and after psychological intervention, experimental groups and control group over the same period of psychosomatic symptoms comparison. Results The scores of SCL-90 positive scores, positive items, scores of each factor and SAS and SDS scores before and after intervention in supportive psychotherapy group and progressive neuromuscular relaxation training group were significantly lower than those in control group (P <0.05). The scores of SCL-90, SAS and SDS in the two experimental groups at 2 and 4 weeks after the intervention were respectively compared with those in the control group, P <0.05, the difference was significant. The score of SCL-90, SAS, SDS scores in progressive neuromuscular relaxation training group 2 weeks after intervention were significantly different from those in supportive psychotherapy group. There were significant differences in SAS and SDS scores 4 weeks after intervention. Conclusions Supportive psychotherapy and gradual neuromuscular relaxation training have obvious effect on improving patients ’psychosomatic symptoms. Progressive neuromuscular relaxation training is better than supportive psychotherapy in improving patients’ negative emotions such as anxiety and depression