银屑病患者生活质量调查

目的:研究银屑病对患者生活质量的影响及皮肤病生活质量指数(DLQI)作为判断银屑病病情及疗效新指标的可信性。方法:采用DLQI研究银屑病患者治疗前、后的生活质量及其影响因素,并与传统的银屑病皮损面积和严重度指数(PASI)进行比较。结果:女性患者的DLQI评分明显高于男性,未婚者的DLQI评分高于已婚者,面部受累者的DLQI评分高于面部未受累者(P<0.05)。DLQI和PASI评分呈显著正相关(r=0.633,P<0.001)。治疗后随着临床病情的改善,PASI和DLQI评分均显著下降,且DLQI改善率和PASI改善率呈显著正相关(r=0.722,P<0.001)。结论:银屑病对患者生活质量的影响较大,DLQI可作为判断银屑病病情及疗效的新指标。     

生物反馈放松疗法治疗寻常型银屑病疗效评价

目的:评价生物反馈放松疗法治疗寻常型银屑病的临床疗效。方法:364例寻常型银屑病患者随机分为治疗组和对照组,各182例。对照组给予维A酸治疗,治疗组在对照组基础上进行生物反馈放松疗法。8周后比较两组患者的疗效及不良反应发生率。结果:两组治疗后相比,治疗组PASI和DLQI评分显著低于对照组(P<0.05);治疗组的有效率为67.05%明显高于对照组的37.36%(P<0.05);研究组不良反应发生率明显低于对照组。结论:生物反馈放松疗法对寻常型银屑病有显著疗效。     

阿维A治疗斑块状银屑病临床疗效观察

目的:观察阿维A治疗中、重度斑块状银屑病的疗效.方法:将中、重度斑块状银屑病患者随机分成两组,分别给予阿维A和海棠合剂治疗,疗程均为8周,以银屑病面积和严重度指数(PASI)和皮肤病生活质量指数(DLQI)作为观察指标,比较两种药物的疗效.结果:治疗后,两组患者的PASI评分和DLQI评分与治疗前比较均显著下降(P＜0.01),但PASI改善率和DLQI改善率两组间比较差异无统计学意义,PASI50和PASI75有效率亦无统计学意义(P＞0.05).结论:阿维A治疗中、重度斑块状银屑病有效.     

活血解毒汤治疗银屑病血瘀证的临床疗效观察

目的观察活血解毒汤治疗银屑病血瘀证的临床疗效和安全性。方法 80例银屑病患者随机分为试验组和对照组,试验组给予活血解毒汤治疗,对照组给予安慰剂治疗,治疗12周后,进行银屑病面积与严重性指数(PASI)评分、中医主要临床症状、皮肤病生活质量指数(DLQI)、临床疗效及安全性评价。结果试验组总有效率为86.84%,对照组总有效率为50.00%,两组总有效率相比差异有统计学意义(P0.05);治疗后试验组与对照组相比,PASI评分、DLQI评分明显降低,差异具有统计学意义(P0.05);治疗后试验组在红斑、浸润改善方面优于对照组,差异具有统计学意义(P0.05)。两组患者均无明显不良反应。结论活血解毒汤对寻常性银屑病血瘀证安全有效。     

外用三草油治疗轻度寻常性银屑病的临床疗效研究

目的:评价外用三草油治疗轻度寻常性银屑病(PV)的临床疗效及安全性。方法:将62例轻度PV患者随机分为2组:治疗组(31例)予外用三草油,对照组(31例)予外用卡泊三醇软膏,14 d为一个疗程,共4个疗程。观察用药前、后2组患者的临床疗效、银屑病皮损面积和严重程度指数(PASI)评分、皮肤病生活质量指标调查表(DLQI)评分及不良反应情况。结果:治疗组有效率为76.67%,对照组有效率为46.67%,2组比较差异有统计学意义(P0.05)。与治疗前比较,治疗后2组PASI评分均降低(P0.05),但2组治疗前、后PASI评分比较,差异无统计学意义(P0.05);与治疗前比较,2组DLQI评分均降低(P0.05),且2组治疗前、后DLQI评分比较,差异有统计学意义(P0.05)。治疗组中1例患者出现接触性皮炎,停药及予外用丁酸氢化可的松治疗后症状消退。结论:外用三草油治疗轻度PV疗效确切,可改善患者的生活质量,且不良反应少。     

阿维A及雷公藤治疗重度斑块状银屑病疗效分析

摘要：目的 观察阿维A和雷公藤治疗重度斑块状银屑病的疗效和安全性;方法：将101例斑块状银屑病患者随机分为3组,阿维A组予阿维A胶囊0.5㎎/（㎏.d）,雷公藤组予雷公藤片,2片,每日3次。联合组同时予雷公藤和阿维A治疗,剂量同单用组,三组均外用10%尿素霜,每日2次。疗程均为8周,治疗前后分别予PASI和DLQI评分。结果：3组患者的PASI和DLQI评分较治疗前明显下降（ P < 0.01）,联合组治疗后的PASI和DLQI评分较单用组比较差异显著（P < 0.05）,联合组有效率较与单用组比较差异显著（P < 0.01）,DLQI 改善率与PASI 改善率亦呈显著正相关( P < 0.01)。结论：单用和联合阿维A和雷公藤治疗重度寻常型银屑病均有疗效,但联合组疗效更好,不良反应无增加且均可耐受,联合PASI和DLQI评分评价银屑病相对更可靠,准确。     

消斑敷剂定向透药法治疗斑块状银屑病临床观察

目的观察消斑敷剂定向透药法治疗斑块状银屑病的临床疗效。方法采用随机数字表法将60例患者分为试验组和对照组各30例。试验组口服活血散瘀汤联合透药仪将消斑敷剂导入皮损,每周3次;对照组口服活血散瘀汤、外用白凡士林,每日1次。治疗前及治疗4周后分别进行银屑病皮损面积和严重度指数(PASI)评分、中医证候评分、瘙痒指数评分及皮肤病生活质量评分(DLQI)评估。结果试验组总有效率89.65%,对照组总有效率65.51%,两组总有效率相比差异有统计学意义(P 0.05)。4周后,试验组与对照组相比,PASI评分、瘙痒指数评分、DLQI明显降低,差异有统计学意义(P 0.05);中医证候评分比较差异无统计学意义(P 0.05)。结论消斑敷剂定向透药法治疗斑块状银屑病疗效肯定。     

中药药浴联合NB-UVB照射治疗稳定期寻常性银屑病及其对患者生活质量的影响

目的观察中药药浴联合窄谱中波紫外线(NB-UVB)照射治疗稳定期寻常性银屑病的临床疗效及其对患者生活质量的影响。方法将入选的84例门诊稳定期寻常性银屑病患者随机分为两组,治疗组予中药药浴及NB-UVB照射治疗,对照组予NB-UVB照射治疗,比较两组患者治疗前后的银屑病面积严重程度指数(PASI)及皮肤病生活质量指数(DLQI)变化情况。结果治疗组有效率为84.2%,对照组有效率为61.5%,差异有统计学意义(P0.05)。治疗组治疗后DLQI评分下降,与治疗前比较差异有统计学意义(P0.05),而对照组治疗前、后DLQI评分差异无统计学意义(P0.05)。结论中药药浴联合NB-UVB照射治疗稳定期银屑病疗效确切,可以改善患者生活质量。     

身心系统护理干预在寻常型银屑病中的应用价值

目的观察身心系统护理干预在寻常型银屑病中的应用价值。方法选择2017年2月～2018年1月至我院进行治疗的75例寻常型银屑病患者作为研究对象,通过不同护理模式分为实验组37例,对照组38例,对照组应用常规护理,实验组应用身心系统护理干预。比较两组患者的治疗有效率、SAS、SDS评分。结果实验组患者治疗有效率97.30%,高于对照组(76.32%),差异有统计学意义(P 0.05)。两组患者干预前SAS、SDS评分差异无统计学意义(P 0.05),干预后实验组的SAS、SDS评分低于对照组,差异有统计学意义(P 0.05)。结论身心系统护理干预有助于寻常型银屑病患者疗效的提高,改善负性情绪及生活质量,值得推广。     

中药浴加窄谱中波紫外线治疗寻常性银屑病疗效和生活质量分析

目的观察中药浴联合窄谱中波紫外线(narrow band ultraviolet B,NB-UVB)治疗寻常性银屑病临床疗效及其对患者生活质量的影响。方法将患者随机分为两组,治疗组(30例)采用中药浴联合NB-UVB治疗,对照组(30例)单独用NB-UVB治疗。结果治疗组银屑病面积和严重指数(psoriasis area and severity index,PASI)积分下降较对照组明显(P0.01),治疗组有效率为83.33%,而对照组有效率仅为53.33%,两者差异具有统计学意义(P0.05)。治疗后两组患者皮肤病生活质量指数(dermatology life quality index,DLQI)评分均有不同程度的改善,治疗组显著优于对照组(P0.01)。结论中药药浴联合NB-UVB对寻常性银屑病的疗效满意。     

银屑病患者的心理因素及外周血单胺类物质的改变

目的：研究心理因素在银屑病发病过程中的作用，探讨单胺类物质在银屑病心理因素致病过程中的作用，揭示心理因素在银屑病发病中的某些物质基础。方法：采用生活事件量表和A塑性格问卷评估患者的心理因素；应用高效液相色谱法检测患者血清中去甲肾上腺素、多巴胺、5－羟基吲哚乙酸（5－HIAA）等单胺类物质的含量。结果：银屑病组有各种生活事件的发生率高于对照组（P＜0．001）。银屑病患者总体倾向为弱A型性格，其A型性格所占的比例高于对照组。银屑病组去甲肾上腺素、多巴胺、5－HIAA的含量均高于对照组（P＜0．001）；A型性格患者3种单胺类物质含量均高于B型性格者；不同皮损严重程度的患者单胺类物质含量之间差异有显著性（P＜0．001）；PASI评分值与去甲肾上腺素、多巴胺、5－HIAA含量之间均有相关性（P＜0．001），患者血清单胺物质含量随PASI评分值的增加而升高。结论：心理因素是银屑病发病的重要危险因素，单胺类物质是心理因素导致银屑病发病的中间机制之一。     

基于萨提亚模式的医疗情景游戏对住院银屑病患儿及家属生活质量和遵医行为的影响

目的：评价基于萨提亚模式的医疗情景游戏对银屑病患儿及家属生活质量、负性情绪、遵医行为的作用。方法：选取我院过敏与风湿免疫科病区2019年3~7月入院患儿为对照组,2019年8月至2020年1月入院患儿为干预组。对照组接受病房常规诊疗活动及健康教育,干预组由3名接受过统一培训的护师实施基于萨提亚模式的医疗情景游戏。干预前、出院时和出院后1个月检测COLQI评分、FDLQI评分、家长疾病管理能力评分和家长积极感受评分。结果：对照组34 例,干预组35 例。出院时干预组患儿COLQI评分低于对照组患儿,出院时和出院后1个月干预组FDLQI评分低于对照组,干预组积极感受评分、疾病管理能力评分高于对照组,差异有统计学意义（P＜0.05）。结论：基于萨提亚模式的医疗情景游戏可改善银屑病患儿及其家长生活质量、遵医行为,可提高家长积极感受和疾病管理能力。     

Temperament and character profile of patients with psoriasis

Background Psychosocial factors have been implicated as being important in the onset and/or exacerbation of psoriasis.¹ The aim of this study is to examine both the personality factors of patients with psoriasis and the correlations between temperament and character dimensions. Material and methods A total number of 105 psoriasis patients and 109 healthy individuals were enrolled in the study. Questionnaires including Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Temperament and Character Inventory (TCI) were administered individually. Both groups were evaluated in terms of depression, anxiety and characteristic features by using these psychological tests and compared statistically. The relationship between psoriasis area and severity index (PASI) score and the BDI, BAI and TCI scales were also evaluated. Results The mean BDI score of the psoriasis group were significantly higher than the control group. The psoriasis group had significantly higher scores of harm avoidance and lower scores of being self‐directedness than the control group. The duration of psoriasis and the PASI scores were not correlated with BDI and BAI scores. Conclusion The current study shows that psoriasis patients have distinctive temperament and character dimensions when compared with the control group. We suggest that evaluation and treatment of psoriasis should also include psychosomatic approaches in clinical practice.     

心理干预在大学生Ⅲ型前列腺炎中的临床疗效

目的:探讨心理干预在大学生Ⅲ型前列腺炎治疗中的临床疗效.方法:63例大学生Ⅲ型前列腺炎患者,随机分为实验组(心理干预联合药物治疗)32例和对照组(药物治疗)31例,分别于治疗前后依据美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)、疼痛不适评分、排尿症状评分、生活质量评分、总评分和焦虑自评量表(SAS)标准分进行评分,比较治疗后临床效果.结果:两组间治疗后 NIH-CPSI总评分、SAS标准分有统计学差异(P<0.05);实验组治疗前后 NIH-CPSI总评分有统计学差异(P<0.05),SAS标准分有统计学显著性差异(P<0.01);对照组治疗前后 NIH-CPSI总评分、SAS标准分有统计学差异(P<0.05).结论:心理干预联合药物治疗大学生Ⅲ型前列腺炎比单纯药物治疗效果显著.     

Psychological distress impairs clearance of psoriasis in patients treated with photochemotherapy

OBJECTIVE: To assess whether psychological distress affects treatment outcome in psoriasis. DESIGN: Cohort study of patients with psoriasis receiving psoralen-UV-A (PUVA) photochemotherapy. SETTING: Two university hospital dermatology departments. PATIENTS: One hundred twelve patients with chronic plaque psoriasis. MAIN OUTCOME MEASURES: We assessed clinical severity of psoriasis, psychological distress, and other potential confounders of treatment outcome such as skin phototype, family history of psoriasis, and alcohol intake before starting PUVA therapy. Clinical severity of disease and response to therapy were assessed at every fourth appointment. RESULTS: Pathological or high-level worry was the only significant (P =.01) predictor of time taken for PUVA to clear psoriasis. Event curves of time to clearance significantly differed between high- and low-level worry groups (log rank test, 6.64; df = 1; P =.01). Patients in the high-level worry group cleared with PUVA treatment at a rate 1.8 times slower than that of the low-level worry group (ExpB = 1.81; 95% confidence interval, 1.13-2.90). Fiftieth percentile time to clearance of psoriasis in the high- and low-level worry groups showed a median difference of 19 days. CONCLUSIONS: Psychological distress, in the form of excessive worrying, has a significant and detrimental affect on treatment outcome in patients with psoriasis. Patients with psoriasis who are classified as high-level worriers may benefit from adjunctive psychological intervention before and during treatment. These findings provide further evidence of the existence of a brain-skin axis.     

行放射线检查患者的心理评估及心理干预

目的探讨行放射线检查患者的心理因素、心理干预对检查结果的影响。方法将1200例放射线检查患者随机分为干预组和对照组各600例,干预组在检查的同时,采用心理治疗和认知疗法,根据焦虑自评量表（SAS）和抑郁自评量表（SDS）分别评估两组患者的心理状况。结果两组检查前后比较,干预组患者SAS、SDS标准分有显著性差异（P〈0．05）,对照组无显著性差异（P〉0．05）。结论心理因素在放射检查中的作用不可忽视,有效的心理干预能使患者检查顺利进行。     

寻常型银屑病患者心理因素分析及护理干预

目的探究寻常型银屑病患者的心理状态及个性特征,为本病的治疗和护理提供更多的参考依据;方法采用症状自评量表（Symptom Check List90,SCL-90）调查寻常型银屑病患者的心里状态和个性特征,并于实施心理护理干预28周后做以对照比较。结果随机调查寻常型银屑病患者44例,结果干预前有29例（65．91％）存在不同程度心理障碍;SCL-90各因子分值比较显示,干预前存在躯体、强迫、人际关系、抑郁、焦虑、恐怖和偏执等心理问题,干预后有显著性改善（P〈0．05）。结论寻常型银屑病患者治疗前存在不同程度的心理障碍,表现为情绪不稳、抑郁、急躁、易怒、被动。针对不同的个性特征,给予相应的心理干预和护理对策,对提高患者的生活质量有重要意义。     

Indications for psychological intervention in patients with psoriasis

Various forms of psychological interventions have since long been proposed as potentially helpful adjuncts to standard pharmacological therapy of psoriasis. All studies investigating the effectiveness of psychological intervention in psoriasis reported its positive impact on the patients' psychological well-being and some studies also reported improvements in the skin condition as a result of psychotherapy. When making a decision about the referral of a given patient to the psychologist, both clinical (psoriasis-specific) and general (psychotherapy-specific) indications should be taken into consideration. This can allow a better identification of those psoriasis patients who are in real need for psychological intervention and who are most likely to benefit from it.     

手术联合授权教育干预对育龄期宫颈癌术后患者心理抑郁程度及性生活质量影响

目的探究性康复干预对育龄期宫颈癌术后患者心理抑郁程度及性生活质量影响。方法选取2015年5月至2016年6月在安康市中医医院诊治的宫颈癌患者120例,随机数字法将其分为对照组和授权组,各60例。两组均采用"腹式全子宫切除+盆腔淋巴结清扫术+双附件切除术"手术治疗,给予对照组患者一般护理,在对照组基础上给予授权组患者授权教育模式的性康复护理。于干预前后评估两组患者女性性功能量表(FSFI)、抑郁自评量表(SDS),比较两组患者的干预效果。结果干预后,授权组FSFI评分显著高于对照组,SDS评分显著低于对照组,差异均具有统计学意义(P<0.05);干预后,对照组7人未恢复性生活,授权组全部恢复,差异具有统计学意义(P<0.05)。结论手术联合授权教育模式性康复干预可以有效提高育龄期宫颈癌患者性生活质量,改善患者抑郁。     

Evaluation of the impact of writing exercises interventions on quality of life in patients with psoriasis undergoing systemic treatments

Background Emotional writing is a short‐term psychological intervention that has been successfully used in several controlled studies. Objectives The overall objective of the study was to test the efficacy of Pennebaker’s emotional writing intervention in patients with psoriasis treated with systemic therapy. Methods A randomized controlled trial was conducted in seven clinical centres in Italy, over a 2‐year period. The main outcome measures were the psoriasis area and severity index and the Physician Global Assessment, as well as generic and dermatology‐specific quality of life questionnaires. Such outcomes were measured at 4 weeks, and 6 and 12 months from baseline. The project recruitment time was 12 months, and the total follow‐up time for each individual was also 12 months. Results In total, 202 patients were enrolled and assessed at baseline, 67 of whom completed all three follow‐up visits. The writing exercise had little or no effect on patients with psoriasis who were undergoing systemic treatment. In the Generalized Estimating Equations models no statistically significant differences were observed in the Pennebaker intervention group vs. the control group. In subgroup analysis for health status, small effects in favour of patients assigned to the Pennebaker group were documented at the end of the study in women, in overweight individuals, in patients under treatment with biological drugs, and on the Physical Component Summary of the Short Form of the Medical Outcomes Study Questionnaire. Conclusions The Pennebaker and control groups had similar changes over time for practically all the outcome variables, and also when considering all observations and adjusting for all the variables of interest. The longitudinal analysis confirmed that the intervention had little or no effect on the variables of interest. The implementation of writing exercises requires a careful and ad hoc organization, including dedicated spaces for the writing itself.