心理干预对育龄期系统性红斑狼疮患者的影响

目的 探讨心理干预对育龄期系统性红斑狼疮患者治疗效果、依从性及心理状态的影响。 方法 收集2015年6月-2016年12月蚌埠医学院第一附属医院就诊的育龄期系统性红斑狼疮患者共64例,按随机数字表法分为心理干预组和对照组,对照组在院期间予以内科常规护理,心理干预组在常规护理基础上加用心理干预措施,比较2组患者治疗前后的系统性红斑狼疮疾病活动度评分(SLEDAI)、汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)评分、匹茨堡睡眠质量指数量表(PSQI)、依从性、疾病复发率、使用维持激素量和相关实验室指标。 结果 与治疗前比较,治疗后心理干预组的HAMA评分(12.14±3.68)分 vs. (9.29±3.43)分,P<0.001]、HAMD评分(11.32±3.86)分 vs. (9.70±3.01)分,P=0.041]、SLEDAI评分(10.29±4.60)分 vs. (6.85±2.78)分,P<0.001]下降,差异有统计学意义,PSQI评分下降,但差异无统计学意义。对照组的评分变化差异均无统计学意义。治疗6个月后心理干预组的治疗依从性高于对照组(χ2=4.947,P=0.025),病情复发率(χ2=4.433,P=0.032)及SLEDAI评分(t=-3.410,P=0.039)均较对照组低,差异有统计学意义,而C3、C4、ESR、CEP及使用激素量差异均无统计学意义。 结论 心理干预治疗可以缓解患者的焦虑和抑郁情绪,提高患者的治疗依从性,可促进病情缓解,减少复发,对巩固SLE患者的治疗效果、改善生活质量以及预后都有积极的影响。 

Effect of psychological intervention on patients with systemic lupus erythematosus of reproductive age

Objective To explore the effect of psychological intervention on the curative efficacy, compliance and psychological status of patients with systemic lupus erythematosus (SLE). Methods Total 64 SLE patients in our hospital between June, 2015 and December, 2016 were divided into psychological intervention group and control group. The control group received medical routine nursing, while the other group received psychological intervention. Before and after the treatment, SLE disease activity score (SLEDAI), Hamilton anxiety scale (HAMA) and depression scale (HAMD) scores, and the Pittsburgh sleep quality index scale (PSQI) were compared between the two groups. Results HAMA (12.14±3.68 vs. 9.29±3.43, P<0.001), HAMD (11.32±3.86 vs. 9.70±3.01, P=0.04), the SLEDAI score (10.29±4.60 vs. 9.46±5.56, P<0.001) of psychological intervention group were lower than those of the control group, the difference was statistically significant; The treatment adherence was higher, and the SLEDAI and disease recurrence rates were lower than those in the control group. The score of the control group was not statistically significant. After 6 months of treatment, the treatment compliance in the psychological intervention group was higher than that in the control group (χ2=4.947, P=0.025); the SLEDAI (t=-3.410, P=0.039) and disease recurrence rate (χ2=4.433, P=0.032) of the psychological intervention group was lower than those of the control group, the difference was statistically significant. C3, C4 and ESR, CEP were no statistically significant different between the two groups. Conclusion The psychological intervention can relieve the anxiety and depressed mood, improve the treatment compliance of patients, promote the remission and reduce the recurrence, improve the therapeutic effect, prognosis and QOL of patients with SLE.