中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2009年
15期
1406-1409
,共4页
何荣国%武钦学%田华%邬运学%伍绍国%成友军%杨晓梅%庄碧嘉%罗绮群
何榮國%武欽學%田華%鄔運學%伍紹國%成友軍%楊曉梅%莊碧嘉%囉綺群
하영국%무흠학%전화%오운학%오소국%성우군%양효매%장벽가%라기군
皮炎%特应性%儿童%焦虑%抑郁%心理疗法%行为疗法
皮炎%特應性%兒童%焦慮%抑鬱%心理療法%行為療法
피염%특응성%인동%초필%억욱%심리요법%행위요법
Dermatitis,atopic%Child%Anxiety%Depression%Psychotherapy%Behavior therapy
目的 探讨社区综合性心理、行为干预对学龄期儿童特应性皮炎的疗效.方法 采用随机对照方法,将广州市部分社区2006年2月-2008年6月诊断为儿童特异性皮炎且符合入组标准的58例患儿随机分为综合性心理、行为干预组(干预组,30例)和对照组(28例).两组患儿均给予常规药物治疗,干预组在此基础上给予综合性心理、行为干预,时间为8周.另选择20例健康儿童作为正常对照组.比较治疗前后干预组和对照组患儿的儿童焦虑障碍自评量表(SCARED)和儿童抑郁障碍自评量表(DSRSC)评分、湿疹面积及严重度指数(EASI)、视觉模拟评分(VAS)及血清神经生长因子(NGF)、P物质(SP)水平.结果 (1)治疗前干预组和对照组患儿SCARED评分[(27.5±3.2)分和(28.1±2.6)分]、DSRSC评分[(18.2±3.4)分和(18.9±3.2)分]、EASI[(33.3±7.8)和(33.0±8.0)]、VAS[(7.3±1.3)分和(6.9±1.3)分]及血清NGF[(2 700±289)pg/ml和(2 643±292)pg/ml]、SP[(557±63)pg/ml和(553±58)pg/ml]水平间差异无统计学意义(P>0.05),两组SCARED和DSRSC评分均高于全国常模的划界分,血清NGF、SP水平与正常对照组[(102±53)pg/ml和(150±51)pg/ml]比较,差异均有统计学意义(P<0.01).(2)治疗8周后,干预组和对照组患儿的SCARED评分[(17.9±2.8)分和(25.0±3.0)分]、DSRSC评分[(10.2±2.4)分和(15.3±2.3)分]、EASI[(10.2±4.0)和(22.9±8.7)]、VAS[(2.6±0.9)分和(4.3±1.0)分]及血清NGF[(962±227)pg/ml和(2 206±296)pg/ml]、SP[(239±41)pg/ml和(447±57)pg/ml]水平间差异均有统计学意义(P<0.01).(3)治疗后干预组痊愈2例,显效24例,进步4例,无效0例;对照组痊愈0例,显效5例,进步18例,无效5例,两组疗效间差异有统计学意义(u=5.22,P<0.01).结论 社区综合性心理、行为干预能明显改善学龄期特应性皮炎患儿的焦虑/抑郁症状和躯体症状,提高疗效.
目的 探討社區綜閤性心理、行為榦預對學齡期兒童特應性皮炎的療效.方法 採用隨機對照方法,將廣州市部分社區2006年2月-2008年6月診斷為兒童特異性皮炎且符閤入組標準的58例患兒隨機分為綜閤性心理、行為榦預組(榦預組,30例)和對照組(28例).兩組患兒均給予常規藥物治療,榦預組在此基礎上給予綜閤性心理、行為榦預,時間為8週.另選擇20例健康兒童作為正常對照組.比較治療前後榦預組和對照組患兒的兒童焦慮障礙自評量錶(SCARED)和兒童抑鬱障礙自評量錶(DSRSC)評分、濕疹麵積及嚴重度指數(EASI)、視覺模擬評分(VAS)及血清神經生長因子(NGF)、P物質(SP)水平.結果 (1)治療前榦預組和對照組患兒SCARED評分[(27.5±3.2)分和(28.1±2.6)分]、DSRSC評分[(18.2±3.4)分和(18.9±3.2)分]、EASI[(33.3±7.8)和(33.0±8.0)]、VAS[(7.3±1.3)分和(6.9±1.3)分]及血清NGF[(2 700±289)pg/ml和(2 643±292)pg/ml]、SP[(557±63)pg/ml和(553±58)pg/ml]水平間差異無統計學意義(P>0.05),兩組SCARED和DSRSC評分均高于全國常模的劃界分,血清NGF、SP水平與正常對照組[(102±53)pg/ml和(150±51)pg/ml]比較,差異均有統計學意義(P<0.01).(2)治療8週後,榦預組和對照組患兒的SCARED評分[(17.9±2.8)分和(25.0±3.0)分]、DSRSC評分[(10.2±2.4)分和(15.3±2.3)分]、EASI[(10.2±4.0)和(22.9±8.7)]、VAS[(2.6±0.9)分和(4.3±1.0)分]及血清NGF[(962±227)pg/ml和(2 206±296)pg/ml]、SP[(239±41)pg/ml和(447±57)pg/ml]水平間差異均有統計學意義(P<0.01).(3)治療後榦預組痊愈2例,顯效24例,進步4例,無效0例;對照組痊愈0例,顯效5例,進步18例,無效5例,兩組療效間差異有統計學意義(u=5.22,P<0.01).結論 社區綜閤性心理、行為榦預能明顯改善學齡期特應性皮炎患兒的焦慮/抑鬱癥狀和軀體癥狀,提高療效.
목적 탐토사구종합성심리、행위간예대학령기인동특응성피염적료효.방법 채용수궤대조방법,장엄주시부분사구2006년2월-2008년6월진단위인동특이성피염차부합입조표준적58례환인수궤분위종합성심리、행위간예조(간예조,30례)화대조조(28례).량조환인균급여상규약물치료,간예조재차기출상급여종합성심리、행위간예,시간위8주.령선택20례건강인동작위정상대조조.비교치료전후간예조화대조조환인적인동초필장애자평량표(SCARED)화인동억욱장애자평량표(DSRSC)평분、습진면적급엄중도지수(EASI)、시각모의평분(VAS)급혈청신경생장인자(NGF)、P물질(SP)수평.결과 (1)치료전간예조화대조조환인SCARED평분[(27.5±3.2)분화(28.1±2.6)분]、DSRSC평분[(18.2±3.4)분화(18.9±3.2)분]、EASI[(33.3±7.8)화(33.0±8.0)]、VAS[(7.3±1.3)분화(6.9±1.3)분]급혈청NGF[(2 700±289)pg/ml화(2 643±292)pg/ml]、SP[(557±63)pg/ml화(553±58)pg/ml]수평간차이무통계학의의(P>0.05),량조SCARED화DSRSC평분균고우전국상모적화계분,혈청NGF、SP수평여정상대조조[(102±53)pg/ml화(150±51)pg/ml]비교,차이균유통계학의의(P<0.01).(2)치료8주후,간예조화대조조환인적SCARED평분[(17.9±2.8)분화(25.0±3.0)분]、DSRSC평분[(10.2±2.4)분화(15.3±2.3)분]、EASI[(10.2±4.0)화(22.9±8.7)]、VAS[(2.6±0.9)분화(4.3±1.0)분]급혈청NGF[(962±227)pg/ml화(2 206±296)pg/ml]、SP[(239±41)pg/ml화(447±57)pg/ml]수평간차이균유통계학의의(P<0.01).(3)치료후간예조전유2례,현효24례,진보4례,무효0례;대조조전유0례,현효5례,진보18례,무효5례,량조료효간차이유통계학의의(u=5.22,P<0.01).결론 사구종합성심리、행위간예능명현개선학령기특응성피염환인적초필/억욱증상화구체증상,제고료효.
Objective To study the effect of community comprehensive psychological and behavioral intervention in treatment of atopic dermatitis for school age children.Methods Totally 58 school age children diagnosed as having atopic dermatitis,from January 2006 to June 2008,were randomly divided into two groups of intervening group (n=30) and control group (n=28).The patients in the control group were treated only with conventional therapies,while those in the intervening group received comprehensive psychological and behavioral intervention additionally for 8 weeks.And another 20 healthy children were enrolled as normal controls.The scores of screen for child anxiety related emotional disorders (SCARED) and depression self rating scale for children (DSRSC),eczema area and severity index (EASI),visual analogue scale(VAS),level of serum nerve growth factor(NGF) and substance P(SP) were assessed before and after the treatment.Results (1)Before treatment,in the intervening and control groups the scores of SCARED were respectively (27.5±3.2) and (28.1±2.6),the scores of DSRSC(18.2±3.4) and (18.9±3.2),the scores of EASI (33.3±7.8) and(33.0±8.0),the scores of VAS (7.3±1.3) and (6.9±1.3),the levels of serum NGF (2 700±289)pg/ml and (2 643±292)pg/ml,the levels of serum SP(557±63)pg/ml and (553±58)pg/ml,with no significant difference between the two groups (P>0.05).In the two groups,the scores of SCARED and DSRSC were higher than the normal limits in China,and the levels of serum NGF and SP were higher significantly than (102±53)pg/ml and (150±51)pg/ml of the normal group (P<0.01).(2)After 8 weeks treatment,in the intervening and control groups the scores of SCARED were respectively (17.9±2.8) and (25.0±3.0),the scores of DSRSC (10.2±2.4) and (15.3±2.3),the scores of EASI (10.2±4.0) and (22.9±8.7),the scores of VAS (2.6±0.9) and (4.3±1.0),the levels of serum NGF (962±227)pg/ml and (2 206±296)pg/ml,the levels of serum SP (239±41)pg/ml and (447±57)pg/ml,with significant differences between the two groups (P<0.01).(3)After treatment,in the intervening group there 2 patients who recovered,24 who got remarkable effect,4 who got improvement,and no one who did not respond; while in the control group there were no patient who recovered,5 who got remarkable effect,18 who got improvement,and 5 who did not respond (u =5.22,P<0.01).Conclusion Community comprehensive psychological and behavioral intervention can obviously reduce the anxiety/depression and physical symptoms of school age children with atopic dermatitis,and thus raise the effect.