CAJ | 학술논문

目的探讨认知行为治疗社区高血压患者心理情绪障碍对血压、血脂、血糖的影响.方法将社区599名高血压患者按照随机数字表达方法分为干预组(n=302)和对照组(n=297).干预组采用药物加认知行为技术的综合治疗,对照组采用常规降压药物治疗,疗程6个月.症状自评量表(SCL-90)评价治疗前后的心理健康、血糖、低密度脂蛋白、总胆固醇、收缩压、舒张压的生理变化.结果干预组患者干预后SCL-90的躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、恐怖评分[分别为(1.44±0.29)分,(1.78±0.39)分,(1.66±0.38)分,(1.63±0.48)分,(1.43±0.35)分,(1.37±0.52)分,(1.28±0.41)分]均低于干预前[分别为(2.01±0.59)分,(2.04±0.68)分,(1.88±0.38)分,(1.84±0.59)分,(1.92±0.54)分,(1.61±0.53)分,(1.60±0.50)分]均差异有统计学意义(P＜0.01).干预组患者干预后血糖、低密度脂蛋白、总胆固醇、收缩压、舒张压[分别为(4.65±0.811) mmol/L,(2.97±0.702) mmol/L,(4.86±0.884) mmol/L,(134.11±13.39)mm Hg(1 mm Hg=0.133 kPa),(93.73±7.61)mm Hg],低于干预前[分别为(5.09±0.710) mmol/L,(3.23 ±0.584) mmol/L,(5.36±1.138) mmol/L,(150.13±12.23) mm Hg,(89.64 ±8.35)mm Hg],均差异有统计学意义(P＜0.05).结论认知行为综合干预能改善社区高血压患者生理心理状况,利于血压、血脂、血糖控制.
목적 탐토인지행위치료사구고혈압환자심리정서장애대혈압、혈지、혈당적영향.방법 장사구599명고혈압환자안조수궤수자표체방법분위간예조(n=302)화대조조(n=297).간예조채용약물가인지행위기술적종합치료,대조조채용상규강압약물치료,료정6개월.증상자평량표(SCL-90)평개치료전후적심리건강、혈당、저밀도지단백、총담고순、수축압、서장압적생리변화.결과 간예조환자간예후SCL-90적구체화、강박증상、인제관계、억욱、초필、활대、공포평분[분별위(1.44±0.29)분,(1.78±0.39)분,(1.66±0.38)분,(1.63±0.48)분,(1.43±0.35)분,(1.37±0.52)분,(1.28±0.41)분]균저우간예전[분별위(2.01±0.59)분,(2.04±0.68)분,(1.88±0.38)분,(1.84±0.59)분,(1.92±0.54)분,(1.61±0.53)분,(1.60±0.50)분]균차이유통계학의의(P＜0.01).간예조환자간예후혈당、저밀도지단백、총담고순、수축압、서장압[분별위(4.65±0.811) mmol/L,(2.97±0.702) mmol/L,(4.86±0.884) mmol/L,(134.11±13.39)mm Hg(1 mm Hg=0.133 kPa),(93.73±7.61)mm Hg],저우간예전[분별위(5.09±0.710) mmol/L,(3.23 ±0.584) mmol/L,(5.36±1.138) mmol/L,(150.13±12.23) mm Hg,(89.64 ±8.35)mm Hg],균차이유통계학의의(P＜0.05).결론 인지행위종합간예능개선사구고혈압환자생리심리상황,리우혈압、혈지、혈당공제.
Objective To investigate the influence of psychological intervention in emotional disorder on blood pressure,lipids and glucose in hypertensive patients in community.Methods 599 hypertensive in community were divided to intervention group (n =302) and control group (n =297) by randomization.The control group received routine medication.Additionally the intervention group got another psychological intervention which lasted 6 months.An SCL-90 scale was adopted to evaluate patients'psychological change of mental health,blood sugar,low density lipoprotein cholesterol,total cholesterol,systolic pressure and diastolic blood pressure before and after treatment.Results Somatization,compulsion,interpersonal relationship,depression,anxiety,hostility and terror in intervention group((1.44±0.29),(1.78 ±0.39),(1.66±0.38),(1.63 ±0.48),(1.43 ±0.35),(1.37 ± 0.52) and (1.28 ± 0.41) respectively) had a lower score than control group ((2.01 ± 0.59),(2.04±0.68),(1.88 ±0.38),(1.84±0.59),(1.92±0.54),(1.61 ±0.53)and(1.60±0.50)).The differences were significant(P＜ 0.01).After intervention,blood glueose,low density lipoprotein,total cholesterol,systolic pressure,and diastolic pressure were ((4.65 ± 0.811) mmol/L,(2.97 ± 0.702) mmol/L,(4.86 ± 0.884)mmol/L,(134.11 ± 13.39)mm Hg(1 mm Hg =0.133 kPa) and (93.73 ±7.61)mm Hg respectively) and before intervention((5.09 ± 0.710) mmol/L,(3.23 ± 0.584) mmol/L,(5.36 ± 1.138) mmol/L,(150.13 ± 12.23) mm Hg and (89.64 ± 8.35) mm Hg respectively).The differences were significant (P＜ 0.05).Conclusion Cognitive behavioral therapy can improve community hypertension patients' physiology and psychology,which is good for blood pressure,lipids,glucose control.