CAJ | 학술논문

目的：观察心理干预治疗对慢性乙型病毒性肝炎（CHB）患者心身症状和外周血T细胞亚群的影响。方法选择64例 CHB 患者，随机分为干预组和对照组，2组患者均给予拉米夫定抗病毒及常规药物保肝治疗，干预组同时进行8周的心理干预治疗。应用症状自评量表（SCL-90）评估2组患者在治疗前、后的心身症状变化，同时观察治疗前、后 T 细胞亚群比例的变化。结果治疗前，64例患者 SCL-90因子中除偏执因子外的8项因子分值与常模组比较差异均有统计学意义（P均＜0．05）。与治疗前比较，治疗后干预组该8项因子分值明显下降、CD4＋T 细胞比例上升、CD8＋T细胞比例下降、CD4＋／CD8＋T 细胞比值上升（P 均＜0．05）；对照组9项因子分值均无明显变化（P均＞0．05），且 T 细胞亚群亦无明显变化（P 均＞0．05）。治疗后，干预组强迫、抑郁、焦虑、敌对、精神病性因子分值均明显低于对照组（P 均＜0．05）；干预组 CD4＋T 细胞比例、CD4＋／CD8＋T 细胞比值高于对照组，CD8＋T 细胞比例低于对照组（P 均＜0．01）。结论心理干预治疗可有效改善 CHB患者的心身症状，提高外周血 T 细胞亚群功能。
목적：관찰심리간예치료대만성을형병독성간염（CHB）환자심신증상화외주혈T세포아군적영향。방법선택64례 CHB 환자，수궤분위간예조화대조조，2조환자균급여랍미부정항병독급상규약물보간치료，간예조동시진행8주적심리간예치료。응용증상자평량표（SCL-90）평고2조환자재치료전、후적심신증상변화，동시관찰치료전、후 T 세포아군비례적변화。결과치료전，64례환자 SCL-90인자중제편집인자외적8항인자분치여상모조비교차이균유통계학의의（P균＜0．05）。여치료전비교，치료후간예조해8항인자분치명현하강、CD4＋T 세포비례상승、CD8＋T세포비례하강、CD4＋／CD8＋T 세포비치상승（P 균＜0．05）；대조조9항인자분치균무명현변화（P균＞0．05），차 T 세포아군역무명현변화（P 균＞0．05）。치료후，간예조강박、억욱、초필、활대、정신병성인자분치균명현저우대조조（P 균＜0．05）；간예조 CD4＋T 세포비례、CD4＋／CD8＋T 세포비치고우대조조，CD8＋T 세포비례저우대조조（P 균＜0．01）。결론심리간예치료가유효개선 CHB환자적심신증상，제고외주혈 T 세포아군공능。
Objective To investigate the influence of psychological intervention on psychosomatic symptoms and peripheral blood T lymphocyte subsets of patients with chronic hepatitis B (CHB).Methods Sixty four patients were randomly divided into the intervention and control groups(n =32 for each group).Pa-tients in both groups received lamivudine and hepatoprotective medicine.Besides,psychological intervention was supplemented for eight weeks in the intervention group.The changes in the psychosomatic symptoms before and after treatment were evaluated by SCL-90 symptom self-evaluation scale.The variations in the percentage of T lymphocyte subsets before and after treatment were observed.Results Prior to treatment,eight factors from the SCL-90 in 64 patients significantly differed from those of the normal group (all P <0.05).In the interven-tion group,the scores of eight factors from the SCL-90 were considerably decreased,the percentage of CD4 +T was significantly increased,the proportion of CD8 +T was dramatically reduced and the ratio of CD4 +/CD8 +T was significantly elevated after corresponding treatment(all P <0.05).In the control group,the scores of nine factors from the SCL-90 and T lymphocyte subsets did not significantly differ before and after treatment(all P >0.05).Following corresponding treatment,the scores of obsession,depression,anxiety,hostility and psycho-sis in the intervention group were significantly lower compared with those of the control group (all P <0.05). Compared with the control group,the percentage of CD4 +T and the ratio of CD4 +/CD8 +T was significantly higher,whereas the proportion of CD8 +T was significantly lower (both P <0.01).Conclusion Psychological intervention can effectively improve the psychosomatic symptoms and function of peripheral blood T cell subsets in patients with CHB.