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目的 研究正念减压疗法(Mindfulness-based stress reduction, MBSR)对康复期精神分裂症患者的疗效及细胞炎性因子的影响,为康复期精神分裂症患者的临床治疗提供新的参考。方法 选取2021年6月-2022年6月于精河县人民医院精神卫生中心收治的150例康复期精神分裂症患者为研究对象,使用随机数字表法将其分为对照组和观察组,每组75例。对照组给予常规的药物治疗,观察组在常规治疗的基础上增加正念减压治疗方案,共8周。比较两组患者的临床总体印象量表(CGI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、自我效能感量表(GSES)得分以及外周血白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)的水平。结果 治疗前,观察组和对照组患者的HAMA、HAMD、SAS、SDS、GSES得分及IL-6、IL-1β、TNF-α水平无明显差异。治疗8周后,两组患者的HAMA、HAMD、SAS、SDS得分及IL-6、IL-1β、TNF-α水平明显低于治疗前,GSES得分明显高于治疗前(P<0.05);治疗8周后,观察组患者的HAMA、HAMD、SAS和SDS评分及IL-6、IL-1β、TNF-α水平均明显低于对照组,观察组的自我效能感量表评分(GSES)高于对照组(P<0.05)。观察组的疗效明显优于对照组(P<0.05)。结论 正念减压疗法明显提升康复期精神分裂症患者的自我效能且有更好的疗效,并能减轻患者的抑郁和焦虑的严重程度及降低IL-6、IL-1β、TNF-α水平。
Abstract:Objective To study the effect of mindfulness-based stress reduction(MBSR) on convalescent schizophrenic patients and the effect of cellular inflammatory factors for rehabilitation of the patients with schizophrenia clinical intervention to provide a new reference. Methods A total of 150 convalescent schizophrenia patients admitted to the hospital from June 2021 to June 2022 were selected as the study objects, and the patients were randomly divided into control group and observation group with 75 cases in each group with using random number table method.The control group was given conventional drug treatment, and the observation group was added the mindfulness-based decompression therapy program on the basis of conventional treatment, a total of 8 weeks.The scores of clinical general Impression Scale(CGI), Self-rating Anxiety Scale(SAS), Self-rating Depression Scale(SDS), Hamilton Depression Scale(HAMD), Hamilton Anxiety Scale(HAMA), Self-efficacy Scale(GSES),and the levels of interleukin-6(IL-6), interleukin-1β(IL-1β) and tumor necrosis factor(TNF-α) were compared between the two groups. Res-ults Before the treatment, there were no significant differences in HAMA, HAMD, SAS, SDS, GSES scores and levels of IL-6, IL-1β and TNF-α. After 8 weeks of the treatment, scores of HAMA, HAMD, SAS and SDS and the levels of IL-6, IL-1β and TNF-α in two groups were significantly lower than before the treatment, while GSES scores were significantly higher than before the treatment(P<0.05). After 8 weeks of the treatment, the HAMA, HAMD, SAS and SDS scores, IL-6, IL-1β and TNF-α levels in the observation group were significantly lower than those in the control group, and the self-efficacy scale score(GSES) in the observation group was higher than that in the control group(P<0.05), and the efficacy of the observation group was significantly better than that in the control group(P<0.05). Conclusion Mindfulness-based stress reduction therapy can significantly improve the self-efficacy and better efficacy of convalescent schizophrenia patients, reduce the severity of depression and anxiety, and reduce the levels of IL-6, IL-1β and TNF-α.
[1] ZHANG Y H.Application research of humanistic care and situational integration in nursing of schizophrenia in recovery period[J].Contrast Media Mol Imaging,2022,2022:4705107.
[2] 朱永宏,张俊峰.康复期住院精神分裂症患者人文关怀的需求现状及其影响因素分析[J].贵州医药,2022,46(10):1680-1681.
[3] HOGE E A,BUI E,PALITZ S A,et al.The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder[J].Psychiatry Res,2018,262:328-332.
[4] VERWEIJ H,RAVESTEIJN H,HOOFF M L M,et al.Mindfulness-based stress reduction for residents:A randomizedcontrolled trial[J].J Gen Intern Med,2018,33(4):429-436.
[5] DOWSEY M,CASTLE D,KNOWLES S,et al.The effectof mindfulness training prior to total joint arthroplasty on post-operative pain and physical function:A randomised controlled trial[J].Complement Ther Med,2019,46:195-201.
[6] LENGACHER C A,GRUSS L F,KIP K E,et al.Mindfulness-based stress reduction for breast cancer survivors [MBSR(BC)]:evaluating mediators of psychological and physical outcomes in a large randomized controlled trial[J].J Behav Med,2021,44(5):591-604.
[7] FARVER-VESTERGAARD I,O′TOOLE M S,O′CONNOR M,et al.Mindfulness-based cognitive therapy in COPD:a cluster randomised controlled trial[J].Eur Respir,2018,51(2):1702082.
[8] DEMA H,VIDETIC P A,KOUTER K,et al.Effects of mindfulness-based therapy on clinical symptoms and DNA methylation in patients with polycystic ovary syndrome and high metabolic risk[J].Curr Issues Mol Biol,2023,45(4):2717-2737.
[9] 秦洁,李晓波,柏素萍,等.正念减压疗法在慢性疾病中的研究进展[J].中国健康心理学杂志,2020,28(10):1593-1597.
[10] WALSH E,EISENLOHR-MOUL T,BAER R.Brief mindfulness training reduces salivary IL-6 and TNF-α in young women with depressive symptomatology[J].Consult Clin Psychol,2016,84(10):887-897.
[11] SUNDQUIST K,MEMON A A,PALMéR K,et al.Inflammatory proteins and miRNA-144-5p in patients with depression,anxiety,or stress- and adjustment disorders afterpsychological treatment[J].Cytokine,2021,146:155646.
[12] DUNSTAN D A,SCOTT N,TODD A K.Screening for anxiety and depression:reassessing the utility of the Zung scales[J].BMC Psychiatry,2017,17(1):329.
[13] CHEN X,HU W,HU Y,et al.Discrimination and structural validity evaluation of Zung self-rating depression scale for pregnant women in China[J].Psychosom Obstet Gynaecol,2022,43(1):26-34.
[14] CHANDNA S,SHARMA P,MOOSATH H.The mindful self:Exploring mindfulness in relation with self-esteem and self-efficacy in Indian population[J].Psychol Stud (Mysore),2022,67(2):261-272.
[15] XU Y M,LI F,LIU X B,et al.Depressive symptoms in Chinese male inpatients with schizophrenia:Prevalence and clinical correlates[J].Psychiatry Res,2018,264:380-384.
[16] GARROTE-CAPARRóS E,BELLOSTA-BATALLA M,MOYA-ALBIOL L,et al.Effectiveness of mindfulness-based interventions on psychotherapy processes:A systematic review[J].Clin Psychol Psychother,2022,29(3):783-798.
[17] YU Y,TANG B W,LIU Z W,et al.Who cares for the schizophrenia individuals in rural China-A profile of primary family caregivers[J].Compr Psychiatry,2018,84:47-53.
[18] GUPTA S,ISHERWOOD G,JONES K,et al.Assessing health status in informal schizophrenia caregivers compared with health status in non-caregivers and caregivers of otherconditions[J].BMC Psychiatry,2015,15:162.
[19] SHARMA R,SHARMA S C,PRADHAN S N.Assessing caregiver burden in caregivers of patients with schizophrenia and bipolar affective disorder in kathmandu medical college[J].J Nepal Health Res Counc,2018,15(3):258-263.
[20] REYNOLDS G O,WILLMENT K,GALE S A.Mindfulness and cognitive training interventions in mild cognitive impairment:Impact on cognition and mood[J].Am J Med,2021,134(4):444-455.
[21] SLUTSKY J,CHIN B,RAYE J,et al.Mindfulness training improves employee well-being:A randomized controlled trial[J].Occup Health Psychol,2019,24(1):139-149.
[22] YüKSEL A,BAHADIR-YILMAZ E.The effect of mindfulness-based psychosocial skills training on functioning and insight level in patients with schizophrenia[J].Community Ment Health J,2021,57(2):365-371.
[23] O′CONNELL K E,THAKORE J,DEV K K.Pro-inflammatory cytokine levels are raised in female schizophrenia patients treated with clozapine[J].Schizophr Res,2014,156:1-8.
[24] SONG X,FAN X,LI X,et al.Changes in pro-inflammatory cytokines and body weight during 6-month risperidone treatment in drug naive,first-episode schizophrenia[J].Psychopharmacology,2014,231(2):319-325.
[25] GON?ALVES R B,COLETTA R D,SILVéRIO K G,et al.Impact of smoking on inflammation:overview of molecular mechanisms[J].Inflamm Res,2011,60:409-424.
基本信息:
中图分类号:R749.3
引用信息:
[1]张哲栋,孟蕾,靳路,等.正念减压疗法对康复期精神分裂症患者疗效及细胞炎性因子影响的研究[J].新疆医科大学学报,2023,46(09):1176-1181.
基金信息:
新疆维吾尔自治区卫生与健康适宜技术推广项目(SYTG-202152)
2023-09-15
2023-09-15