摘要
目的:观察帕罗西汀联合音乐治疗后中重度烧伤患者情绪状况,并分析烧伤患者血清肿瘤坏死因子、白细胞介素6水平的变化及其影响因素。方法:选择2003-04/2005-04在绵阳市中心医院、攀枝花钢铁公司总医院烧伤专科住院的中重度热力烧伤患者84例。①于烧伤后3d内行汉密顿抑郁量表、汉密顿焦虑量表测定(汉密顿抑郁量表>9分,汉密顿焦虑量表>8分为有焦虑抑郁情绪),将患者分为有焦虑抑郁情绪患者和不伴有焦虑抑郁情绪患者。将有焦虑抑郁情绪患者随机分为治疗组28例及抑郁对照组27例,不伴有焦虑抑郁的患者为烧伤对照组29例。②各组患者均采用相似的液体复苏、营养支持、抗感染及手术治疗。治疗组在此基础上,于第4天合用帕罗西汀及音乐治疗。帕罗西汀用量20～40mg/d,共治疗30d。音乐治疗用感应性音乐聆听,1h/d,15d为1个疗程,连续听2个疗程。③比较3组患者治疗前后汉密顿抑郁量表、汉密顿焦虑量表评分。采用酶联免疫吸附法检测血清肿瘤坏死因子、白细胞介素6水平,并应用逐步回归分析判断影响血清肿瘤坏死因子、白细胞介素6水平的主要因素。结果:治疗组1例,抑郁对照组3例,烧伤对照组2例因经费困难中断治疗。最后纳入分析治疗组27例,抑郁对照组24例,烧伤对照组27例。①治疗后治疗组汉密顿抑郁量表评分低于抑郁对照组(4.74±1.99,14.79±5.28,P<0.05)。各组汉密顿焦虑量表评分比较,差异无显著性(P>0.05)。②治疗后第21天治疗组血清肿瘤坏死因子、白细胞介素6水平低于抑郁对照组。③逐步回归分析选出影响肿瘤坏死因子水平的3个主要因素,即治疗前抑郁分值、治疗后抑郁分值和治疗后白细胞介素6水平;影响白细胞介素6水平的为烧伤后血清肿瘤坏死因子水平。结论:帕罗西汀联合音乐治疗能改善抑郁情绪,同时降低血清肿瘤坏死因子、白细胞介素6水�
AIM： To observe the emotion in patients with moderate or severe burn after treated with selective serotonin reuptake inhibitors （SSRIs） combined music therapy, and explore the changes in serum levels of tumor necrosis factor α （TNF-α） and interleukin-6 （IL-6） and their influential factors. METHODS： Totally 84 moderate or severe burn inpatients were selected from Mianyang Central Hospital and Department of Burn, General Hospital of Panzhihua Iron ＆ Steel Co., Ltd from April 2003 to Apnl 2005. （1）They were measured with Hamilton Rating Scale for Depression （HAMD）, and Hamilton Rating Scale for Anxiety （HAMA）, and those with 〉 9 in HAMD and 〉 8 in HAMA were diagnosed as depression or anxiety emotion. The patients were divided into anxiety-depression patients and non-anxiety-depression patients, then the former group was randomly subdivided into treatment group （n =28） and depression control group （n =27）, and the non-anxiety-depression patients served as normal control group （n =29）. （2）The patients of each group were treated with similar fluid restoration, nutrient support, anti-infection and operation treatments. Besides the routine burn treatment, from the fourth day, the control group was given SSRIs, 20-40 mg daily for 30 days and music therapy of receptive music, 1 hour daily, 15 days as one course for 2 courses. （3）The scores of two scales and the degree of wound healing in three groups were observed. The levels of TNF-α and IL-6 in serum were measured with enzyme linked immunosorbent assay, and the stepwise regression was adopted to identify the main factors that influenced the levels of TNF-α and IL-6. RESULTS： One case of the treatment group, three of the depression control group and two of the bum control group withdrew from the treatment due to the expensive cost. Finally 27 cases of the treatment group, 24 of the depression control group and 27 of the burn control group were involved in the result analysis.（1）The scores of HAMD in the treat
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第52期10527-10529,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
四川省医药卫生科研项目(020091)~~
