摘要
目的:观察心理护理对围绝经期抑郁症患者的临床疗效及血清雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)的影响。方法:围绝经期抑郁症患者117例,随机分为观察组59例和对照组58例,均联合应用激素替代疗法(HRT)及抗抑郁药物治疗。观察组采用护患共同参与的心理护理模式,对患者进行认知行为干预,通过卫生宣教,帮助其正确认知围绝经期的心身反应,提高自我调节能力和接受治疗的依从性,连续治疗3个月。用汉密尔顿抑郁量表(HAMD)评分评价2组抑郁程度;围绝经期症状评分(KMI)评分评价围绝经期总体症状;放射免疫分析法测定治疗前后血清E2、FSH及LH浓度;治疗结束后6个月对2组患者进行随访,并再次HAMD评分及KMI评分。结果:与治疗前比较,治疗后1、2和3个月时2组HAMD及KMI评分、FSH及LH浓度明显下降,E2则明显上升(P<0.05,0.01),与对照组比较,观察组表现更显著(P<0.05,0.01)。临床疗效比较,观察组总有效率明显高于对照组(89.8%与70.7%,P<0.05)。治疗结束后6个月随访,HAMD及KMI评分观察组仍明显低于对照组(P<0.01)。结论:药物治疗对围绝经期抑郁症具有一定疗效,辅以心理护理后,具有明显的增效作用,且疗效持久。
Objective： To investigate the clinical effectiveness of psychological care for perimenopausal depression and its effect on serum estradiol （E2）, follicule-stimulating hormone （FSH） and luteinizing hormone （LH）. Methods： One hundred and seventeen patients were randomly divided into treatment group （59 cases） and control group （58）. Both groups received the combined therapies of hormone replacement treatment （HRT） and anti-depressant drug treatment. The treatment group also received mental nursing through which the patients were given cognitive behavioral intervention in the form of health education and the correct cognition of physical and psychological reactions was built up during the peri-menopausal period to improve their self-control ability and compliance with treatment. The treatment lasted 3 months. The HAMD was used to rate depression degree and the KMI was used to evaluate the overall symptoms of the peri-menopausal period. The radioimmunoassay was used to determine serum E2, FSH and LH levels in both groups before and after the treatment. HAMD and KMI scores in both groups were revisited 6 months later after the treatment. Results： As compared with the conditions before treatment, the scores of both HAMD and KMI as well as the levels of FSH and LH on the 1st, 2nd and 3rd month after the treatment were declined significantly, while the E2 levels were increased significantly （P〈0.05, 0.01）. There was significant difference between the treatment group and control group （P〈0.05, 0.0l）. The total effective rate in the treatment group was significantly higher than in the control group （89.8% vs 70.7%, P〈0.05）. The revisits performed on the patients 6 months later after the treatment showed that the HAMD and KMI scores were significantly lower in the treatment group than in the control group （P〈0.01）. Conclusion： Drug therapy had therapeutic effectiveness on perimenopausal depression and its combination with psychological care can obviously improve the th
出处
《中国康复》
2011年第6期459-461,共3页
Chinese Journal of Rehabilitation
关键词
围绝经期
抑郁症
心理护理
perimenopausal period
depression
psychological care
