中医按摩加运动、心理干预提高抑郁障碍患者社会适应度的研究

目的探讨中医按摩加运动、心理干预对提高抑郁障碍患者社会适应度的临床疗效。方法采用中医按摩加运动、心理疗法对60例抑郁障碍患者进行干预。结果应用中医按摩加运动、心理干预治疗4周后患者的汉密顿抑郁量表（HAMD）及抑郁自评量表（SDS）评分较治疗前明显降低,与治疗前比较,患者抑郁症状明显改善,经SPSS16.0软件包统计学分析,差异有统计学意义（P〈0.01及P〈0.05）;患者的社会适应度亦较治疗前大幅度提升,差异有高度统计学意义（P〈0.01）。结论中医按摩加运动、心理干预可以有效缓解患者抑郁障碍及提高其社会适应度。     

药物加心理干预治疗急性心肌梗死后抑郁障碍临床研究

目的探讨心理干预加氟西汀治疗在急性心肌梗死后抑郁障碍患者中的作用。方法应用Hamilton抑郁量表(HAMD),采用问卷调查方式对126例急性心肌梗死患者进行抑郁状况评定,对诊断为抑郁障碍的患者应用氟西汀加心理干预治疗,在治疗前、治疗后6周进行2次评分。结果126例急性心肌梗死患者中76例出现抑郁障碍,占60.3%,治疗前HAMD平均分为23.7±5.1,治疗后为4.7±2.8,经氟西汀加心理干预治疗后患者的HAMD评分明显下降(t=5.4,P<0.01)。结论对急性心肌梗死后抑郁障碍患者,治疗原发病的同时,积极应用抗抑郁治疗加心理干预能明显提高患者生活质量,提高疗效。     

心理干预对缓解膀胱癌Bricker术后患者焦虑抑郁状态的影响

目的:探讨心理干预对缓解膀胱癌患者膀胱全切加回肠膀胱术(Bricker)术后患者焦虑抑郁状态的影响,为临床治疗提供客观依据.方法:对27例膀胱癌患者行Bricker手术,并在常规护理基础上给予系统的心理干预,于心理干预前后应用Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)进行评分.结果:心理干预前患者平均SAS、SDS评分与国内常模比较,差异有统计学意义(P<0.01,P<0.05);心理干预后患者焦虑抑郁发生率及评分均低于干预前(P<0.01,P<0.05).结论:对膀胱癌Bricker手术患者实行心理干预能减轻其焦虑抑郁情绪,提高患者生活质量.     

心理干预对抑郁障碍糖尿病患者抑郁程度及生活质量影响的分析

目的 探讨心理干预对抑郁障碍糖尿病患者生活质量的影响.方法 将40例抑郁障碍糖尿病患者随机分为实验组和对照组各20例,实验组在常规治疗护理基础上进行心理干预,对照组仅执行常规治疗护理.干预前后分别对2组患者用自评抑郁量表(SDS)、生活质量综合评定问卷(GQOLI-74)进行测评.结果 干预后实验组SDS评分指数较对照组显著降低,差异有统计学意义(P＜0.01);干预后实验组GQOLI-74测评躯体功能、心理功能、社会功能3个维度的评分均高于干预前,差异有统计学意义(P＜0.01);干预后实验组GQOLI-74评分较对照组显著升高,差异有统计学意义(P＜0.01).结论 心理干预能有效改善抑郁障碍糖尿病患者的抑郁症状,提高生活质量.     

卒中后抑郁患者心理干预疗效分析

目的探讨心理干预对脑卒中后抑郁患者生活质量的影响。方法将72例脑卒中后抑郁患者随机分为治疗组37例和对照组35例。两组均进行脑血管疾病常规治疗,治疗组联合心理干预治疗,观察6w。于治疗前后采用Zung氏抑郁自评量表评定临床疗效。结果治疗6w末治疗组抑郁自评量表评分较治疗前有极显著性下降(P<0.01),与对照组比较有极显著性差异(P<0.01)。结论心理干预可有效缓解脑卒中患者的抑郁症状。结合脑卒中神经内科常规治疗将对脑卒中患者的疗效、预后和康复有重要的临床意义。     

舍曲林联合认知行为疗法对抑郁症患者认知功能的影响

目的探讨舍曲林联合认知行为疗法对抑郁症患者认知功能的影响。方法将60例抑郁症患者按照随机数字表法分为研究组与对照组,各30例。两组均给予舍曲林治疗,研究组联合认知行为疗法治疗,观察治疗全程。干预前后采用抑郁自评量表及汉密顿抑郁量表评定两组的抑郁状况,采用威斯康星卡片分类测验评定患者的执行功能。结果干预后两组抑郁自评量表及汉密顿抑郁量表评分均较干预前显著降低(P<0.01),研究组较对照组下降更显著(P<0.01);两组威斯康星卡片分类测验分类完成数及正确应答数均较干预前显著升高(P<0.05或0.01),持续错误数较干预前显著降低(P<0.05或0.01),研究组较对照组变化更显著(P<0.05或0.01)。结论舍曲林联合认知行为疗法能显著缓解抑郁症患者的抑郁症状,提高认知功能,值得推广应用。     

综合性心理干预对老年失眠症患者的疗效观察

目的探讨综合性心理干预对老年失眠症患者的临床疗效。方法将60例门诊老年失眠症患者随机分为综合心理干预组和药物治疗组,每组各30例,疗程8w。于治疗前及治疗8w末采用汉密尔顿抑郁量表、焦虑量表评定临床疗效,并进行比较分析。结果治疗8W末,综合干预组汉密尔顿抑郁量表、焦虑量表评分均低于治疗前(P<0.01),药物治疗组治疗前后评分差异无显著性(P>0.05);两组间评分比较综合干预组显著低于药物治疗组(P<0.01)。综合干预组总有效率93.33%,药物治疗组63.33%,两组疗效差异显著(P<0.05)。结论综合心理干预能有效缓解老年失眠症患者的焦虑、抑郁情绪,有利于失眠症的改善和康复。     

心理干预对2型糖尿病患者焦虑抑郁情绪的影响

目的了解2型糖尿病患者的心理健康状况,探讨心理干预对其焦虑抑郁情绪的影响。方法将100例糖尿病患者随机分为治疗组和对照组各50例,两组均接受糖尿病常规治疗,治疗组联合心理干预,观察4 w。于治疗前及治疗1 w、2 w、3 w、4 w末采用症状自评量表评定心理健康状况,采用汉密顿焦虑量表、汉密顿抑郁量表评定焦虑抑郁状况及心理干预效果,同时检测空腹血糖的变化。结果2型糖尿病患者存在不同程度的心理问题,治疗后两组症状自评量表、汉密顿焦虑量表、汉密顿抑郁量表评分及空腹血糖测定均较治疗前显著下降(P<0.01),但治疗组各时段均较对照组下降显著(P<0.01~0.05)。结论2型糖病患者存在不同程度的心理问题,心理干预能显著缓解其焦虑抑郁情绪,提高原发病疗效,改善生活质量。     

个案管理对肿瘤心脏病患者焦虑抑郁及希望水平的影响

目的探讨个案管理对肿瘤心脏病患者焦虑抑郁及希望水平的影响。方法将62例肿瘤心脏病患者按随机数字表法分为两组,每组31例。对照组予以常规治疗护理,观察组予以个案管理,观察6个月。于干预前后采用焦虑自评量表、抑郁自评量表评定焦虑抑郁情绪,采用Herth希望量表评定患者的希望水平。结果干预后观察组焦虑自评量表、抑郁自评量表评分较干预前显著降低(P<0.01),对照组仅抑郁自评量表评分较干预前显著降低(P<0.01),观察组焦虑自评量表、抑郁自评量表评分显著低于对照组(P<0.01)。干预后观察组Herth希望量表总分及对现实和未来的积极态度、与他人保持密切关系维度分较干预前显著升高(P<0.01),对照组仅对现实和未来的积极态度维度分较干预前显著升高(P<0.05),观察组Herth希望量表总分及各维度分均显著高于对照组(P<0.01)。结论个案管理可以缓解肿瘤心脏病患者的焦虑抑郁情绪,提高其希望水平。     

综合性心理干预对老年心衰患者负性情绪和睡眠质量的影响

目的:探讨综合性心理干预对老年心衰(HF)患者焦虑、抑郁等负性情绪和睡眠质量的影响。方法:老年HF患者80例,随机分为干预组与对照组各40例。2组均给予常规治疗和护理,干预组加用心理疏导、认知疗法、加强社会和家庭支持系统、指导辅助睡眠等综合性心理干预。干预前后应用焦虑量表(SAS)、抑郁自评量表(SDS)和匹兹堡睡眠质量指数量表(PSQI)评定。结果:干预3周后,干预组的SAS、SDS评分显著低于干预前及对照组干预后(P<0.01)。干预组PSQI总分及分项中睡眠质量、入睡时间、睡眠时间、睡眠障碍评分均较干预前及对照组干预后显著下降(P<0.01)。结论:综合性心理干预能够有效改善老年HF患者焦虑、抑郁情绪等负性情绪,提高患者的睡眠质量。     

Shin splints Painful to have and to treat

When people overuse their legs they develop an uncomfortable awareness of these limbs manifested as a dull burning or aching. The cause is often clear to the person with the problem as a result of the often obvious relationship to overdoing an exercise or activity and the pain. “Shin splints” is the lay term; physicians use the term medial tibial stress syndrome. The pathophysiology that leads to this pain is unclear, although there are a number of competing theories. Differential diagnosis includes stress fractures and compartment syndromes. Bone tumors or lipomas can also cause similar pain to shin splints. Diagnosis can be made by history alone in a majority of cases, but if the diagnosis is unclear, an X-ray and magnetic resonance imaging should be considered. Treatment is still mostly supportive and symptom related. Rest is the most important aspect of treatment. Locally applied cold and anti-inflammatory medication have also been felt to be beneficial. The authors has stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

When to suspect and how to monitor babesiosis

In the past decade, cases of babesiosis in humans have been reported with increasing frequency, especially in the northeastern United States. Babesia microti (in the United States) and bovine strains (in Europe) cause most infections in humans. Most cases are tick-borne, although cases of transfusion-associated and transplacental/perinatal transmission have also been reported. Factors associated with more severe disease include advanced age, previous splenectomy and immunodeficient states. Symptoms include high fever, chills, diaphoresis, weakness, anorexia and headache. Later in the course of the illness, the patient may develop jaundice. Congestive heart failure, renal failure and acute respiratory distress syndrome are the most common complications. Therapy using the combination of quinine sulfate and clindamycin was the most commonly used treatment; however, atovaquone suspension plus azithromycin was recently reported an equally effective and less toxic therapy. Exchange transfusion, together with antibabesial chemotherapy, may be necessary in critically ill patients.     

How to recognize and respond to refeeding syndrome

If your patient is malnourished, you need to assess her carefully before she restarts nutrition by any route to avoid potentially lethal consequences.