耳穴压豆联合五音疗法对乳腺癌术后化疗后焦虑抑郁状态患者情绪、生活质量和免疫功能的影响

目的:观察耳穴压豆联合五音疗法对乳腺癌术后化疗后焦虑抑郁状态患者情绪、生活质量和免疫功能的影响。方法:本研究所选90例病例均为乳腺癌术后化疗后焦虑抑郁状态患者,采用随机数字表法分为观察组与对照组,每组45例。两组患者均给予常规治疗,同时予以心理安慰。对照组予以米氮平口服治疗,观察组在对照组基础上,根据辨证分型,选取相应的耳穴压豆及五音疗法进行治疗。通过汉密尔顿抑郁量表(hamilton depression scale,HAMD)积分变化和减分率的比较评定总体疗效;采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)进行心理焦虑和抑郁状态的评定;采用所有癌症患者生命质量测定其共性部分的的核心模块(quality of life questionnaire-core-30,QLQ-C30)和专用于乳腺癌患者测定模块(quality of life questionnaire-breast cancer module 23,QLQ-BR23)进行生活质量评价;并检测患者外周血CD3^+、CD4^+、CD8^+和CD4^+/CD8^+,观察患者不良反应发生情况。结果:观察组痊愈率20.0%,有效率为95.6%,对照组痊愈率11.1%,有效率为86.7%,两组比较,差异有统计学意义(P<0.05);观察组治疗后SAS评分、SDS评分低于对照组,差异有统计学意义(P<0.05);观察组治疗后疲劳、恶心呕吐、疼痛、气促、失眠评分低于对照组,差异有统计学意义(P<0.05);观察组治疗后躯体功能、情绪功能、社会功能和总体生活质量评分均高于对照组,差异有统计学意义(P<0.05);观察组治疗后对未来的憧憬、系统治疗不良反应以及脱发引起的烦恼评分高于对照组,差异有统计学意义(P<0.05);观察组治疗后CD3^+、CD4^+和CD4^+/CD8^+水平高于对照组,CD8^+水平低于对照组(P<0.05);对照组不良反应发生率为8.9%,观察组不良反应发生率为0,观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:耳穴压豆配合五音疗法能明显减轻乳腺癌术后化疗后焦虑抑郁状态患者的焦虑抑郁状态,能提高患者生活质量,改善患者免疫功能,且无明显不良反应。

The Influence of Auricular Acupoint Pressing Beans in Combination with the Five Notes Therapy on Mood and Quality of Life and Immune Function of Patients with Anxiety and Depression After Chemotherapy for Breast Cancer

Objective:To observe the influence of auricular acupoint pressing beans in combination with the five notes therapy on mood and quality of life and immune function of patients with anxiety and depression after chemotherapy for breast cancer.Methods:In this study,90 cases were all patients with anxiety and depression after chemotherapy for breast cancer.They were divided into the observation group and the control group according to random number table method,with 45 cases in each group.The patients in the two groups were given routine treatment and psychological comfort at the same time.The control group was additionally given mirtazapine for oral administration,while the observation group selected the corresponding auricular acupoint pressing beans in combination with the five notes therapy on the basis of the control group,according to the type of syndrome differentiation.The overall effect was evaluated by comparing the scores of Hamilton Depression Scale(HAMD)and reduction rate.Self rating Anxiety Scale(SAS)and self-rating Depression Scale(SDS)were used to assess the state of mental anxiety and depression.Quality of life(QLQ-C30)and quality of life(QLQ-BR23)were used to evaluate the quality of life of all cancer patients.The peripheral blood CD3^+,CD4^+,CD8^+ and CD4^+/CD8^+were measured,and the adverse reactions were observed.Results:The recovery rate and the effective rate of the observation group was 20.0% and 95.6% respectively,while the recovery rate and the effective rate of the control group was 11.1% and 86.7% respectively,and all the differences were statistically significant(P<0.05).After the treatment,the scores of SAS and SDS in the observation group were lower than those in the control group,and all the differences were statistically significant(P<0.05).The scores of fatigue,nausea and vomiting,pain,shortness of breath and insomnia in the observation group were lower than those in the control group,and all the differences were statistically significant(P<0.05).The scores of physical function,emotional function,social function and overall quality of life in the observation group were higher than those in the control group,and all the differences were statistically significant(P<0.05).The scores of vision,side effects of systematic treatment and troubles caused by hair loss in the observation group were higher than those in the control group,and all the differences were statistically significant(P<0.05).The levels of CD3^+,CD4^+and CD4^+/CD8^+ in the observation group were higher than those in the control group,and the levels of CD8^+was lower than that in the control group(P<0.05).The incidence of adverse reactions in the control group was 8.9%,while that in the observation group was 0,and the incidence of adverse reactions in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Auricular acupoint pressing beans in combination with the five notes therapy has a remarkable efficacy on patients with anxiety and depression after chemotherapy for breast cancer,can improve the quality of life and immune function of patients without obvious adverse reactions.