认知行为干预护理对抑郁症患者影响的临床对照研究

目的探讨认知行为干预护理对抑郁症患者应对方式的影响。方法采用随机数字表法将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的64例抑郁症患者分为研究组和对照组各32例。两组患者均接受抗抑郁药物治疗,研究组合并认知行为干预护理,对照组仅予常规精神科护理。所有患者在入组时、治疗6周后采用汉密尔顿抑郁量表24项(HAMD-24)、抑郁自评量表(SDS)、焦虑自评量表(SAS)及简易应对方式问卷(SCSQ)进行评估。结果干预6周后研究组的HAMD-24、SDS、SAS得分较对照组低(P0.01);研究者组SCSQ中消极应对方式评分较对照组低(P0.01),积极应对方式评分则高于对照组(P0.01)。结论认知行为干预护理可能有利于改善抑郁症患者焦虑抑郁情绪和提高其积极应对能力。     

团体心理辅导对新入职护士工作压力、焦虑抑郁情绪及应对方式的影响

目的探讨团体心理辅导对新入职护士工作压力、焦虑抑郁情绪及应对方式的影响,为改善其心理健康状况提供参考。方法选取自贡市第四人民医院2018年新入职护士94名,采用随机数字表法分为研究组和对照组各47名,两组均采用常规培训法,研究组在此基础上再进行8次系统的团体心理辅导。于辅导前后采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、中国护士工作压力源量表(CNSS)、简易应对方式问卷(SCSQ)对两组进行评定。结果团体心理辅导后,研究组CNSS时间分配及工作量、管理及人际关系、总压力源评分均低于辅导前,且低于对照组,差异均有统计学意义(P<0. 05或0. 01);研究组SAS、SDS评分均低于对照组,差异均有统计学意义(P均<0. 01);研究组SCSQ中积极应对评分高于对照组,差异有统计学意义(P<0. 01)。结论团体心理辅导可能有助于减少新入职护士焦虑、抑郁情绪,减轻工作压力,提高积极应对方式。     

团体心理辅导对精神分裂症患者低自尊的效果研究

目的探讨团体心理辅导对精神分裂症患者自尊水平的影响。方法对144例恢复期精神分裂症患者,随机分为研究组和对照组,在原有药物治疗的基础上,研究组配合团体心理辅导,在入组前、辅导后,分别采用焦虑自评量表、抑郁自评量表和缺陷感量表对两组患者进行评定。结果研究组实施团体心理辅导前后SAS、SDS、FIS评分,差异均有统计学意义(P<0.01),团体心理辅导后两组间SAS、SDS、FIS评分,差异也均有统计学意义(P<0.01)。结论团体心理辅导可提高精神分裂症患者的自尊水平,缓解其焦虑、抑郁情绪。     

68例开放管理的女性精神分裂症患者陪护家属的心理状况及健康教育的效果分析

目的探讨开放管理女性精神分裂症住院患者陪护家属的心理状况及健康教育的效果。方法将132例开放管理女性精神分裂症住院患者陪护家属随机分为两组,研究组68例,对照组64例,研究组实施健康教育,对照组未实施。采用自编的调查表对两组陪护家属在患者入院时进行调查;并采用抑郁自评量表（SDS）和焦虑自评量表（SAS）对两组家属在患者入院3 d内和健康教育结束时分别进行评定。结果开放管理女性精神分裂症住院患者陪护家属的心理状况不容乐观,均存在一定的焦虑、抑郁情绪,且对疾病的认知不同,对医生的干预性治疗建议的领悟接受不一。研究组在健康教育结束时抑郁自评量表和焦虑自评量表评分均有显著下降（P〈0.01）,均显著低于对照组（P〈0.01）。结论对开放管理女性精神分裂症住院患者陪护家属及时进行健康教育,能改善家属的心理状况,提高家属对疾病的正确认识,有助于提高患者的治疗依从性,利于患者的早日康复。     

综合干预对精神分裂症患者亲属抑郁与焦虑情绪的影响

目的:探讨综合干预对精神分裂症患者亲属抑郁、焦虑情绪的影响。方法:对114位精神分裂症患者家属进行综合干预6个月;干预前、干预3及6个月后分别采用抑郁自评量表(SDS)和焦虑自评量表(SAS)对入组者的抑郁、焦虑情绪进行评估,分析影响其抑郁、焦虑情绪的因素。结果:干预前患者亲属SDS和SAS评分明显高于国内常模(t=12.10,t=10.81;P均0.001);女性亲属SDS和SAS评分明显高于男性亲属(t=3.35,P=0.001;t=2.32,P=0.022);无固定职业的患者亲属SDS和SAS评分明显高于有固定职业的患者亲属(t=2.00,P=0.048;t=2.06,P=0.042);不同教育程度的患者亲属的SDS和SAS评分比较差异有统计学意义(F=3.18,P=0.046;F=3.24,P,0.043);但不同亲属关系的患者亲属间SDS和SAS评分比较差异无统计学意义。干预3个月后及6个月后,患者亲属的SDS和SAS评分较基线有明显下降(P均0.05),但与国内常模相比,差异仍有统计学意义(P均0.05)。结论:精神分裂症患者家属有明显的抑郁、焦虑情绪,并与其性别、受教育程度和职业状况有关。综合干预能有效改善精神分裂症患者家属的焦虑、抑郁情绪。     

心理干预对改善精神分裂症患者家属心理状况的效果分析

目的 探讨心理干预对改善精神分裂症患者家属心理状况的效果.方法 采用症状自评量表(SCL-90)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对229名精神分裂症患者家属进行调查,并对其进行为期4周的心理干预.结果 精神分裂症患者家属的SCL-90各因子、SAS和SDS的评分均显著高于全国常模(P<0.05),心理干预后,患者家属的SCL-90各因子、SAS和SDS的评分较干预前有显著性降低(P<0.05).结论 精神分裂症患者家属的心理问题状况较为严重,而心理干预可有效改善患者家属的心理状况.     

心理干预对精神分裂症患者经期情绪障碍影响的研究

目的 了解精神分裂症患月经期的情绪障碍问题及心理干预时情绪障碍的影响，从而解决女性病人治疗中的疑难问题。方法 对我院126名住院的女性精神分裂症病人分别进行经期和非经期的焦虑自评量表SAS和抑郁自评量表SDS的测定，然后将126名病人随机分成干预组和对照组各63名，干预组进行2个月的心理干预，对照组不进行上述干预，其他治疗相同。第3个月再分别对两组病人进行经期和非经期的焦虑自评量表和抑郁自评量表的测定。结果 (1)精神分裂症病人经期SAS、SDS量表分均较非经期高，经统计学检验两差异显；(2)干预组经心理干预后无论经期还是非经期SAS、SDS量表分与对照组比较差异显；(3)干预组自身前后量表分比较差异显。结论 精神分裂症患月经期存在明显的焦虑、抑郁，易引起病情波动，针对女性病人内分泌变化进行心理干预有一定疗效。     

团体心理治疗对急性期精神分裂症患者焦虑抑郁情绪的效果

目的探讨团体心理治疗对急性期精神分裂症患者焦虑抑郁情绪的影响,为改善精神分裂症患者的不良情绪提供参考。方法选取2016年8月-2017年8月于眉山市东坡区精神病医院就诊的符合《国际疾病分类(第10版)》(ICD-10)诊断标准的急性期精神分裂症患者120例,随机分为研究组和对照组各60例。对照组给予奥氮平治疗,研究组给予奥氮平联合团体心理治疗,两组均治疗4周。治疗前及治疗4周后,采用焦虑自评量表(SAS)与抑郁自评量表(SDS)评定疗效。结果治疗前,两组SDS和SAS评分比较差异均无统计学意义(P均0.05)。治疗4周后,两组SDS和SAS评分均低于治疗前,且研究组SDS和SAS评分均低于对照组,差异均有统计学意义(P0.05或0.01)。结论奥氮平联合团体心理治疗与单用奥氮平均能改善急性期住院精神分裂症患者的焦虑抑郁情绪,但联合治疗的效果更佳。     

产科心理护理对孕产妇妊娠结局及产后抑郁情况的影响

目的探究孕产妇实施心理护理干预对其妊娠结局及产后抑郁状况的影响。方法选取我院妇产科于2012年8月~2013年7月收治的65例孕产妇,设为对照组,开展常规护理模式;选取我院妇产科于2013年8月~2014年7月收治的69例孕产妇,设为研究组,在对照组基础上实施心理干预。记录两组孕产妇剖宫产率、自然分娩率及产后出血率,同时记录两组孕产妇于住院当天及分娩前1天的SAS(焦虑自评量表)和SDS(抑郁自评量表)测评。结果研究组剖宫产及产后出血率均低于对照组(P<0.05)。研究组产后3天的SAS评分和SDS评分均低于对照组(P<0.05)。结论个体化心理干预应用于孕产妇,能有效改善其围产期的负性情绪,同时亦能降低剖宫产率,提高自然分娩率。     

心理干预对伴有负性情绪糖尿病患者的治疗作用

目的　探讨心理干预对伴有负性情绪糖尿病患者的治疗作用。方法　将 12 0例糖尿病患者随机分为干预组 6 0例 ,对照组 6 0例 ,对照组单用药物治疗 ,干预组加用心理干预 ,均于干预前后进行焦虑自评量表(SAS)和抑郁自评量表 (SDS)评定 ,并测空腹血糖 (FBG)及餐后 2小时血糖 (PBG)。结果　心理干预组的SAS和SDS评分明显低于对照组 ,FBG和PBG减分干预组高于对照组。讨论　心理干预治疗能帮助糖尿病患者缓解负性情绪 ,更好的控制血糖 ,临床中应予重视。     

Mechanisms of the suppression of the nociceptive reflex of the opening of the mouth during stimulation of the structures of the limbic brain

The comparative effectiveness of the inhibitory influence of tetanic stimulation of hypothalamus, amygdala and limbic cortex on EMG-response of m. digastricus evoked by electrical stimulation of tooth pulp nociceptive afferents was studied in cats anesthetized with a mixture of chloralose and nembutal. It was found that inhibition of the EMG-component of the jaw-opening reflex is most pronounced in case of stimulation of medial and lateral region of the hypothalamus, the inhibitory effect of central and medial nuclei of the amygdala is less pronounced and the effect of the limbic cortex is the weakest. It was shown that the mechanism of the antinociceptive effect of tetanic stimulation of the hypothalamus is not related to the concomitant increase of the blood pressure. After stabilization of the blood pressure the suppressive effect of the hypothalamus remains without changes, that points out to a direct, primary, not baro-afferent mechanism of the inhibition of the activity of nociceptive neurons of the trigeminal sensory nuclei. Noradrenaline, injected intravenously, induced a large increase of the blood pressure accompanied by a pronounced inhibition of the pain reflex. Angiotensin causes the same degree of blood pressure elevation without changes in the amplitude of the EMG-response of the pain reflex. Hypothalamic and noradrenergic mechanisms for control of pain sensitivity are discussed.     

药物治疗与合并认知行为治疗对强迫症疗效的比较

目的探讨认知行为心理治疗(CBT)在强迫症(OCD)患者各亚型治疗中的有效性和规律性。方法本研究为临床对照研究。符合入组标准的强迫症患者按患者自愿原则分为两组,治疗观察3、6、12个月。疗效评定分别运用Yale-Brown强迫量表,自拟的自评好转程度量表和临床疗效评定。结果认知行为心理治疗合并药物治疗组31例,临床有效率70.9%,其中治愈率1.8%。单纯药物治疗组24例,临床有效率33.3%。Yale-Brown强迫量表和自评量表得分在6个月和12个月两组有显著差异(P<0.05)。其中强迫症亚型(怕脏型、反复检查型和反复担心型)的疗效比较,怕脏型在治疗3个月末两组间自评量表评分有显著性差异(P<0.05);反复担心型在治疗6个月末两组间Yale-Brown强迫量表总分有显著性差异(P<0.05);反复检查型两组间无统计学差异。结论认知行为心理治疗合并药物治疗强迫症的疗效明显优于单纯药物治疗。强迫症的亚型在治疗中的有效性次序为:反复担心型>怕脏型>反复检查型。     

Characteristics of the sympathetic innervation of the nictitating membrane and of the vasculature of the nose and tongue of the cat

Summary Vasomotor responses from the nasal mucosa and tongue, and contractions of the nictitating membrane, were recorded on stimulation of the cervical sympathetic or internal carotid nerves.Preganglionic sympathetic nerve fibres which elicited a membrane response possessed a lower threshold than those which evoked nasal vasoconstriction, while the latter displayed a lower threshold than fibres which evoked tongue vasoconstriction. The sympathetic vasodilator fibres to the tongue, whose activity was revealed after-receptor blockade, had a similar threshold to the vasoconstrictor fibres.Membrane contraction, nasal vasoconstriction and occasionally tongue vasoconstriction could be evoked by stimulating the internal carotid nerve. The postganglionic fibres innervating the nasal mucosa had a similar threshold to those of the nictitating membrane, which may indicate that there are small myelinated fibres innervating the mucosa.The preganglionic compound nerve action potential had four major components, S₁–S₄. S₁, S₂ and usually S₃ fibres were associated with membrane contraction; S₂, S₃ and sometimes S₁ fibres were associated with nasal vasoconstriction; and S₃, usually S₂ and occasionally S₁ fibres were associated with vasoconstriction in the tongue. It is concluded that each of these three groups of nerve fibres, but not S₄ fibres, may include fibres associated functionally with the three effectors.There was a considerable difference between the relative amplitude of the responses of the three effectors elicited by stimulation of the cervical sympathetic nerve at frequencies between 0.2 and 2 Hz. Vasoconstrictor responses were relatively larger than membrane contractions suggesting differences in the mechanisms of neurotransmission at the neuroeffector junctions.     

Development of the projection from the nucleus of the brachium of the inferior colliculus to the superior colliculus in the ferret

Neurons in the deeper layers of the superior colliculus (SC) have spatially tuned receptive fields that are arranged to form a map of auditory space. The spatial tuning of these neurons emerges gradually in an experience-dependent manner after the onset of hearing, but the relative contributions of peripheral and central factors in this process of maturation are unknown. We have studied the postnatal development of the projection to the ferret SC from the nucleus of the brachium of the inferior colliculus (nBIC), its main source of auditory input, to determine whether the emergence of auditory map topography can be attributed to anatomical rewiring of this projection. The pattern of retrograde labeling produced by injections of fluorescent microspheres in the SC on postnatal day (P) 0 and just after the age of hearing onset (P29), showed that the nBIC-SC projection is topographically organized in the rostrocaudal axis, along which sound azimuth is represented, from birth. Injections of biotinylated dextran amine-fluorescein into the nBIC at different ages (P30, 60, and 90) labeled axons with numerous terminals and en passant boutons throughout the deeper layers of the SC. This labeling covered the entire mediolateral extent of the SC, but, in keeping with the pattern of retrograde labeling following microsphere injections in the SC, was more restricted rostrocaudally. No systematic changes were observed with age. The stability of the nBIC-SC projection over this period suggests that developmental changes in auditory spatial tuning involve other processes, rather than a gross refinement of the projection from the nBIC.     

A contribution to the study of the architecture of the autonomic nervous system of the digestive tract of the rat

Summary The distribution of aminergic and non-aminergic nerve fibres to the different constituents of the wall of the digestive tract in various regions is described. Aminergic fibres synapse with all nervous perikarya. Densely interlacing networks of nerve fibres are found in both layers of the tunica muscularis and in the lamina muscularis mucosae. A finely meshed plexus is observed in relation to the wall of the blood vessels in the wall of the gut. There are many fibres connecting the muscular and the vascular plexus. No nerve fibres have been observed in direct relation to the epithelium.The functional implications of these findings are discussed.