舒利迭与必可酮治疗32例中重度儿童哮喘的临床疗效对比

目的评价舒利迭治疗中重度儿童哮喘的临床疗效。方法将64例中重度哮喘患儿随机分为治疗组与对照组。治疗组采用舒利迭（SFC）治疗，对照组采用必可酮（BDP）。结果两组治疗前后PEF差值比较P〈0．05；治疗后日间症状评分改善比较P〈0．05。结论舒利迭总体疗效与必可酮相当，但在PEP改善与日间咳嗽症状改善方面舒利迭效果更优。     

心理干预对心肌梗塞患者抑郁情绪的影响

目的：通过心理干预观察心肌梗塞患者的抑郁情绪，躯体症状，心功能的改变，探讨其临床意义。方法：共收治76例心肌梗塞患者，其中47例合并抑郁情绪，按抽签的方法将其随机分成干预组（n=26)与对照组（n=21)，对照组对予常规药物治疗，干预组则在常规药物治疗的基础上进行健康教育及心理干预，抑郁情绪严重者者服用适量抗抑郁药物治疗，3个月后行Zung氏抑郁自评量表（SDS），汉密顿抑郁量表（HRSD）评估，并对所存在的体症状及心功能进行分析评价。结果：3个月后，干预组SDS评分，HRSD（24项）显著低于对照组（P＜0．01），抑郁指数与对照组相比有明显下降（P＜0．05），干预组与对照组相比，躯体症状明显缓解（P＜0．01），心功能得到有效改善（与对照组相比，心功能分级P＜0．01，LVEFP＜0．05），结论：心肌梗塞患者常合并有抑郁情绪；心理干预不仅有助于心肌梗塞患者抑郁情绪改善，而且有益于患者的躯体症状及心功能恢复。     

用阳性和阴性症状量表与ERP观察心理社会干预对慢性精神分裂症康复的影响

目的：应用精神分裂症阳性症状和阴性症状量表（PANSS）评分和事件相关电位（ERP）检测,探讨药物治疗联合心理社会干预对慢性精神分裂症病人精神症状及认知功能的影响。方法：将符合入组标准的100例慢性精神分裂症患者随机分为干预组（药物治疗联合心理社会干预,48例）和对照组（单纯药物治疗,52例）。分别在两组人组时及治疗3个月时进行PANSS评分和听觉ERP检测。结果：经3个月治疗,与对照组相比,于预组PANSS评定阴性量表分、反应缺乏因子和抑郁因子评分下降（P〈0．05）,ERPP3波潜伏期缩短和波幅升高（分别为P〈0．01,P〈0．05）。结论：心理社会干预对改善慢性精神分裂症患者的精神症状及认知功能有重要作用。     

Graves病131碘治疗后甲状腺功能减退症的心理干预研究

目的 探讨心理干预措施在131碘治疗后甲状腺功能减退症（简称甲减）治疗中的疗效。方法 将398例甲减患者按心理检查时单双序号随机抽取200例,分为研究组和对照组。研究组在常规药物治疗的基础上,采用行为干预治疗、支持性心理治疗等综合性心理干预;对照组仅常规药物治疗,观察两组干预前、后SCL-90检测结果并进行比较,两组患者对治疗的依从性进行比较。结果 经综合治疗3～6个月后,SCL-90因子除敌对、偏执因子外,其余均有显著性差异（P〈0．05～0．01）,研究组对治疗的依从性优于对照组（P〈0．01）。结论 综合性心理干预有效提高甲减患者对替代疗法的依从性和疗效及生活质量。     

心理疗法和抗抑郁剂治疗不稳定型心绞痛的临床疗效观察

目的：评价心理疗法和抗抑郁剂治疗不稳定型心绞痛的临床疗效。方法：100例患者以性别、年龄、诊断相匹配的方法分为2组,对照组50例给予内科常规治疗,研究组50例在内科常规治疗的同时,给予支持性心理治疗和抗抑郁药物治疗。结果：治疗后,研究组焦虑量表（HAMA）、抑郁量表（HAMD）评分较对照组明显降低（P＜0．01）,研究组的临床疗效及心电图疗效明显优于对照组（P＜0．01）。结论：心理疗法和抗抑郁剂对不稳定型心绞痛有明显疗效。     

药物联合心理行为干预对42例注意缺陷多动障碍儿童的疗效分析

目的探讨药物联合心理行为干预治疗儿童的注意缺陷多动障碍的疗效。方法选取63例注意缺陷多动障碍儿童．分为对照组和治疗组,对照组单纯药物治疗,治疗组采用药物联合心理行为干预治疗。结果治疗组总有效率高于对照组（P〈0．03）。结论采用心理行为干预联合药物治疗注意力缺陷多动障碍患儿．疗效显著     

心理干预治疗围绝经期症状群疗效研究

为探讨心理干预对围绝经期症状群的影响，将符合入组标准的有围绝经期症状的妇女随机分为心理干预组和对照组．在药物治疗的同时，干预组给予心理治疗，结果干预组躯体、强迫、人际关系、抑郁、焦虑、敌对性、恐怖诸因素显示明显疗效，心理干预结合药物治疗对围绝经期症状群有良好的临床疗效。     

心理干预对耳鸣患者疗效的影响

目的探讨心理干预在耳鸣患者治疗中的效果，为临床应用提供依据。方法在耳鼻喉科门诊随机抽出以耳鸣为第一主诉患者121例，将患者随机分为两组，A组62例接受心理干预、掩蔽及药物治疗，B组59例接受掩蔽、药物治疗。治疗前后用SCL-90及耳鸣程度主观评估进行比较。结果两组患者治疗前SCL-90评分比较无差异（P〉0．05），治疗组治疗前后SCL-90评分在躯体化、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执因子上前后差异较为明显（P〈0．05，P〈0．01），对照组治疗前后各因子分无差异（P〉0．05），两组治疗后在躯体化、抑郁、焦虑、敌对、恐怖、偏执因子上相比均有显著差异（P〈0．05或P〈0．01）。两组患者疗效均有改善，而治疗组改善更为明显（P〈0．05）。结论心理干预对耳鸣患者有较好的疗效。     

氟西汀联合心理干预治疗伴情绪障碍帕金森病患者的临床观察

目的探讨氟西汀联合心理干预对帕金森病患者情绪障碍的疗效。方法将符合CCMD-3抑郁症诊断标准的帕金森病50例患者随机分成两组。研究组在抗帕金森病药物基础上联合氟西汀20mg／d和心理干预治疗,对照组仅用抗帕金森病药物治疗,疗程8周。采用汉密顿抑郁量表（HAMD）评定疗效。结果经8周治疗后．研究组显效率为80．0％,对照组为32．0％,两组之间有显著性差异（P〈0．01）,研究组比对照组抑郁评分下降显著（P〈0．05）,两组间HAMD减分率于第2、4、8周末比较均有显著性差异（P〈0．05～0．01）。结论氟西汀联合心理干预对帕金森病患者情绪障碍具有良好疗效,而且副反应没有明显增加。     

心理干预对老年冠心病伴焦虑抑郁的影响

目的研究心理干预对老年冠心病伴焦虑抑郁的影响。方法将62例老年冠心病伴焦虑抑郁的住院病人随机分为两组,一组为单纯药物治疗组（对照组）,另一组为心理治疗结合药物治疗组（心理干预组）。两组在治疗前和治疗3周均采用SDS、SAS评分,在出院时进行住院时间及临床疗效总体评估。结果心理干预组与对照组SAS、SDS首次评定结果差异无显著性,3周后再次评定,心理干预组的SAS、SDS评分显著低于对照组（P〈0.05）,两组差值比较显示：两组SAS、SDS评分均下降,但心理干预组与对照组相比下降程度更为显著（P〈0.01）;心理干预组住院天数为21～51天,平均25.3±5.8天;对照组住院天数为22～65天,平均34.2±7.3天,差异有显著性（P〈0.01）;心理干预组临床疗效总体评价优于对照组（χ^2=6.42,P〈0.05）。结论心理干预对老年冠心病伴焦虑抑郁有很好的治疗效果,缩短了住院时间。     

社区综合干预对分裂症患者药物消耗量和社会功能的影响

目的 评价社区综合干预对分裂症患者精神症状,药物消耗量、社会功能的影响.方法 选取社区精神分裂症患者200例,随机分为干预组100例,对照组100例,观察12个月.干预组给予社区综合干预,包括健康教育、社会功能锻炼、药物干预及心理干预;对照组仅作门诊随访不进行特殊干预.用阳性和阴性症状量表(PANSS)、社会功能缺陷筛查量表(SDSS)于基线和干预后4,8,12个月末分别进行评定.并记录基线和4,8,12个月末前1周的用药量.结果 干预组PANSS总分(61.78±8.46)于第4月末起减分明显优于对照组(65.21±7.58)(t=3.02,P＜0.01);干预8,12个月末,干预组SDSS总分及各因子分明显低于对照组(P＜0.05或P＜0.01);8个月末开始,干预组日均药物消耗量(467.61±63.97)明显低于对照组(497.21±60.02)(t=3.36,P＜0.01).结论 社区综合干预可以改善精神分裂症患者的精神症状,降低药物消耗量,减少社会功能缺陷.     

全程护理干预模式对雾化治疗的学龄期哮喘患儿生命体征和临床症状的影响

目的：探讨及研究全程护理干预模式对雾化治疗的学龄期哮喘患儿生命体征和临床症状的影响及治疗效果。方法：选取112例2015年8月至2016年2月来我院诊治的学龄期哮喘患儿为研究对象,随机分为全程护理干预组(A组,n=56)和常规护理干预组(A组,n=56)。患者均采用氧驱动雾化吸入治疗后,A组患者给予全程护理干预,B组患者给予传统常规护理干预,观察比较两组患者干预前后生命体征、护理后症状评分及护理工作满意度等情况。结果：A组患者在全程护理干预模式背景下,症状得到改善,生命体征以及日间和夜间症状评分均优于传统常规护理组(P<0.05);A组满意率为98.3%相较于B组满意率83.4%,两者满意度差异大(P<0.05)。结论：采用全程护理模式干预氧驱动雾化吸入治疗的学龄期哮喘儿童,可改善患儿生命体征和临床症状,全程护理干预模式值得在相关临床活动中应用与推广。     

Certain hydrolyzed formulas reduce the incidence of atopic dermatitis but not that of asthma: three-year results of the German Infant Nutritional Intervention Study

BACKGROUND: Recommendations for primary prevention of allergic diseases in high-risk children include feeding with hydrolyzed formulas if breast-feeding is insufficient. OBJECTIVE: The primary objective of the German Infant Nutritional Intervention study was to investigate the allergy preventive effect of 3 hydrolyzed formulas compared with cow's milk formula in the first 3 years of life in a randomized, double-blind trial. METHODS: Between 1995 and 1998, 2252 newborns with atopic heredity were allocated to a group receiving cow's milk formula, partially or extensively hydrolyzed whey formula, or extensively hydrolyzed casein formula as a milk substitute for the first 4 months if breast-feeding was insufficient. Main outcome parameters were allergic manifestations, atopic dermatitis (AD), and asthma. RESULTS: After 3 years, 396 of 2252 children (17.6%) had dropped out. Breast-fed infants without formula feeding during the intervention (n = 889) were considered separately. A significant reduction of the incidence of AD was achieved with the extensively hydrolyzed casein formula in the intention-to-treat (ITT; n = 1363) and per protocol (PP; n = 904) analyses (ITT: population odds ratio [95% CI], 0.67 [0.45-0.99]; PP: adjusted odds ratio [OR(adj)], 0.53 [0.32-0.88]), and with the partially hydrolyzed whey formula in the PP analysis (ITT: population odds ratio, 0.76 [0.52-1.11]; PP:OR(adj), 0.60 [0.37-0.97]). None of the formulas reduced the incidence of asthma. CONCLUSION: The risk for AD, but not for asthma, can be reduced with certain cow's milk hydrolyzates in high-risk infants when breast-feeding is insufficient. CLINICAL IMPLICATIONS: Early nutritional intervention in high-risk children has significant influence on the incidence of AD, but not of asthma.     

Effectiveness of a multicomponent self-management program in at-risk, school-aged children with asthma.

BACKGROUND: Improving asthma knowledge and self-management is a common focus of asthma educational programs, but most programs have had little influence on morbidity outcomes. We developed a novel multiple-component intervention that included the use of an asthma education video game intended to promote adoption of asthma self-management behaviors and appropriate asthma care. OBJECTIVE: To determine the effectiveness of an asthma education video game in reducing morbidity among high-risk, school-aged children with asthma. METHODS: We enrolled 119 children aged 5 to 12 years from low-income, urban areas in and around San Francisco, CA, and San Jose, CA. Children with moderate-to-severe asthma and parental reports of significant asthma health care utilization were randomized to participate in the disease management intervention or to receive their usual care (control group). Patients were evaluated for clinical and quality-of-life outcomes at weeks 8, 32, and 52 of the study. RESULTS: Compared with controls, the intervention group had significant improvements in the physical domain (P = .04 and P = .01 at 32 and 52 weeks, respectively) and social activity domain (P = .02 and P = .05 at 32 and 52 weeks, respectively) of asthma quality of life on the Child Health Survey for Asthma and child (P = .02 at 8 weeks) and parent (P = .04 and .004 at 32 and 52 weeks, respectively) asthma self-management knowledge. There were no significant differences between groups on clinical outcome variables. CONCLUSIONS: A multicomponent educational, behavioral, and medical intervention targeted at high-risk, inner-city children with asthma can improve asthma knowledge and quality of life.     

早期干预对幼儿发展影响的研究

目的：探讨早期干预对幼儿躯体、智力、社会能力发展的影响，为早期教育提供依据。方法：随机抽取年龄为４２天至３个月的正常婴儿６０例为早期干预组，３５例为１岁干预组。早期干预组入组后即接受早期干预。婴儿一岁后两组接受同等干预。两岁半时，早期干预组４６例，１岁干预组３０例，此时，按相同条件抽取对照组５６例，三组幼儿采用贝利婴儿发展量表进行评估，测量身高、体重。结果：早期干预组的智力发展指数（ＭＤＩ＿     

行为问题儿童的社会技能训练效果分析

目的:探讨行为问题儿童的社交焦虑、个性特征及其干预方法和效果。方法:采用儿童行为量表(CBCL)筛查行为问题儿童82名,分为干预组(n=41)和对照组(n=41),随机抽取非行为问题儿童50名作为正常组。对干预组儿童采用以社会技能训练为主的行为干预一个学期,干预前后采用儿童社交焦虑量表(SASC)及艾森克人格问卷(EPQ)进行评估。结果:行为问题组儿童的社交焦虑总分及各因子分均高于正常组儿童,行为问题组情绪稳定性(N)分高于正常组、内外向(E)分低于正常组(P<0.01,0.001)。干预前干预组社交焦虑及个性与对照组比较差异均无显著性意义(P>0.05);干预后干预组与对照组比较,社交焦虑及各因子统计学差异显著(P<0.01),与正常组比较,社交焦虑及个性各因子差异均无显著性(P>0.05)。结论:行为问题儿童和正常儿童在社交焦虑水平、个性特征方面存在差异。以社会技能训练为主的行为干预对行为问题儿童的社交焦虑和个性缺陷有效。     

Outcome results of a school-based screening program for undertreated asthma.

BACKGROUND: Undertreatment of asthma is associated with significant potentially preventable morbidity, including frequent school absences. Guideline dissemination and clinician education have met with variable success. School-based identification of children with potentially undertreated asthma may provide an alternative strategy for improving asthma management in children. OBJECTIVE: To evaluate the effectiveness of school-based identification of potentially undertreated asthma. METHODS: A controlled trial of school-based identification of children with known but symptomatic asthma using mailed parent surveys, letters recommending medical follow-up, and medical record review to evaluate changes in asthma treatment after referral. RESULTS: Most parents (79.9%, n = 5,116 respondents) responded to the survey and 19.4% (n = 994) of children were reported to have a physician diagnosis of asthma or reactive airway disease. Letters of referral were sent to 489 children with parent-reported asthma who were identified as having potentially undertreated asthma. Approximately one-third (31.2%, n = 153) of these children had physician visits, and 92 (18.8% of all referred) had documented medication changes. In addition, there were 20 new physician diagnoses in this group of children. In the control group of 604 children with asthma, there were significantly fewer children with asthma-related visits (131, 21.7%, P = 0.0004) and children with medication changes (74, 12.3%, P = 0.002) in a comparable 6-month window. CONCLUSIONS: School-based screening or case identification increased the number of physician asthma-related visits and changes in asthma therapy.     

哮喘儿童支气管肺泡灌洗液IL-17、 IL-8和VEGF水平测定及意义

目的: Th17细胞是以分泌IL-17为主的新型T细胞亚群,其在哮喘中的作用尚不十分清楚。本文通过观察哮喘急性发作儿童支气管肺泡灌洗液(BALF)IL-17、IL-8、血管内皮生长因子(VEGF)等的水平变化,探讨其在哮喘急性发作儿童气道炎症中的作用。方法: 我院2009年2月-2009年12月期间行纤维支气管镜检查患儿共88例,包括哮喘急性发作组(哮喘组,n=52)、非喘息组(肺炎组,n=25)及对照组(n=11),收集所有病例的BALF,进行细胞学分类,ELISA法测定BALF中细胞因子IL-17、IL-8、VEGF、IL-4、IFN-γ和IL- 4/IFN-γ水平。结果: 与对照组比较,哮喘组和肺炎组患儿的IL-17和IL-8水平均明显增高(均P<0.05);哮喘组患儿的IL-8水平较肺炎组低(P<0.05),而2组IL-17水平无显著差异(P>0.05);与肺炎组和对照组比较,哮喘组患儿VEGF水平明显增高(均P<0.01);肺炎组与对照组患儿VEGF水平无显著差异(P>0.05);3组患儿的IL-4,IFN-γ和IL-4/IFN-γ水平均无显著差异(均P>0.05)。与对照组比较,哮喘组及肺炎组患儿中性粒细胞百分比明显增高(均P<0.01),而哮喘组与肺炎组患儿的中性粒细胞百分比无显著差异(P> 0.05)。结论: IL-17、IL-8及VEGF在哮喘儿童气道炎症中发挥重要作用,Th17细胞可能参与儿童哮喘急性发作的发病机制。     

Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma

BACKGROUND: Few studies have characterized the atopic profile of toddler-aged children with recurrent wheezing at high risk of the development of persistent asthma. Objective We sought to determine the atopic profile of toddler-aged children with frequent wheeze at high risk for the development of persistent asthma who either had a parental history of asthma, a personal history of atopic dermatitis, or both. METHODS: Participants enrolled in the Prevention of Early Asthma in Kids study (n = 285) on the basis of a modified Asthma Predictive Index were characterized on the basis of allergy and asthma questionnaire responses and allergy skin puncture test results. RESULTS: The majority of the children (60.7%, n = 148) were sensitized to either food or aeroallergens. Male children were significantly more likely to be sensitized to aeroallergens ( P = .03) and to have a blood eosinophil level of 4% or greater ( P = .03) and a total serum IgE level of greater than 100 IU/mL ( P = .0004). Additionally, eosinophilia and total serum IgE level had the strongest correlation with aeroallergen sensitization. CONCLUSION: The high prevalence of aeroallergen sensitization in this high-risk cohort suggests that aeroallergens might have an important role in the early development of asthma. As such, the Prevention of Early Asthma in Kids cohort appears to be an appropriate cohort in which to test whether early intervention with an inhaled corticosteroid can significantly attenuate, or perhaps even prevent, the allergic march from the initial stages of allergic sensitization to the subsequent development of asthma in toddlers with episodic wheezing.     

Identification of preschool children with asthma from low-income families in Los Angeles, CA.

BACKGROUND: Few studies have addressed asthma screening in the preschool age group. Early asthma recognition and intervention in preschool children may reduce costs related to unscheduled medical care and missed school and work. OBJECTIVE: To facilitate an early recognition and referral process for asthma in a preschool education program in Los Angeles, CA. METHODS: We administered a 7-question survey to parents and guardians of children aged 12 months to 6 years in the prekindergarten program of a large school district in Southern California. English and Spanish survey questions addressed health care use, school absenteeism, and asthma symptoms. Postsurvey reports to parents recommended clinical evaluation of children who had probable asthma. RESULTS: Of the 609 surveys returned from 8 centers (> or = 80% survey return rate), 12% were positive for probable asthma and only 5.4% of these cases had been previously diagnosed. Of the 12% found to have a high probability of asthma, 3 independent factors were associated with a lower likelihood of prior asthma diagnosis: Hispanic descent; Spanish speaking; and medicine use 2 or more times per week for symptoms such as cough, chest tightness, trouble breathing, or wheezing. Symptoms at play, during the day, and at night were noted in 35% to 44% of the preschoolers. Cough was the most frequently reported symptom (71.9%, n = 424). CONCLUSIONS: A school-based screening process in an early education program can help identify preschool children with a high probability of asthma and offer a basis for early recognition and intervention.