心理干预联合药物治疗对哮喘患者焦虑抑郁情绪及肺功能的影响

目的：探讨心理干预联合药物治疗对哮喘患者焦虑和抑郁情绪、病情控制水平和肺功能的影响。方法收集2012年11月至2013年3月期间就诊于中南大学湘雅医院呼吸内科门诊的轻、中度持续期哮喘患者160例，参照随机量表将其分为干预组(心理+药物联合治疗组)和对照组(单纯药物治疗组)，每组80例，疗程6个月。分别于入组及治疗结束时两次行综合医院焦虑抑郁量表(HAD)测试、肺功能检测和哮喘控制测试(ACT)，比较两组患者的焦虑、抑郁分值、肺功能及哮喘病情控制水平。结果治疗前两组患者的焦虑抑郁情绪、肺功能、哮喘控制水平比较差异均无统计学意义(P>0.05)；治疗后，两组患者的焦虑发生率(6.25%vs 22.5%)、抑郁发生率(7.5%vs 16.25%)比较，干预组低于对照组，差异均有统计学意义(P<0.05)；两组患者的△FEV1%(13.99±4.23)%vs (10.26±3.24)%]、△PEF%(14.06±4.39)%vs (10.07±3.49)%]、△MMEF%(13.76±5.90)%vs (9.97±3.78)%]比较，干预组肺功能较对照组改善明显，差异均有显著统计学意义(P<0.01)；干预组的哮喘控制水平明显优于对照组，差异有显著统计学意义(P<0.01)。结论轻、中度慢性持续期的哮喘患者采用心理干预联合药物治疗较之于单纯药物治疗，可以减少焦虑、抑郁等不良情绪的发生，改善肺功能，提高哮喘患者的病情控制水平。

Influence of psychological interventionin combined with drugs on anxiety and/or depression and lung function in asthmatic patients

Objective To explore the influence of psychological intervention combined with drugs on negative emotion and the level of asthma control and pulmonary function in asthma patients. Methods A total of 160 asthmatic patients in mild-to-moderate stage, who admitted to Department of Respiratory Medicine of Xiangya Hospital from No-vember 2012 to March 2013, were selected and divided into the intervention group (psychological intervention com-bined with drugs) and the control group (drug treatment) according to random scale, with 80 patients in each group. All the patients were treated for 6 months, the Hospital Anxiety and Depression (HAD) test, lung function and Asthma Con-trol Test (ACT) were collected at enrollment and the end of treatment. Results There was no significant difference between two groups in negative emotion percentage, lung function and ACT before treatment (P>0.05). After treat-ment, the incidence of anxiety and incidence of depression of the intervention group (6.25%, 7.5%, respectively) were significantly lower than those of the control group (22.5%, 16.25%, respectively) (P<0.05). The change of lung func-tion of intervention group △FEV1%=(13.99±4.23)%,△PEF%=(14.06±4.39)%,△MMEF%=(13.76±5.90)%] was bet-ter than that of the control group △FEV1%=(10.26 ± 3.24)%,△PEF%=(10.07 ± 3.49)%,△MMEF%=(9.97 ± 3.78)%] (P<0.01). The level of asthma control were significantly better in intervention group than that in control group (P<0.01). Conclusion Compared with drug treatment, psychological intervention combined with drug can relieve anxiety and de-pression, and improve the level of asthma control and pulmonary function.