心理干预对膝骨关节炎患者临床疗效的研究

目的 探讨心理干预对膝骨关节炎患者临床疗效的作用.方法 采用随机对照研究试验方法,对92例膝骨关节炎患者进行为期1个月的观察,47例物理治疗合并心理干预,45例物理治疗为对照组.测查一般资料、生理指标、健康状况调查问卷(SF-36)、抑郁自评量表(SDS)和焦虑自评量表(SAS)并作干预前后比较分析.统计学方法采用t检验,方差分析.结果 ①膝骨关节炎患者治疗前后生理指标变化的差异均无统计学意义(P＞0.05);②SDS分有随治疗时间逐渐下降的趋势,SDS总分心理干预组较无心理干预组下降明显(P＜0.05).③SAS分有随治疗时间逐渐下降的趋势,2组SAS分下降程度差异无统计学意义(P＞0.05).④治疗前后心理干预组在生理机能、躯体疼痛、精力、情感职能4个纬度较无心理干预组改善明显.⑤SDS与生理机能、躯体疼痛、一般健康状况、精力、社会功能负相关(r=-0.739～-0.521,P＜0.05);SAS与精力、社会功能呈负相关(r=-0.699～-0.475,P＜0.05).结论 心理干预可以缓解膝骨关节炎患者抑郁情绪,改善膝骨关节炎患者生存质量.

Psychological intervention on the clinical curative effect of knee osteoarthritis inpatients

Objective To explore the effect of psychological intervention on knee osteoarthritis patients. Methods A total of 92 OA patients were included into a one-month randomized controlled followup study, 47 of them were treated with combined psychological intervention, the other 45 cases were routinely treated. All cases were investigated on their demographic information , physiological parameters and score of the short form-36 health survey questionnaires (SF-36), self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Statistics method used t-test and variance analysis. Results There was no signi-ficant difference in terms of the physiologic parameters changes between before and after treatment (P＞0.05) of the two groups. ① The SDS scores of the two groups decreased gradually after the treatment (P＜0.05),while there was remarkable descending of SDS score in patients of psychological intervention group (P＜0.05). ② The SAS scores of the two groups decreased gradually after the treatment (P＜0.05). And there was no significant difference between the two groups (P＞0.05). Compared with the non-intervention group, the four factors scores including physical function, pain, vitality and role limitations due to emotional problems of the intervention group were significantly improved (P＜0.05). Anegative correlation was observed between SDS and PF, BP, GH, VT and SF (r=-0.739-0521,P＜0.05). SAS was correlated negatively with VT and SF (r=-0.699～-0.475,P＜0.05). Conclusion Psychological intervention could ameliorate the depression of knee osteoarthritis patients. The quality of life of knee osteoarthritis patients can be improved by psychological intervention.