积极认知行为疗法对乳腺癌化疗患者心理状态及生活质量的影响

目的探讨乳腺癌化疗患者的心理状态及实施积极认知行为疗法（ACBT）对心理状态及生活质量的影响。方法采用随机数字表法将58例乳癌化疗患者随机分为两组，实验组（n=28）采用化疗药物治疗同时联合ACBT治疗，对照组（n=30）单纯采用化疗药物治疗。首次化疗第1天及治疗后6个月，采用Zung焦虑量表（SAS）、抑郁量表（SDS）、生活质量核心问卷（QLQ—C30）评定两组患者干预前后心理状态及生活质量。结果实验组干预后SAS评分为（42．21±4．83）分，SDS评分为（41．43±5．62）分，对照组分别为（45．15±4．68）分和（45．78±9．25）分，组间比较差异具有统计学意义（t=2．35，2．19；P〈0．05）。两组生活质量核心问卷中躯体功能、角色功能、情绪功能、认知功能、社会功能、疼痛、疲劳、恶心、呕吐、失眠、总的健康状况比较差异有统计学意义（P〈0．05），气促、食欲、便秘、腹泻症状比较差异无统计学意义（P〉0．05）。结论在化疗药物治疗基础上联合ACBT治疗可减轻乳癌患者的抑郁和焦虑症状，改善患者康复过程中的心理社会适应能力，提高生活质量。

Active cognition-behavior therapy of breast cancer chemotherapy patients' psychological status and the influence on the quality of life

Objective To explore the psychological state of breast cancer patients and implement active cognitive behavior therapy (ACBT) of psychological status and the influence on the quality of life. Methods choose 58 cases of breast cancer chemotherapy patients from January 2008 - December 2010 treatment in our hospital,randomly divided into two groups, and the chemotherapy drugs also combined treatment group ACBT pure chemotherapy drugs. In the first day and treatment first chemotherapy after 6 months, we adopt Zung anxiety scale (SAS) and depressionscale (SDS) measurement patients before and after the intervention of the psychological condition, and using quality of life questionnaire (core QLQ-C30) to assess its before and after the treatment of quality of life. Results SAS score in ACBT group was (42.21 ± 4. 83 ), and SDS score was (41.43 ± 5.62),those in control group were (45.15 ±4.68) and (45.78 ±9.25), respectively, and the difference was significant (t =- 2. 235, t =2. 19 ; P ＜ 0. 05 ). Quality of life questionnaire, the conclusion of evaluating the core body function, role function, mood function, cognitive function, social function, fatigue, disgusting, vomiting,insomnia, overall health status with significant difference (P ＜ 0. 05), pain, shortness of breath, appetite,constipation and diarrhea non-significance difference (P ＞ 0. 05). Conclusions Chemotherapy drug treatment on the basis of joint ACBT can significantly reduce breast cancer treatment of depression and anxiety symptoms, and improve patients' rehabilitation process of psychological adaptation to society, improve the quality of life.