进食障碍患者专科医师指导家庭治疗效果观察

Observation on the effect of family treatment under the guidance of specialists in patients with eating disorders

目的探讨专科医师指导的家庭治疗在进食障碍中的价值。方法选择2017-01-01-2020-01-01南阳市第四人民医院收治的60例进食障碍患者(包括贪食、厌食、神经性呕吐)为研究对象,根据组间基本资料匹配的原则分为对照组(28例)和指导组(32例)。对照组采用常规干预,指导组在对照组基础上增加基于专科医师指导的家庭治疗。于干预前后记录2组患者的生理指标,并采用进食障碍调查量表(EDI)、自我控制量表(SCS)及生活质量量表(QOL)分别评估2组患者进食障碍和自我控制力度及生活质量。结果干预后,指导组患者体质量为(47.88±3.56)kg,高于对照组的(43.69±3.24)kg,t=4.742,P<0.001;指导组患者身体质量指数为(21.01±0.71)kg/m^(2),高于对照组的(20.38±0.74)kg/m^(2),t=3.362,P=0.001;指导组患者上臂围为(21.35±1.34)cm,高于对照组的(19.88±1.23)cm,t=4.404,P<0.001;指导组患者上臂肌围为(18.47±0.86)cm,高于对照组的(17.56±0.82)cm,t=4.178,P<0.001;指导组患者白蛋白为(34.27±2.82)g/L,高于对照组的(31.57±2.16)g/L,t=4.117,P<0.001;指导组患者血红蛋白为(124.28±6.58)g/L,高于对照组的(116.33±6.24)g/L,t=4.782,P<0.001。干预后,指导组患者EDI评分为(40.55±3.64)分,低于对照组的(44.23±3.21)分,t=4.126,P<0.001;指导组患者SCS评分为(60.43±5.21)分,高于对照组的(55.66±5.28)分,t=3.516,P=0.001;指导组QOL量表中躯体功能、心理功能和社会功能各维度评分均高于对照组,差异有统计学意义,均P<0.05。结论专科医师指导的家庭治疗能够改善进食障碍患者体质量、身体质量指数、上臂围、上臂肌围、白蛋白、血红蛋白,且减少进食障碍,提高自我控制力,增强生活质量。

Objective To explore the value of family therapy guided by specialists in eating disorders.Methods A total of 60 patients with eating disorders(including bulimia,anorexia and neurovomiting)treated in Nanyang Fourth People’s Hospital from January 1,2017 to January 1,2020 were divided into control group(28 cases)and guidance group(32 cases)according to the principle of matching basic data between two groups.The control group used routine nursing intervention,and the guidance group added family therapy based on the guidance of specialists on the basis of the control group.The physiological indexes of the two groups were recorded before and after the intervention.The eating disorder,self-control and quality of life of the two groups were evaluated by eating disorder inventory(EDI),self-control scale(SCS)and quality of life scale(QOL).Results After intervention,the body weight of patients in the guidance group was(47.88±3.56)kg,which was higher than that in the control group(43.69±3.24)kg,t=4.742,P<0.001.The body mass index of patients in the guidance group was(21.01±0.71)kg/m^(2),which was higher than that in the control group(20.38±0.74)kg/m^(2),t=3.362,P=0.001.The upper arm circumference in the guidance group was(21.35±1.34)cm,which was higher than that in the control group(19.88±1.23)cm,t=4.404,P<0.001.The upper arm muscle circumference in the guidance group was(18.47±0.86)cm,which was higher than that in the control group(17.56±0.82)cm,t=4.178,P<0.001.The albumin in the guidance group was(34.27±2.82)g/L,which was higher than that in the control group(31.57±2.16)g/L,t=4.117,P<0.001.The hemoglobin in the guidance group was(124.28±6.58)g/L,which was higher than that in the control group(116.33±6.24)g/L,t=4.782,P<0.001.After the intervention,the EDI score of the guidance group was 40.55±3.64,which was lower than that of the control group44.23±3.21,t=4.126,P<0.001.The score of SCS in the guidance group was 60.43±5.21,which was higher than that in the control group 55.66±5.28,t=3.516,P=0.001.The scores of physical function,psychological function and social function in QOL scale in the guidance group were higher than those in the control group,the difference was statistically significant,all P<0.05.Conclusion Family therapy guided by specialists can improve the body mass,body mass index,upper arm circumference,upper arm muscle circumference,albumin and hemoglobin of patients with eating disorders,reduce eating disorders,improve self-control and enhance the quality of life.