颈椎病康复理疗患者的心理干预效果的研究

Effect of psychotherapy during physiotherapy in patients with cervical spondylosis

目的:探讨颈椎病患者心理特征及接受理疗康复的同时综合性心理治疗与单纯的康复理疗的差异.方法:符合颈椎病诊断标准的60例患者随机分为对照组(理疗康复治疗)、治疗组(在实施理疗康复治疗的同时,施加心理干预).Health心理健康水平检测采用吴文源修订的症状自评量表(SCL-90),人格个性特征评定采用由龚耀先修订的艾森克个性问卷(EPQ).理疗康复效果评定采用日常生活活动能力(ADL)量表(Barthel)指数.结果:颈椎病两组患者治疗前SCL-90各因子分没有明显差异,经理疗康复治疗和介入心理干预后,治疗组各因子与对照组比较明显降低(P<0.05).颈椎病患者的人格特征为情绪不稳定,有精神质倾向,而治疗组的患者人格特征比较稳定,P维度(精神质)和N维度(情绪性)得分明显低于对照组(P<0.05).治疗组的Barthel指数明显高于对照组(P<0.05).结论:颈椎病患者的康复理疗效果与心理治疗明显相关,适时的心理治疗有助于此病康复.

AIM： To evaluate the mental status and the differences in the outcomes between the comprehensive treatment of physiotherapy and psychotherapy and mere physiotherapeutic treatment in patients with cervical spondylosis. METHODS： Sixty patients, who met the cervical spondylosis diagnostic standards, were randomly divided into control group （ physiotherapy and rehabilitation training） and therapy group （treated with both physiotherapy, rehabilitation training and psychotherapy ）. Mental health status was evaluated with the Symptom Checklist （SCL-90） introduced and revised by Wen-Yuan Wu, and personality characteristics were evaluated with the Eysenck Personality Questionnaire（EPQ） revised by Yao-Xian Gong. The efficacy of physiotherapy and rehabilitation training was evaluated with activity of daily living （ADL） scale （Barthel index）. The evaluations were conducted at the beginning of the study and 3 months later. The results were analyzed with SPSS12.0 software. RESULTS： There were no significant differences in the scores of SCL-90 between the 2 groups before treatment. After treatment, scores in the therapy group decreased significantly as compared with those in the control group （ P 〈 0. 05 ）. Personality characteristics of cervical spondylosis patients were emotional instability, tendency of nervousness. Personality characteristics in the therapy group were more stable, the scores of N dimension and P dimension were significantly lower than those in the control group （P 〈 0.05）. Barthel index in the therapy group was significantly higher than that in the control group （P 〈0.05）. CONCLUSION： The psychology of the cervical spondylosis patients influences directly the therapeutic efficacy of physiotherapy and rehabilitation training. The introduction of psychotherapy can improve the physiotherapy and rehabilitation effect of cervical spondylosis patients.