心理社会因素与慢性湿疹的临床研究

Clinical Study of Social and Psychological Factors and Chronic Eczema

目的探讨病程和发病部位不同的慢性湿疹患者采取应对方式的差异以及应对方式与患者情绪障碍、躯体症状的关系。方法采用医学应对方式问卷(MCMQ)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对105例慢性湿疹患者进行问卷调查评定;采用视觉模拟评分法(Visual Analogue Scale,VAS)、"湿疹面积及严重度指数(Eczema Area Severity Index,EASI)"对患者瘙痒和皮损严重程度进行评定。结果发病部位累及会阴部或乳房的患者MCMQ-面对、MCMQ-屈服评分均高于其他患者(P<0.05,P<0.01);病程越长的患者MCMQ-屈服评分越高;MCMQ-屈服评分与SAS、SDS评分呈显著正相关性(r分别为0.477、0.513,P均<0.01);MCMQ-屈服评分与瘙痒SAS评分、皮损严重程度评分均呈显著正相关性(r分别为0.384、0.282,P均<0.01)。结论病程和发病部位不同的慢性湿疹患者采取的应对方式有所差异;"屈服"应对方式不论对患者的心理健康状况还是躯体症状均产生负面影响。

Objective To discuss the differences of coping style of patients with different disease position and course of disease, and the relation between the medical coping style and emotional discorder and somatic symptoms of patients. Methods 105 patients with chronic eczema were investigated with Medical Coping Mode Question (MCMQ), Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS). Severity of pruritus and skin rash of chronic eczema of patients suffering from chronic eczema were assessed by visual analogue scale(VAS) and eczema area severity index(EASI). Results MCMQ-face scores and MCMQ-submit scores of patients whose disease position implicated pubes or breast were significantly higher than those of other patients (P<0.05, P<0.01). The course of disease was longer and MCMQ-submit score was higher (P<0.01). MCMQ-face scores were higher in patients suffering from chronic eczema than those in the healthy group. MCMQ-avoid scores and MCMQ-submit scores were higher in patients with chronic eczema than those in the healthy group. The difference had statistical significance(P<0.01). Scores of MCMQ-submit had correlation with scores of VAS and EASI(P<0.01). Conclusion The coping style of patients with different disease position and course of disease are different. The patients with chronic eczema adopted 'face' coping style principally. 'Submit' coping style has the negative influence of the psychologically health condition and body symptom of the patients with chronic eczema.