选择性心理干预对乳腺癌患者血清细胞因子和不良情绪评分的影响

Effects of selective psychological intervention on cytokine and unhealthy emotion in patients with breast cancer

目的:观察选择性心理干预对乳腺癌术后化疗期患者外周血中细胞因子白细胞介素2、4、肿瘤坏死因子γ(IL-2、IL-4、TNF-γ)及不良情绪评分的变化。方法:80例乳腺癌术后化疗患者,随机分为对照组和干预组,两组同时按常规给予化疗及健康教育,干预组同时进行选择性心理干预。采用Zung焦虑量表(Self-rating anxiety scale,SAS)、Zung抑郁量表(Self-rating depression scale,SDS)、症状自评量表(SCL-90)心理行为评定量表,观察选择性心理干预对乳腺癌化疗患者不良情绪的影响;放免法测定选择性心理干预对患者外周血中IL-2、IL-4及TNF-γ的变化情况。结果:化疗后,对照组和干预组乳腺癌患者不良心理评分均明显降低(P<0.05);与对照组相比较,选择性心理干预组乳腺癌患者不良心理的评分明显降低(P<0.05);选择性心理干预对乳腺癌化疗患者外周血中IL-2、IL-4有明显的增强作用(P<0.05),TNF-γ虽有增高,但没有差异性(P>0.05)。结论:选择性心理干预可改善化疗期乳腺癌患者的不良情绪,也可提高患者外周血中部分细胞因子的含量,可能与提高免疫力有关。

Objective：To study the role of selective psychological intervention on peripheral blood cytokine（interleukin-2,interleukin-4,tumor necrosis factor-γ）（IL-2,IL-4,TNF-γ）and unhealthy emotion in patients with chemotherapeutical breast cance.Methods：Randomized-control study method was adopted.Eighty chemotherapeutical inpatients with breast cancer were divided into intervention group and control group（40 patients in each group）.Patients in both groups received mutine chemotherapy and health education,while the intervention group also received selective psychological intervention.The psychological and behavior rating were observated with Zung anxiety scale（SAS）/Zung depression scale（SDS）and symptom checklist（SCL-90）pre-and three month post-chemotherapy.Psychological intervention methods were selected independently and completed by patients.The effect of selective psychological intervention on unhealthy emotions were observed in breast cancer inpatients undergoing chemotherapeutics.The changes of IL-2/IL-4/TNF-γin peripheral blood were detemined by radioimmunity.Results：The breast cancer inpatients in both groups were noticeably depressed after chemotherapy（P0.05）.In contrast to control group,the unhealthy emotions of breast cancer inpatients with selective psychological intervention were obvious depression after chemotherapy（P0.05）（.these two sentences are not clear in meaning.Rewrite them）After chemotherapy,the IL-2/IL-4 were increased obviously with selective psychological intervention as compared with the control group（P0.05）,the TNF-γwas increased too,but showing no statistical difference（P0.05）.Conclusion：The selective psychological intervention could inhibit the unhealthy emotion of breast cancer patients undergoing chemotherapy and increase the content of some cytokines in peripheral blood,which may be related with immunity enhancement.