心理干预对膝骨关节炎患者临床疗效的研究

Psvchological intervention on the clinical curative effect of knee osteoarthritis inpatients

目的探讨心理干预对膝骨关节炎患者临床疗效的作用。方法采用随机对照研究试验方法，对92例膝骨关节炎患者进行为期1个月的观察，47例物理治疗合并心理干预，45例物理治疗为对照组。测查一般资料、生理指标、健康状况调查问卷（SF-36）、抑郁自评量表（SDS）和焦虑自评量表（SAS）并作干预前后比较分析。统计学方法采用t检验，方差分析。结果①膝骨关节炎患者治疗前后生理指标变化的差异均无统计学意义（P〉0．05）；⑦SDS分有随治疗时间逐渐下降的趋势，SDS总分心理干预组较无心理干预组下降明显（P〈0．05）。③SAS分有随治疗时间逐渐下降的趋势，2组SAS分下降程度差异无统计学意义（P〉0．05）。④治疗前后心理干预组在生理机能、躯体疼痛、精力、情感职能4个纬度较无心理干预组改善明显。⑤SDS与生理机能、躯体疼痛、一般健康状况、精力、社会功能负相关（r=-0．739—0．521，P〈0．05）；SAS与精力、社会功能呈负相关（r=0．699--0．475，P〈0．05）。结论心理干预可以缓解膝骨关节炎患者抑郁情绪，改善膝骨关节炎患者生存质量。

Objective To explore the effect of psychological intervention on knee osteoarthritis patients. Methods A total of 92 OA patients were included into a one-month randomized controlled followup study, 47 of them were treated with combined psychological intervention, the other 45 cases were routinely treated. All cases were investigated on their demographic information , physiological parameters and score of the short form-36 health survey questionnaires （SF-36）, self-rating depression scale （SDS） and self-rating anxiety scale （SAS）. Statistics method used t-test and variance analysis. Results There was no signi-ficant difference in terms of the physiologic parameters changes between before and after treatment （P〉0.05） of the two groups. ①The SDS scores of the two groups decreased gradually after the treatment （P〈0.05）, while there was remarkable descending of SDS score in patients of psychological intervention group （P〈0.05）. ② The SAS scores of the two groups decreased gradually after the treatment （P〈0.05）. And there was no significant difference between the two groups （P〉0.05）. Compared with the non-intervention group, the four factors scores including physical function, pain, vitality and role limitations due to emotional problems of the intervention group were significantly improved （P〈0.05）. Anegative correlation was observed between SDS and PF, BP, GH, VT and SF （r=-0.73-0.521,P〈0.05）. SAS was correlated negatively with VT and SF （r=-0.699- -0.475,P〈0.05 ）. Conclusion Psychological intervention could ameliorate the depression of knee osteoarthritis patients. The quality of life of knee osteoarthritis patients can be improved by psychological intervention.