心理干预对糖尿病患者不良情绪及糖脂代谢的影响

Influence of psychological intervention on bad mood of diabetic patients and their blood glucose and lipid metabolism

目的探讨通过心理干预改善糖尿病患者焦虑、抑郁情绪，控制血糖、血脂代谢的效果。方法将200例病人随机分成两组，对照组（n=100）接受常规治疗及护理，干预组（n=100）在常规治疗与护理的同时给予心理干预、认知重建。分别于干预前及干预后3个月测定两组患者焦虑量表（HAMA）、焦虑自评量表（SAS）、抑郁量表（HAMD）、抑郁自评量表（SDS）、症状自评量表（SCL-90）评分以及空腹血糖（FPG）、餐后2h血糖（PG2h）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、低密度脂蛋白胆固醇（HDL-c）、甘油三酯（TG）水平。结果干预前两组患者血糖、血脂代谢指标及不良情绪评分差异无统计学意义（P〉0．05）。3个月后干预组患者HAMD评分（12．99±3．51）、HAMA评分（14．15±3．92）、SAS评分（35±12．4），SDS评分（28±14．5），均低于对照组（17．94±4．92），（18．64±4．19），（49±19．6）（43±19．6）分，两组比较差异均有统计学意（t=9．407，7．825，6．036，6．151；P〈0．01）；与各组干预前比较，差异均有统计学意义（P〈0．05）。干预后两组HbA。FPG、PG2h、TC、HDL—c、TG水平均有所下降，干预组效果更好（P〈0．05）。结论心理干预有助于改善糖尿病焦虑、抑郁情绪，改善糖脂代谢水平，提高生活质量。

Objective To investigate the psychological intervention to control anxiety and depression mood of diabetic patients and blood glucose and lipid metabolism. Methods 200 patients were randomly divided into two groups, control group （n = 100） received routine treatment and care, the intervention group （n = 100） in the conventional treatment and care while providing psychological interventions, cognitive restructuring. Respectively, before intervention and 3 months after intervention in patients with anxiety scale measured two groups （HAMA）, self-rating anxiety scale （SAS）, depression scale （HAMD）, self-rating depression scale （ SDS）, symptom assessment table （SCL-90） score, and fasting plasma glucose （ FPG）, postprandial 2 h blood glucose （PG 2 h）, glycated hemoglobin （HbA1c）, total cholesterol （TC）, low-density lipoprotein cholesterol （HDL-c）, triglycerides （TG） levels. Results Difference of blood glucose and lipid metabolism and adverse mood score in patients of the two groups, before intervention was not statistically significant （ P 〉 0. 05 ）. 3 months after the intervention group were HAMD score （12.99 ±3.51 ）, HAMA score （14.15±3.92）, SAS score （ 35 ±12. 4）, lower than the control group [ （ 17.94± 4.92）, （ 18.64 ±4.19）, （49 ± 19.6 ）, （43± 19.6） respectively], the difference was statistically significance （t =9. 407, 7. 825, 6. 036, 6. 151;P 〈 0. 01 ） ; Before intervention, the difference was statistically significant （P 〈 0. 05）. HbAlc, FPG, PG 2 h, TC, HDL-c, TG levels are decreased in the intervention group （P 〈 0. 05 ）. Conclusions Psychological intervention can help improve diabetes anxiety and depression, improve glucose and lipid metabolism, and improve quality of life.