心理护理对乳腺癌患者负面情绪和免疫功能的影响

Effects of mental nursing on emotions and immune function of breast cancer patients

目的探讨心理护理对乳腺癌患者术后放化疗期负面情绪和免疫功能的影响。方法选取术后放化疗乳腺癌患者76例,随机分为观察组和对照组各38例;2组均给予常规放化疗,观察组在此基础上进行心理护理,1个月为1个疗程。分别于干预前后根据SAS及SDS评价患者的焦虑情绪和抑郁情绪;同时,取患者空腹外周血,以流式细胞法测定全血NK、LAK及T细胞亚群(CD3+、CD4+、CD8+)细胞计数,并以酶联免疫法测定患者免疫球蛋白(IgA、IgG、IgM)及补体(C3、C4)水平。结果干预前2组患者在情绪评分、免疫功能测定等方面的指标均无显著性差异(P>0.05);经为期1个月的治疗,观察组患者的SAS评分及SDS评分均显著低于对照组(P<0.05);全血NK、LAK、CD3+及CD4+细胞计数显著高于对照组(P<0.05),CD8+细胞计数无显著差异(P>0.05);血清IgG、IgM及C3水平显著高于对照组(P<0.05),IgA及C4水平无显著差异(P>0.05)。结论心理干预能够有效缓解乳腺癌患者负面情绪诱发的免疫功能失调,可作为乳腺癌术后放化疗的辅助治疗手段。

Breast cancer is one of the most common diseases for women, whose morbidity and mortality are both on the top of high-risk disease list. Resent research shows that emotional stress play stimulative role on the exacerbation of the patients, and mental nursing may get positive effect on therapy. We aim to discuss the effect of mental nursing on emotions and immune function of breast cancer patient through this study in which 76 cases of postoperative breast cancer patients in radiotherapy or chemotherapy were selected and randomly divided into two groups. All patients were given conventional treatment while 38 cases of observation group were given additional psychological nursing. The anxious and depressed score were measured by SAS and SDS after one month＇s treatment; at the same time, peripheral blood of each patient was extracted to detect the cell count of NK, LAK, and T cell subsets （CD3＋, CD4＋, CD8~） by flow cytometry, as well as the level of immune globulin （IgA, IgG, IgM） and complement （C3, C4） by euzymelinked immunosorbent assay. We found that before treatment, there was no significant different between groups in mood score and immune function （P 〉 0.05）. After treatment, SAS and SDS scores of observation group were significantly lower than that of control group （P〈 0.05）, while NK, LAK, CD3＋, and CD4＋ cell counts were significantly higher than that of control group （P〈0.05）; furthermore, IgM and C3 levels were also significantly higher than that of control group （P〈 0.05）; but there was no significantly difference in CD8~ cell count and IgA, C4 level. Our research results indicate that psychological intervention could prevent the immune function damage caused by emotional stress and could be used as an aid in the treatment of breast cancer.