认知行为干预疗法对癌症患者抑郁症的对照研究

Comparative Study of Cognitive Behavioral Intervention Therapy on Depression in Cancer Patients

目的 观察自行编制的认知行为干预疗法——“音乐治疗加放松内心意象法”在癌症患者抑郁症治疗中的作用。方法 对 90例抑郁症癌症患者随机分为 3组 ,A组 30例 ,采用“音乐治疗加放松内心意象法”,B组 30例 ,采用阿米替林治疗 ;C组 30例 ,采用“音乐治疗加放松内心意象法”合并阿米替林治疗。抑郁症严重程度及疗效采用汉米顿抑郁量表( HAMD)评定和患者自评相结合 ,进行连续 1 2周的观察 ,其评定结果采用 t检验及 Ridit分析。结果 A、B、C 3组疗法在 4周前无明显差异 ,但在 4～ 6周 C组疗法与 A组疗法存在一定差异 ( P<0 .0 5)。 8～ 1 2周 C、B两组疗法与 A组疗法存在显著差异 ( P<0 .0 1 ) ,而 B、C两组却无明显差异 ( P>0 .0 5)。B、C两组从整体比较 ,C组疗法不仅疗效启动时间早 ( 8周 ,P<0 .0 5) ,而且同时可降低阿米替林的使用剂量 ( P<0 .0 1 )。结论 “音乐治疗加放松内心意象法”合并药物治疗是一种更经济、更安全。

Objective To clarify the role of'musicotherapy and relaxation inner image'in the treatment of depression in cancer patients.Methods 90 depressive cancer patients were divided into three groups randomly:group A(30 cases)received only'musicotherapy and relaxation inner image';group B(30 cases)received only Amitriptyline therapy;group C(30 cases)received both'musicotherapy and relaxation inner image'and Amitriptyline.HAMDwas used to evaluate the change of symptoms.The study persisted for 12 weeks.Ridit analysis and t test were used in data analysis.Results There was no difference between the 3 groups in the first 4 weeks of treatment.During 4 weeks to 6 weeks,the therapeutic effect of group C was better than that of group A(P<0.05).By the end of 12 weeks,the effects of both group C and group B were better tthan that of group A.But,there was no difference between group C and group B.Based on the ressults mentioned above,the therapeutic effect of group C came early.At the same time,dosage of Amitriptyline was lower in group C than in group B.Conclusion Combinning drug therapy with'musicotherapy and relaxation inner image'is more economic and safer as well as with better compliance.