行为习惯逆转疗法对老年性皮肤瘙痒症患者生命质量的影响

Effect of habit reversal training on the quality of life of patients with senile pruritus

目的探讨行为习惯逆转疗法(HRT)对老年性皮肤瘙痒症(SP)患者生命质量的干预效果。方法采用便利抽样法在成都中医药大学附属医院皮肤科选取60例SP患者,按照随机数字表法分成试验组和对照组,每组30例。遵医嘱给予2组患者基础治疗(抗组胺类药物口服及局部止痒膏外用)。在此基础上,对照组通过举办集体健康讲座的方式实施健康指导,1次/周,约60min/次,,连续进行8次;试验组在对照组基础上实施HRT,前4周每周1次,第5—12周每2周1次,30~60min/次。干预疗程共12周。2组均于干预前和干预后第4、8、12周末采用负性情绪量表、匹兹堡睡眠质量指数(PSQI)分别:NCRSE患者的负性情绪及睡眠质量;于干预前、干预后第12周末采用瘙痒症综合量表(SES)、皮肤病生命质量指数量表(DLQI):分别评价SP患者的瘙痒症状及生命质量。结果干预后第4周末、第8周末、第12周末试验组负性情绪量表得分及PSQI总分均低于同期对照组,差异具有统计学意义(负性情绪量表得分方面:T=0.131、一6.072、-6.884;PSQI总分方面:T=-3.972、-5.173、-8.246,均P<0.01),且在组间效应、时间效应、交互效应上均有统计学意义(负性情绪量表得分方面:F时间=96.635、F组间=10.329;PSQI总分方面:F交互=5.371,F时间=368.063、F组间=19.910、F交互=47.818,均P<0.05);干预后第12周末,试验组SPS总分和DLQI总分均低于对照组,差异有统计学意义(Z=一3.267、T=8.283,均P<0.01),其中DLQL日常生活维度得分差异无统计学意义(T=1.873,P>0.05);进一步组内两两比较:干预后,试验组各时间点负性情绪量表得分、PSQI总分及各维度得分均低于前一时间点(P<O.05);干预后第12周末,两组SPS、DLQI总分均低于干预前(Z=-4.610、T=15.850,均P<0.01)。结论HRT可有效缓解SP患者的瘙痒症状,改善负性情绪并提高睡眠质量,从而有效提高患者的生命质量,值得在临床进一步推广。

Objective To explore the effect of habit reversal training(HRT)on the quality of life of patients with senile pruritus(SP) Methods A total of 60 patients with SP were selected from the dermatology department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine. Using random number table method,the patients were divided into two groups,namely 30 patients in each group.Two groups of patients were treated with antihistamines and anticnesmatic.On this basis,the control group given health guide by holding group health lecture,once a week,about 60min each time,for eight consecutive times.The experimental group adopted the HRT on the basis of the control group,1 times per week in the first 4 weeks,and once every 2 weeks in the 5th to 12th week,and 30-60min each time.Before the intervention and 4 weeks,8 weeks and 12 weeks after intervention,the Negative Emotion Scale and the Pittsburgh Sleep Quality Index(PSQI)were respectively used to evaluate the negative emotion and the sleep quality.Before the intervention and12weeks after intervention,the Structured Pruritus Symptom(SPS)and Dermatology Life Quality Index(DLQ1)were respectively used to evaluate the pruritus symptom and the life quality of the patients with SP.ResultsThe scores of Negative Emotion Scale and PSQI in the experimental group at the fourth,eighth and 12th weekends after intervention were lower than those in the control group at the same time,and the difference was statistically significant(the negative emotion:t=0.131,-6.072,-6.884;PSQI:t=-3.972,-5.173,-8.246,P<0.01).And the scores of two scales in the two groups were statistically significant in the inter-group effect,time effect and interaction effect.(The score of the Negative Emotion Scale:Ftime=96.635,Finter-group=10.329, Finteraction=5.371;the total score of PSQI:Ftime=5.371,Finter-group=368.063,Finteraction=19.910, P<0.05).Meanwhile,the total score of the SPS and the DLQI in the experimental group were lower than the control group after 12 weeks of intervention(Z=-3.267#=8.283,P<0.01).Among them,there was no statistically significant difference in daily living items of DLQI(t=1.873,P>0.05).Also,after intervention,the total score of the Negative Emotion Scale,PSQI and each item of PSQI in the experimental group at each time point were lower than previous point(P<0.05).The total score of the SPS,DLQI and each item of DLQI in the experimental.group were lower than pre-intervention(Z=-4.610,t= 15.850,P<0.01).ConclusionsHRT could effectively relieve itching symptoms of patients with SP,improve the negative emotion and the sleep quality.It is worthy of further clinical promotion,thus effectively improve the quality of life of the patients with SP.