短期正念行为训练对髋部骨折固定术后老年患者负性情绪及免疫功能的影响

Effects of mindfulness behavior training on emotional disorder and immunological function in elderly patients after hip fracture fixation surgery

目的 探讨短期正念行为训练对髋部骨折固定术后老年患者负性情绪及免疫机能的影响.方法 将60例符合条件的髋部骨折固定术后老年患者按随机数字表法分为对照组和训练组,每组30例.对照组给予早期运动康复训练;训练组在此基础上给予正念行为训练,每周1次,每次90 min,共5周.分别于治疗前和治疗5周后（治疗后）,对2组患者采用心境状态量表（POMS）评测患者心境状态,采用正念注意觉知量表（MAAS）评测患者的正念水平;并采用EXPO32-ADC流式分析软件实施免疫荧光的数据分析,对血清T淋巴细胞亚群（CD3＋、CD4＋、CD8＋）数目进行免疫机能评测.结果 治疗前,2组患者POMS和MAAS评分及血清T细胞CD3＋、CD4＋、CD8＋数目比较,组间差异均无统计学意义（P＞0.05）.治疗后,2组患者的POMS和MAAS评分及血清T细胞水平明显优于组内治疗前（P＜0.05）.治疗后,与对照组相比,训练组中患者正念水平MAAS评分（58.00 ±4.78 vs 54.00±4.89）及POMS各项评分中的紧张-焦虑（13.14 ±3.36 vs 15.90±4.28）、忧郁-沮丧（18.10±6.24 vs 20.06±5.42）、疲惫-惰性（16.53±3.50 vs18.98±4.88）,活力-好动（26.68±5.22 vs22.43±5.20）,组间差异均有统计学意义（P＜0.05）;但愤怒-敌意（9.94±2.48 vs 10.38±2.30）和困惑-迷惑（13.60±3.48 vs 13.78±3.50）两项指标评分组间差异无统计学意义（P＞0.05）.与对照组相比,训练组患者治疗后的血清T细胞CD3＋、CD4＋、CD8＋数目升高（75.75±5.40 vs69.91±4.42;39.54±3.29 vs34.44±4.21;39.82±3.55 vs 36.82±3.55）,训练组亦明显优于对照组（P＜0.05）.结论 短期正念训练可改善髋部骨折固定术后老年患者心境情绪状态,提高患者免疫机能.

Objective To investigate the effects of mindfulness behavior training on emotional disorder and immunological function in elderly patients after hip fracture fixation surgery.Methods Sixty elderly patients with fixed hip fracture by operation were randomly divided into a training group and a control group with 30 cases in each group.The training group received mindfulness behavior training in addition to routine rehabilitation training,while the control group only received routine rehabilitation training.The mindfulness behavior training was administered 90 min for once a week,lasting for 5 weeks.The emotional disorder was assessed with the profile of mood states （POMS）,and the immune system function were evaluated by the number of CD3 ＋ 、CD4 ＋ 、CD8 ＋ in T cell subgroup before and after 5 weeks of training.Results Before training,there was no significant difference in scores of POMS and the cells number of CD3 ＋,CD4 ＋,CD8 ＋ （P ＞ 0.05） between the two groups.After treatment,scores of POMS including tension-anxiety （13.14 ± 3.36 vs 15.90 ± 4.28）,depression-dejection （18.10 ± 6.24 vs 20.06 ± 5.42）,fatigue-inertia （16.53 ± 3.50 vs 18.98 ± 4.88）,vgor-activity （26.68 ± 5.22 vs 22.43 ± 5.20） （P ＜ 0.05）,the level of mindfulness practice（58.00 ± 4.78 vs 54.00 ± 4.89） and the cells number of CD3 ＋,CD4 ＋,CD8 ＋ （75.75 ± 5.40vs 69.91 ± 4.42 ;39.54 ± 3.29 vs 34.44 ± 4.21 ; 39.82 ± 3.55 vs 36.82 ± 3.55） in experimental group improved more than those in control group （P ＜ 0.05）.Conclusion Mindfulness behavior training can improve the patients＇ mood state and have positive promotion on immunological function.