眼动脱敏和再加工与认知行为疗法对创伤后应激障碍患者生活质量的效果比较

Comparison of the Effects of Eye Movement Desensitization and Reprocessing and Cognitive Behavior Therapy on Quality of Life in Patients with Post-traumatic Stress Disorder

目的:比较眼动脱敏和再加工(EMDR)与认知行为疗法(CBT)对创伤后应激障碍(PTSD)患者生活质量改善的效果。方法:将符合纳入标准的研究对象随机分为EMDR组和CBT组,每组各27人,采用世界卫生组织生存质量测定量表(WHOQOL-Bref)在治疗前、治疗后及3个月后随访对两组患者的生活质量进行评估。结果:治疗结束后,两组的失访率分别为29.6%(EMDR)、7.4%(CBT),两组患者在生理、心理、社会关系及环境4个领域均有显著性提高,在心理领域和环境领域,CBT效果优于EMDR(t=-2.258,P=0.028;t=-2.740,P=0.008),重复测量方差分析验证了这一结果。结论:EMDR和CBT均能有效提高PTSD患者的生活质量,由于EMDR组存在较高的失访率,因此当引用CBT在心理和环境两个领域优于EMDR这一结论时应慎重。

Objective：To compare efficacy of eye Movement Desensitization and Reprocessing and Cognitive--Be- havioral Therapy in quality of life among posttraumatic stress disorder. Methods： A total of 54 participates with PTSD were randomly allocated to EMDR, CBT（27 participates per group）,All the patients were assessed by blind raters prior to randomization,at the end of the treatment and 3 months follow--up with The World Health Organi- zation Quality of Life--Bref Scale（WHOQOL--Bref）.Results：Drop--out rates between the two group were 29.6% for EMDR group and 7.4% for CBT group.In general,there were significant increases in all of the four domains of quality of life（physical, psychological social relationship, environment）.There was a greater improvement in psycho- logical domain and environment domain for CBT in comparison to EMDR（t =-2.258 ,-2.740;P 〈0.05）.The results of repeated measures variance analysis confirmed this result.Conclusion：Both EMDR and CBT are effective in impro ring quality of life of PTSD patients.