综合性心理干预对鼻咽癌患者免疫功能的影响

The influence of comprehensive psychological intervention on the immune function of patients with nasopharyngeal carcinoma

目的探讨综合性心理干预对鼻咽癌患者免疫功能的影响。方法将40例鼻咽癌同期放化疗患者按随机数字表法分为干预组和对照组，每组20例。在同期放化疗期间，干预组患者进行综合性心理行为干预，对照组接受一般的健康教育及心理护理。采用抑郁自评量表（SDS）和焦虑自评量表（SAS）对2组患者进行问卷调查，通过流式细胞仪检测患者血清中自然杀伤细胞活性。结果2组患者确诊后SDS、SAS评分比较差异无统计学意义（P〉0．05）；治疗结束时，干预组患者SDS、SAS评分分别为（45．26±3．83）、（42．57±3．75）分，均低于对照组的（52．68±3．66）、（51．16±3．62）分，差异有统计学意义（t=6．264、7．370，P〈0．05）。2组患者确诊后自然杀伤细胞活性比较差异无统计学意义（P〉0．05）；治疗结束时，干预组患者自然杀伤细胞活性为26．96±9．01，高于对照组的22．84±7．19，差异有统计学意义（t=2．120，P〈0．05）。干预组患者确诊后及治疗结束时SDS、SAS评分差值与自然杀伤细胞水平差值呈正相关（r=0．238，P=0．006；r=0．527，P=0．003）。结论综合性心理干预可显著改善鼻咽癌患者在放化疗期间的抑郁、焦虑不良情绪，并提高机体自然杀伤细胞活性，有助于维持治疗期间患者的白细胞水平。

Objective To explore the influence of psychological intervention on the immune function of patients with nasopharyngeal carcinoma. Methods Forty nasopharyngeal carcinoma patients with concomitant radiochemotherapy were divided into intervention group and control group by random digits table method with 20 cases each. Among concomitant radiochemotherapy nasopharyngeal carcinoma patients, intervention group were treated with comprehensive psychological behavior, and control group received only concurrent radiotherapy and chemotherapy. Both groups were investigated by Self-rating Anxiety Scale（SAS） and Self-rating Depression Scale（SDS）. Natural killer cells activity were measured by flow cytometry. Results There were no significantly difference in score of SDS and SAS between two confirmed groups （P〉0.05）. After treatment, the score of SDS and SAS in intervention group were （45.26± 3.83） , （42.57± 3.75） points, which were significantly lower than those of control group （52.68±3.66） , （51.16± 3.62） points, the difference was statistically significant（t =6.264, 7.370, P〈0.05）. Meanwhile, natural killer cell activity between two groups showed no significantly difference （P〉0.05）. However, the activity of natural killer cells in intervention group was 26.96±9.01, which was higher than that of control group 22.84±7.19, there were statistically significant difference between two groups （t=2.120, P〈0.05）. There was a positive correlation between the value difference of SDS scores, SAS scores and natural killer cell activity between two groups （r=0.238, P=0.006; r=0.527, P=0.003）. Conclusions Comprehensive psychological intervention can significantly not only improve the depression and anxiety of nasopharyngeal carcinoma patients, but also enhance the activity of natural killer cells, which help maintain the leukocyte level of patients.