箱庭疗法对神经性皮炎临床疗效影响的研究

Effect of Sandplay Therapy on the Clinical Efficacyof Patients with Neurodermatitis

目的探讨采用箱庭疗法实施心理护理对神经性皮炎临床疗效的影响。方法将78例神经性皮炎患者按照随机数字表法平均分为两组,两组患者均外涂复方氟米松软膏和内服复方甘草酸苷片,干预组同时辅以箱庭疗法。观察两组痊愈率及复发率、症状、体征评价,瘙痒程度由患者根据瘙痒程度标尺自评,皮损形态和皮损面积由3位皮肤科医师进行评分;心理状态采用采SCL-90症状自评量表由患者进行自评。结果 4周后,干预组症状自评量表的躯体化、人际敏感、抑郁、焦虑、敌对、偏执因子分均较治疗前显著降低(P<0.05),而对照组则无显著变化(P>0.05);干预组总有效率为87.18%,对照组为66.67%,干预组痊愈率显著高于对照组(P<0.05)。随访3个月干预组复发率显著低于对照组(P<0.05)。结论药物治疗辅以箱庭疗法进行心理护理可显著改善神经性皮炎患者的心理健康状况,有利于提高临床治愈率,降低复发率,值得临床推广。

Objective To explore the effect of psychological nursing by Sandplay Therapy on the clinical efficacy of patients with neurodermatitis.Methods 78 patients with neurodermatitis were randomly divided into treatment group and control group,two groups of patients are treated with Compound Flumetasone Ointmen and compound glycyrrhizin,while the treatment group plus integrated sandplay therapy.The curerate and relapse rate were assessed in the two groups.Evaluation of symptoms and signs of patients with neurodermatitis:Pruritus self-assessment by the patients according to itch degree rating scale,lesion shape and lesion area were scored by three dermatologists.Psychological status was assessed by SCL-90.Results After 4weeks of treatment,somatization,depression,anxiety,interpersonal sensitivity,hostility,paranoid factor in the treatment group,Eysenck Personality Questionnaire scores were significantly lower than those before treatment(P <0.05 or 0.01),while no significant changes in control group(P>0.05).The effective power in the treatment group was 87.18%,it was significantly higher than the control group which with 66.67%(P<0.05).The recurrence rate of the treatment group was significantly lower than that of the control group(P< 0.05)after a follow-up of 3months.Conclusion The drug therapy combined with psychological nursing by sandplay therapy can improve the cure rate and reduce the relapse rate in the treatment of neurodermatitis,so it is worthy of promotion in clinical.