正念治疗对躯体形式障碍的疗效及脑电影响初步研究

Preliminary investigation on effect of mindfulness therapy on clinical efficacy and EEG in patients with somatoform disorders

目的探讨正念治疗躯体形式障碍的疗效与作用机制。方法将76例躯体形式障碍患者分为研究组(正念治疗+药物治疗,38例)和对照组(健康教育+药物治疗,38例)。治疗期间,以症状自评量表(SCL-90)评价患者心理健康状况改善情况,对比观察两组疗效。以脑电记录仪收集并计算两组中央区α波、额叶区α波和顶叶脑区θ波功率,评价两组脑电变化。结果研究组治疗后SCL-90躯体化、抑郁、焦虑、人际敏感、精神病性5项因子粗分均较治疗前降低(P<0.05),且低于对照组治疗后(P<0.05);对照组SCL-90躯体化、焦虑、人际敏感均较治疗前降低(P<0.05)。研究组治疗后脑电中央区α波、额叶区α波、顶叶脑区θ波功率均高于对照组(P<0.05)。研究组治疗后左侧脑各脑区电波功率波动变化较右侧脑明显,两侧脑电波呈不对称变化,差异有统计学意义(P<0.05)。结论正念治疗躯体形式障碍效果确切,可有效改善患者心理健康状况,并激活更高的中央区α波、额叶区α波、顶叶脑区θ波,有助于改善患者脑电活动,促进积极情绪,值得临床推广使用。

Objective To explore the effect and mechanism of mindfulness therapy on somatoform disorders. Methods A total of 76 patients with somatoform disorders were selected and divided into study group treated with mindfulness therapy and medication(38 cases) and control group treated with health education and medication(38 cases). They were assessed with Symptom Checklist-90(SCL-90). The powers of alpha wave in central area, alpha wave in frontal lobe and theta wave in parietal lobe were collected and calculated with electroencephalograph(EEG) recorder to evaluate the efficacy of EEG. Results After treatment, the factor scores of somatization, depression, anxiety, interpersonal sensitivity, psychosis of SCL-90 in study group decreased significantly compared with those before treatment(P<0.05) and were significantly lower than those in control group after treatment(P<0.05). After treatment, the factor scores of somatization, anxiety and interpersonal sensitivity in control group decreased significantly compared with those before treatment(P<0.05). After treatment, the powers of alpha wave in central area, alpha wave in frontal lobe and theta wave in parietal lobe in study group were all significantly higher than those in control group(P<0.05). In study group, the changes of wave powers in all brain areas of left side were more obvious than those of right side after treatment(P<0.05). Conclusion Mindfulness is effective in the treatment of somatoform disorders, which can effectively improve mental health status in patients, and activate the higher alpha wave in central area, alpha wave in frontal lobe and theta wave in parietal lobe. It is helpful to improve the electroencephalogram and promote positive emotions in patients, worthy of clinical application.