五行音乐联合认知心理辅导对抑郁孕妇晚期先兆流产保胎疗效的影响

Effect of five elements of music combined with cognitive psychological counseling on the efficacy of foetus preservation in late threatened abortion of depressed pregnant women

目的观察五行音乐联合认知心理辅导对晚期妊娠合并抑郁症的疗效,并探讨其对孕妇睡眠质量、血清孕激素和孕激素诱导阻断因子(PIBF)的影响。方法选取2017年3月~2019年3月广东省妇幼保健院产科门诊收治的晚期先兆流产孕妇120例,根据随机数字表法分为常规治疗组(对照组,60例)和五行音乐联合认知心理干预治疗组(观察组,60例)。治疗2周后,比较两组宫缩消失时间、延长妊娠周数和治疗有效率。比较治疗前后匹兹堡睡眠质量评分(PSQI)、抑郁自评量表(SDS)、血清孕酮水平和PIBF浓度的变化。结果两组患者年龄、孕龄、孕次、产次和SDS评分比较,差异无统计学意义(P> 0.05)。观察组较对照组宫缩消失更早,妊娠延长周数更长,治疗有效率更高(P<0.05)。治疗后两组PSQI评分和SDS评分均低于对照组,差异有统计学意义(P<0.05)。治疗2周后,两组SDS评分和中度抑郁孕妇比例均较治疗前明显降低,无抑郁孕妇比例升高(P <0.05);对照组PSQI评分及程度分布与治疗前比较,差异无统计学意义(P> 0.05),观察组治疗后的PSQI评分较治疗前降低,睡眠良好孕妇比例升高(P<0.05)。两组孕妇治疗前的血清孕酮和PIBF水平差异无统计学意义(P> 0.05)。治疗2周后,两组孕妇的孕酮和PIBF水平较治疗前明显升高,观察组的孕酮和PIBF水平较对照组更高(P <0.05)。结论五行音乐联合认知心理干预治疗可通过改善合并抑郁的晚期先兆流产孕妇的抑郁情绪,提高睡眠质量,从而增加孕酮释放,减轻免疫排斥反应,提高治疗有效率。

Objective To observe the effect of five elements of music combined with cognitive psychological counseling on depression threatened abortion in the third trimester,and to explore its effect on maternal sleep quality,serum progesterone and progesterone induced blocking factor(PIBF).Methods A total of 120 pregnant women with advanced threatened abortion admitted to the Department of Obstetrics of Guangdong Provincial Maternal and Child Health Hospital from March 2017 to March 2019 were selected and divided into the conventional treatment group(control group,60 cases) and the five-element music combined cognitive psychological intervention group(observation group,60 cases)according to the random number table method.After two weeks of treatment,the time of disappearance of contractions,the length of gestation weeks and the effective rate of treatment were compared.Pittsburgh sleep quality index(PSQI)score,depression self-rating depression scale(SDS),serum progesterone level and PIBF concentration before and after treatment were compared.Results There was no significant difference in age,gestational age,gestational duration,birth duration and SDS score between the two groups(P> 0.05).Compared with the control group,contractions disappeared earlier in the observation group,gestation was prolonged longer,and treatment efficiency was higher(P <0.05).After treatment,the PSQI score and SDS score of the two groups were lower than that of the control group,and the differences were statistically significant(P <0.05).After 2 weeks of treatment,SDS score and proportion of moderately depressed pregnant women in both groups were significantly lower than before treatment,while proportion of non-depressed pregnant women was higher(P <0.05).The distribution of PSQI score and degree in the control group was not significantly different from that before treatment(P> 0.05).The PSQI score in the observation group after treatment was lower than that before treatment,and the proportion of pregnant women with good sleep was higher(P <0.05).There was no significant difference in serum progesterone and PIBF between the two groups before treatment(P> 0.05).After 2 weeks of treatment,the levels of progesterone and PIBF in the two groups of pregnant women were significantly higher than those before treatment,and the levels of progesterone and PIBF in the observation group were higher than those in the control group(P <0.05).Conclusion Five elements of music combined with cognitive psychological intervention therapy can improve the depression mood of pregnant women with late-stage threatened abortion with depression,improve the quality of sleep,thus increase the release of progesterone,reduce the immune rejection reaction,improve the treatment efficiency.