八段锦联合耳穴贴压疗法对社区精神病管理患者生存质量的影响

Effect of Eight-section-brocade Exercise Combined with Ear Acupoint Sticking Therapy on Quality of Life of Community-treated Patients with Psychosis

【目的】探讨八段锦联合耳穴贴压疗法对社区精神病管理患者生存质量的影响。【方法】将96例辖区内精神病管理患者随机分为观察组和对照组,每组各48例,对照组仅接受常规社区精神病管理方法服务,观察组在常规精神病管理服务方法基础上予以实施八段锦联合耳穴贴压疗法连续性治疗服务。每周耳穴贴压2次(左右耳交替各1次),10次为1个疗程,连续5个疗程。观察2组患者治疗前后世界卫生组织生存质量测定简式量表(WHOQOL-BREF)评分的变化情况,并进行多变量检验分析。【结果】(1)研究过程中,观察组因主动放弃治疗失访2例,对照组因随访过程不配合失访2例。最终观察组48例、对照组48例纳入疗效统计。(2)治疗1个月后,观察组患者在生理领域和心理领域WHOQOL-BREF评分均明显改善(P<0.05);在社会关系领域和环境领域WHOQOL-BREF评分稍有改善,但差异无统计学意义(P>0.05);对照组患者在4个领域WHOQOL-BREF评分均稍有改善,但差异无统计学意义(P>0.05)。治疗3个月后,观察组患者在生理领域、心理领域和环境领域WHOQOL-BREF评分均明显改善,差异有统计学意义(P<0.05);在社会关系领域WHOQOL-BREF评分稍有改善,但差异无统计学意义(P>0.05);对照组患者在生理领域WHOQOL-BREF评分明显改善,差异有统计学意义(P<0.05),其他3个领域WHOQOL-BREF评分均稍有改善,但差异无统计学意义(P>0.05)。治疗6个月后,观察组患者在生理领域、心理领域、社会关系领域和环境领域WHOQOL-BREF评分均明显改善(P<0.05);且观察组在4个领域WHOQOL-BREF评分均明显优于对照组,差异均有统计学意义(P<0.05);对照组患者在4个领域WHOQOL-BREF评分均有改善,但仅生理领域WHOQOL-BREF评分差异有统计学意义(P<0.05),其余3个领域WHOQOL-BREF评分差异无统计学意义(P>0.05)。(3)2组患者WHOQOL-BREF评分中各领域评分进行不同评估时间点的多变量检验分析,结果生理领域、心理领域、社会关系领域和环境领域各时间点的评分差异均有统计学意义(P<0.05),表明这4个领域的评分在不同的时间点中均有出现波动;生理领域、心理领域、环境领域各时间点的评分与组别的交互,差异均有统计学意义(P<0.05),表明这3个领域在2组中的评分波动也存在差异。而社会关系领域的各个时间点评分波动在2组中则不存在显著性差异(P>0.05)。【结论】八段锦联合耳穴贴压疗法治疗精神病患者,能明显改善患者生存质量,疗效显著。

Objective To explor the effect of eight-section-brocade exercise combined with ear acupoint stickingtherapy on the quality of life of community-treated patients with psychosis. Methods Nine-six community-treatedpatients with psychosis were randomly divided into observation group and control group,48 cases in each group.The two groups were treated by routine community-treated service for psychosis,additionally,the observationgroup was treated by continuous treatment service of eight-section-brocade exercise combined with ear acupointsticking therapy. Ear acupoint sticking for 2 times per week(alternating left and right ears once), 10 timesconstituted one course,the treatment lasted 5 courses. The change of World Health Organization’s quality of lifequestionnaire-brief version(WHOQOL-BREF)score before and after treatment was observed in the two groups,and was given multivariate test analysis. Results(1)During the trial,2 cases from the observation group lost tofollow-up due to initiative treatment abandoning, and 2 cases from the control group lost to follow-up due tononcompliance. Ultimately,48 cases in the observation group and 48 cases in the control group were included inthe next test.(2)After one-month treatment,the WHOQOL-BREF score for physiology field and psychology fieldwas improved in the observation group(P<0.05), and the WHOQOL-BREF score for society field andcircumstance field was also improved,but the difference was nonsignificant(P > 0.05). While the WHOQOL-BREF score for the above fields was improved in the control group,but the difference was nonsignificant(P >0.05). After 3-month treatment, the WHOQOL-BREF score for fields of physiology, psychology andcircumstance was improved in the observation group(P<0.05),and the WHOQOL-BREF score for society fieldwas also improved, but the difference was nonsignificant(P > 0.05). While the WHOQOL-BREF score forphysiology field was improved in the control group(P<0.05),and the WHOQOL-BREF score for the other 3 fields was improved,but the difference was nonsignificant(P > 0.05). After 6-month treatment,the WHOQOL-BREF score for fields of physiology,psychology,society and circumstance was improved in the observation group(P<0.05),and the improvement in WHOQOL-BREF score for 4 fields of the observation group was superior tothat of the control group(P<0.05). While the WHOQOL-BREF score for physiology field was improved in thecontrol group(P<0.05), and the WHOQOL-BREF score for the other 3 fields was also improved, but thedifference was nonsignificant(P > 0.05).(3) The multivariate test analysis results showed that there weredifferences between WHOQOL-BREF score for the fields of physiology,psychology,society and circumstance atvarious time points(P<0.05),indicating the fluctuation occurred in the scores of the 4 fields at various timepoints. There were differences between the fields of physiology,psychology and circumstance at various time pointswith groups(P<0.05),indicating fluctuation difference occurred between the scores of the 3 fields of the twogroups. But fluctuation difference not occurred in society field at various time points of the two groups(P>0.05).Conclusion Eight-section-brocade exercise combined with ear acupoint sticking therapy has curative effect on thequality of life of community-treated patients with psychosis.