基于“肝主疏泄”理论实施情志护理干预慢性乙型肝炎情绪障碍临床研究

Clinical Study on Emotional Nursing Intervening Chronic Hepatitis B Complicated with Emotional Disorder Based on “The Liver Governs the Free Flow of Qi” Theory

目的:观察在常规医护措施基础上加用中医情志护理措施干预慢性乙型肝炎情绪障碍患者的效果。方法:将120例肝郁气滞型慢性乙型肝炎情绪障碍患者随机分为观察组和对照组各60例。2组患者均口服替诺福韦酯片,并给予认知宣教指导、生活方式指导、心理护理等综合护理措施。观察组针对肝疏泄太过和肝疏泄不及患者分别进行针对性中医情志护理。2组疗程均为16周。治疗前、治疗16周后评价抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、肝郁气滞证评分,应用特质应对方式问卷[包含积极应对(PC)、消极应对(NC)]评价心理应对情况,应用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评价生活质量。结果:治疗后,2组SAS、SDS评分及肝郁气滞证积分均较治疗前下降(P<0.01),观察组3项分值均低于对照组(P<0.01)。2组PC评分均较治疗前升高,NC评分均较治疗前下降,差异均有统计学意义(P<0.01)。观察组PC评分高于对照组,NC评分低于对照组,差异均有统计学意义(P<0.01)。2组WHOQOL-BREF生理、心理和环境3个因子的评分均较治疗前升高(P<0.01),社会关系因子评分与治疗前比较,差异均无统计学意义(P>0.05);观察组生理、心理和环境3个因子的评分均高于对照组(P<0.01)。结论:在常规医护措施基础上加用中医情志护理措施干预CHB情绪障碍患者,可有效改善其不良情绪,减少消极应对行为次数,缓解肝郁气滞证症状,提高生活质量。

Objective: To observe the effect of emotional nursing of Chinese medicine based on routine medical and nursing measures on intervening chronic hepatitis B complicated with emotional disorder. Methods:A total of 120 cases of patients with chronic hepatitis B complicated with emotional disorder of the liver depression and qi stagnation type were randomly divided into the observation group and the control group,60 cases in each group,60 cases in each group. Both groups were given the oral administration of tenofovir tablets and comprehensive nursing measures such as guidance on cognitive education,guidance on lifestyle,and psychological nursing. The observation group was given emotional nursing of Chinese medicine targeted at overactive qi movement and stagnant qi movement both by the lung respectively. Both groups were treated for 16 weeks. Before treatment and after 16-week treatment,scores of Self-rating Depression Scale(SDS),Self-rating Anxiety Scale(SAS),and the liver depression and qi stagnation syndrome were evaluated;Trait Coping Style Questionnaire [including positive coping(PC) and negative coping(NC)] was used to evaluate psychological coping;the World Health Organization Quality of Life Assessment-Brief Version(WHOQOL-BREF) was used to evaluate quality of life.Results:After treatment,scores of SAS,SDS,and the liver depression and qi stagnation syndrome in the two groups were decreased when compared with those before treatment(P<0.01),and the three scores in the observation group were lower than those in the control group(P<0.01). The scores of PC in the two groups were increased when compared with those before treatment, and scores of NC were decreased, differences being significant(P<0.01). The score of PC in the observation group was higher than that in the control group,and score of NC was lower,differences being significant(P<0.01). In the two groups, scores of the three factors of WHOQOL-BREF, namely physiology, psychology, and environment, were increased when compared with those before treatment(P<0.01);there was no significant difference being found in the comparison of score of social relation as a factor after treatment and that before treatment(P>0.05). The scores of namely physiology,psychology,and environment in the observation group were higher than those in the control group(P<0.01). Conclusion:In the intervention of CHB patients complicated with emotional disorder,emotional nursing of Chinese medicine based on routine medical and nursing measures can improve their negative emotions, lower the frequency of negative coping behavior, relieve symptoms of the liver depression and qi stagnation syndrome, and promote quality of life.