Functional magnetic resonance imaging study of group independent components underpinning item responses to paranoid-depressive scale

BACKGROUND Our study expand upon a large body of evidence in the field of neuropsychiatric imaging with cognitive,affective and behavioral tasks,adapted for the functional magnetic resonance imaging(MRI)(fMRI)experimental environment.There is sufficient evidence that common networks underpin activations in task-based fMRI across different mental disorders.AIM To investigate whether there exist specific neural circuits which underpin differ-ential item responses to depressive,paranoid and neutral items(DN)in patients respectively with schizophrenia(SCZ)and major depressive disorder(MDD).METHODS 60 patients were recruited with SCZ and MDD.All patients have been scanned on 3T magnetic resonance tomography platform with functional MRI paradigm,comprised of block design,including blocks with items from diagnostic paranoid(DP),depression specific(DS)and DN from general interest scale.We performed a two-sample t-test between the two groups-SCZ patients and depressive patients.Our purpose was to observe different brain networks which were activated during a specific condition of the task,respectively DS,DP,DN.RESULTS Several significant results are demonstrated in the comparison between SCZ and depressive groups while performing this task.We identified one component that is task-related and independent of condition(shared between all three conditions),composed by regions within the temporal(right superior and middle temporal gyri),frontal(left middle and inferior frontal gyri)and limbic/salience system(right anterior insula).Another com-ponent is related to both diagnostic specific conditions(DS and DP)e.g.It is shared between DEP and SCZ,and includes frontal motor/language and parietal areas.One specific component is modulated preferentially by to the DP condition,and is related mainly to prefrontal regions,whereas other two components are significantly modulated with the DS condition and include clusters within the default mode network such as posterior cingulate and precuneus,several occipital areas,including lingual and fusiform gyrus,as well as parahippocampal gyrus.Finally,component 12 appeared to be unique for the neutral condition.In addition,there have been determined circuits across components,which are either common,or distinct in the preferential processing of the sub-scales of the task.CONCLUSION This study has delivers further evidence in support of the model of trans-disciplinary cross-validation in psychiatry.

Effects of the Treatment of Carpal Tunnel Syndrome with Surgery and Injections on the Hospital Anxiety and Depression Scale (HADS)

Background: The prevalence of carpal tunnel syndrome (CTS) and of anxiety and depression in primary care practice are high. Different studies had shown an increased prevalence of anxiety and depression in CTS patients. Nevertheless, few papers had been published studying the anxiety and depression scales in the treatment of CTS, either with corticosteroid injections (I) or with surgical decompression (S). Objective: To assess whether clinical improvement observed after the treatment of CTS either with I or with S correlates with an improvement in the punctuations of the Hospital Anxiety and Depression scales (HADS), at 3, 6 and 12-month follow-up. Methods: Randomized and open-label clinical trial, comparing I and S. Patients with symptoms suggestive of CTS (nocturnal paraesthesias) of at least 3 months duration and neurophysiological confirmation were included. Patients with clinically apparent motor impairment were excluded. The subjective evaluation of symptoms was carried out using the visual-analogue scale of pain (VAS-p). Clinical reviews were performed 3, 6 and 12 months after treatment. Each patient completed the HADS questionnaire and a VAS-p at 0, 3, 6, and 12 months. Statistical significance was established using the Student’s t test and the Mann-Whitney U test when necessary. A linear regression analysis was used to know the effect of the treatment adjusted for the initial score of both scales. Results: 65 patients were included (30 in group I and 35 in group S). There was no statistical difference between both groups in terms of age, gender distribution, disease duration, VAS-p, neurophysiological testing severity of CTS or the 8 subscales of HADS. Both groups improved significantly in relation to the baseline VAS-p values, in the reviews at 3, 6 and 12 months, with no significant differences between I and S. At 6 months, the reduction in the anxiety scale was around 3 points for both treatments (S = 3.6 and I = 3.2), without reaching significant differences. At 12 months, it was somewhat higher for those treated with I, but always around 3 points and without significant differences. The Depression scale score was slightly reduced at 6 months, and in a similar way for both groups (I = 1 and S = 1.19;p = 0.8). After 12 months, group I doubled the previous reduction, with group S experiencing a very slight change (I = 1.96 and S = 1.03;p = 0.3). When analysing the effect of group S on group I, the result was a reduction of 0.25 points for Anxiety (p = 0.7) and of 0.02 points for Depression (p = 0.9). Conclusions: Treatment of CTS with I or S results in a similar and discrete improvement in Anxiety scores on the HADS scale at 6 and 12 months. For both types of treatment, the Depression scores barely changed at 6 months, being somewhat higher in group I after 12-month follow-up. The independent effect of the S on both scales is small and not significant.

Clinical effects of nonconvulsive electrotherapy combined with mindfulness-based stress reduction and changes of serum inflammatory factors in depression

BACKGROUND Depression is a common and serious psychological condition,which seriously affects individual well-being and functional ability.Traditional treatment methods include drug therapy and psychological counseling;however,these methods have different degrees of side effects and limitations.In recent years,nonconvulsive electrotherapy(NET)has attracted increasing attention as a noninvasive treatment method.However,the clinical efficacy and potential mechanism of NET on depression are still unclear.We hypothesized that NET has a positive clinical effect in the treatment of depression,and may have a regulatory effect on serum inflammatory factors during treatment.AIM To assess the effects of NET on depression and analyze changes in serum inflammatory factors.METHODS This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022,the observation group that received a combination of mindfulness-based stress reduction(MBSR)and NET treatment(n=70)and the control group that only received MBSR therapy(n=70).The clinical effectiveness of the treatment was evaluated by assessing various factors,including the Hamilton Depression Scale(HAMD)-17,self-rating idea of suicide scale(SSIOS),Pittsburgh Sleep Quality Index(PSQI),and levels of serum inflammatory factors before and after 8 wk of treatment.The quality of life scores between the two groups were compared.Comparisons were made using t and χ^(2) tests.RESULTS After 8 wk of treatment,the observation group exhibited a 91.43%overall effectiveness rate which was higher than that of the control group which was 74.29%(64 vs 52,χ^(2)=7.241;P<0.05).The HAMD,SSIOS,and PSQI scores showed a significant decrease in both groups.Moreover,the observation group had lower scores than the control group(10.37±2.04 vs 14.02±2.16,t=10.280;1.67±0.28 vs 0.87±0.12,t=21.970;5.29±1.33 vs 7.94±1.35,t=11.700;P both<0.001).Additionally,there was a notable decrease in the IL-2,IL-1β,and IL-6 in both groups after treatment.Furthermore,the observation group exhibited superior serum inflammatory factors compared to the control group(70.12±10.32 vs 102.24±20.21,t=11.840;19.35±2.46 vs 22.27±2.13,t=7.508;32.25±4.6 vs 39.42±4.23,t=9.565;P both<0.001).Moreover,the observation group exhibited significantly improved quality of life scores compared to the control group(Social function:19.25±2.76 vs 16.23±2.34;Emotions:18.54±2.83 vs 12.28±2.16;Environment:18.49±2.48 vs 16.56±3.44;Physical health:19.53±2.39 vs 16.62±3.46;P both<0.001)after treatment.CONCLUSION MBSR combined with NET effectively alleviates depression,lowers inflammation(IL-2,IL-1β,and IL-6),reduces suicidal thoughts,enhances sleep,and improves the quality of life of individuals with depression.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.

Cronbach's a reliability, concurrent validity, and factorial structure of the Death Depression Scale in an Iranian hospital staff sample

Objective: Death depression is an important component in the process of death and dying. Death depression is the second element of death. Depression is one of the important features in death distress. The aim of this study was to explore the performance of the Farsi version of the Death Depression Scale with an Iranian convenience sample of nurses (n =106).Methods: Nurses were selected using a convenience sampling method, and completed the Death Depression Scale (DDS), Death Concern Scale (DCS), Collett-Lester Fear of Death Scale (CLFDS), Reasons for Death Fear Scale (RDFS), Templer's Death Anxiety Scale (DAS), and Death Obsession Scale (DOS). Results: The results of exploratory factor analysis on DDS identified 4 factors (56.16%of variance). Factor 1 labeled"Death sadness", Factor 2 labeled"Death finality/end and Death dread/fear", Factor 3 labeled"Death despair and Death depression", and Factor 4 labeled"Death loneliness". Cronbach's a coefficient was 0.84, Spearman-Brown coefficient 0.85, and Guttman Split-Half coefficient 0.81 The DDS correlated 0.40 with the DCS, 0.39 with the CLFDS, 0.50 with the DAS, 0.35 with the RDFS, and 0.44 with the DOS, indicating good construct and criterion-related validity. Concurrent validity for the DDS with the other scales were significant. Conclusions: The DDS has good validity and reliability, and it can use in clinical and research settings.

Development of a Scale to Evaluate the Depressive State among Elderly Patients in General Wards

This study aims to develop a scale to evaluate depressive states among elderly patients in general wards, and verify the reliability and validity of the scale. Based on the results of interviews with nurses, we developed a draft of a scale comprised of 48 questions (NDE48). The Geriatric Depression Scale short version (GDS15), and the Zung Self-rating Depression Scale (SDS) were administered to 54 elderly patients. Two groups of nurses completed the NDE48 on different days. After performing an explanatory factor analysis, the NDE48 was simplified to a 16 question item scale (NDE16), comprising three factors. The correlation coefficient between GDS15 and NDE16 was 0.41 (p = 0.00191), and between SDS and NDE16 was 0.30 (p = 0.02633). Alpha coefficient of the total score of NDE16 was 0.88. For inter-rater reliability, the correlation coefficient was 0.57 (p = 0.00005). The findings suggest that the NDE16 will be highly useful when nurses evaluate depressive states among elderly inpatients.

Diagnostic accuracy and clinical utility of non-English versions of Edinburgh Post-Natal Depression Scale for screening post-natal depression in India:A meta-analysis

BACKGROUND The prevalence of post-natal depression(PND)is high in India,as it is in many other low to middle income countries.There is an urgent need to identify PND and treat the mother as early as possible.Among the many paper and pencil tests available to identify PND,the Edinburgh Postnatal Depression Scale(EPDS)is a widely used and validated measure in India.However,the summary diagnostic accuracy and clinical utility data are not available for this measure.AIM To establish summary data for the global diagnostic accuracy parameter as well as the clinical utility of the non-English versions of the EPDS in India.METHODS Two researchers independently searched the PubMed,EMBASE,MEDKNOW and IndMED databases for published papers,governmental publications,conference proceedings and grey literature from 2000-2018.Seven studies that evaluated the diagnostic accuracy of EPDS in five Indian languages against DSM/ICD were included in the final analysis.Two other investigators extracted the Participants’details,Index measures,Comparative reference measures,and Outcomes of diagnostic accuracy data,and appraised the study quality using QUADS-2.Deek’s plots were used to evaluate publication bias.We used the area under the curve of the hierarchical summary area under the receiver operating characteristic curve,with the random effect model,to summarize the global diagnostic accuracy of EPDS.Using the 2×2 table,we calculated positive and negative likelihood ratios.From the likelihood ratios,the Fagan’s nomogram was built for evaluating clinical utility using the Bayesian approach.We calculated the 95%confidence interval(95%CI)whenever indicated.STATA(version 15)with MIDAS and METANDI modules were used.RESULTS There was no publication bias.The area under the curve for EPDS was 0.97(95%CI:0.95-0.98).The pre-test probability for the nomogram was 22%.For a positive likelihood ratio of 9,the positive post-test probability was 72%(95%CI:68%,76%)and for a negative LR of 0.08,the negative post-test probability was 2%(95%CI:1%,3%).CONCLUSION In this meta-analysis,we established the summary global diagnostic parameter and clinical utility of the non-English versions of the EPDS in India.This work demonstrates that these non-English versions are accurate in their diagnosis of PND and can help clinicians in their diagnostic reasoning.

Association between Self-Rated Health and Depressive Symptoms in Rural Chinese Adults:A Cohort Study Based on Propensity Score Matching

Health status is widely regarded as a correlate of depressive symptoms.However,health assessments based on clinical diagnosis in rural areas with poor medical conditions are very limited.Self-rated health(SRH)serves as a simple and convenient evaluation indicator,which may be used as an independent predictor of depressive symptoms.To confirm the relationship between SRH and depressive symptoms in rural adults,a longitudinal survey of rural households in China was conducted using the China Family Panel Studies(CFPS)from 2012 to 2016.Propensity score matching and logistic regression analysis were used to explore the association.After data cleansing,3,127 pairs(6,254 participants)aged 16 and older followed for 4 years were enrolled,of which the average age was(50.02±14.19)years old,and the proportions of male and female were 48.64%and 51.36%,respectively.The incidence rate of depressive symptoms within 4 years was 30.86%(95%CI:29.24–32.48)in the group with fair or poor SRH,and 21.59%(95%CI:20.14–23.03)in the group with good SRH.The difference between the two groups was statistically significant(χ^(2)=69.51,P<0.001).The results of univariate unconditional logistic regression analysis showed that there was a correlation between SRH and depressive symptoms in rural adults aged 30 and above(OR=1.65,95%CI:1.46–1.85,P<0.001).Thus,a simple and practical assessment tool based on SRH and other indicators should be established for early prevention and intervention in rural primary mental health care.

Development of a Scale to Evaluate Depressive States among Elderly Patients in General Wards —Verification of the Contents to Improve the Accuracy of the Scale

Purpose: This study aims to verify the validity of the contents of the Nurse Administered Depression Scale for Elderly Inpatients16 (NDE16) using the Delphi approach in order to further improve the accuracy of the NDE16, a scale for rating potential depressive states in elderly inpatients through the observations reported by nurses. Methods: Participants were nurses working in general wards for longer than 3 years and who expressed consent to the study participation. Data were collected using the Delphi method (3 times). Responses are scored from 1 to 5 (3 - 5 points as positive) using the Likert method. The standard criteria for inclusion in the further evaluation are “mean ≥ 3.0”, “standard deviation < 1.0”, “median ≥ 3.0”, and “IQR ≤ 1.0”. Items that meet all the criteria at the third survey are employed as question items in the final questionnaire. Results: The respondents were 139 females, 10 males, and 1 unknown, aged 25 to 65. The collection rates of the three surveys were 75% to 82%. Based on the results of the first survey, wordings of 9 questions were modified. Since Question 13 “Queries are not really responded to.” did not meet the criteria (IQR = 2) at the third survey, we excluded this question and named the revised scale NDE15. Discussion: The reason why Question 13 did not meet the criteria could be due to the difficulty in distinguishing “Expressing thought suppression” from the state of cognitive decline in dementia. Further studies are needed to determine cutoff points.

Sociopsychological impact factors of depression patients during the COVID-19 epidemic period

Objective:To investigate the impact factors of the COVID-19 epidemic on the mental health of patients with depression.Methods:The relevant data of 242 residents aged 18-50 years in a certain area were collected,118 patients and 124 healthy people were analyzed by general information questionnaire,the PsychoSocial Index(PSI)questionnaire,Social Support Rating Scale(SSRS)and Symptom Checklist 90(SCL-90).Compare the differences in social and psychological factors between the two groups.Then use logistic regression to evaluate the social and psychological influencing factors of depression patients during the epidemic.Results:Two results of logistic regression analysis showed that marital status,occupational status,abnormal pathological behavior,and utilization of support were still significantly associated with depression.Compared to working,unemployed/unemployed/retired,students are closely related to depression,followed by abnormal pathological behavior and utilization of support.Conclusion:Under the epidemic,depression groups lacking social relationships should actively pay attention to their mental health status and comprehensively enhance their social and psychological support.To avoid the exacerbation of psychological and psychological symptoms caused by the epidemic.

Water scaling predication for typical sandstone geothermal reservoirs in the Xi'an Depression

The Xi'an Depression in the Guanzhong Basin of western China has been suggested to contain geothermal resources that could aid China in achieving carbon neutrality and optimizing energy structure.However,the high concentration of total dissolved solids(TDS)and scale-forming ions in geothermal water from the depression causes severe scaling problems in harvesting geothermal energy.To reduce scale-related problems,accurate identification of scale types and prediction of scaling during geothermal energy utilization are crucial.This study starts with identifying the types and trends of scaling in the study area,using index-based discriminant methods and hydrogeochemical simulation to calculate and analyze the mineral saturation index of water samples from some wellheads and of reconstructed fluid samples of geothermal reservoirs.The results indicate that the scales are mostly calcium carbonate scales rather than sulfate scales as a result of temperature changes.Several portions of the geothermal water systems are found to have distinct mineral scaling components.Quartz and chalcedony are formed in low temperature areas,while carbonate minerals are in high temperature areas.Despite the low iron content of geothermal water samples from the study area,scaling is very common due to scaling-prone iron minerals.The findings can be used to evaluate geothermal drainage systems and guide anti-scaling during geothermal energy utilization in similar settings.

硬膜外分娩镇痛对产妇产后抑郁的影响

目的评估硬膜外分娩镇痛(LEA)对产妇产后抑郁(PPD)的影响。方法选择经阴道分娩的初产妇628例,年龄20~36岁,BMI 20~35 kg/m 2,ASAⅡ或Ⅲ级。根据产妇是否接受硬膜外分娩镇痛分为两组:镇痛组(n=322)和非镇痛组(n=306)。记录分娩期间VAS疼痛评分最高值、产程时间、出血量、新生儿1、5 min Apgar评分和新生儿入NICU的发生情况。于分娩前1周和产后2周、6周分别采用爱丁堡产后抑郁量表(EPDS)评估PPD发生情况(EPDS评分≥11分为PPD),采用广泛性焦虑量表(GAD-7)评估产妇焦虑情绪,采用领悟社会支持量表(PSSS)评估产妇感受到的总社会支持度。结果与非镇痛组比较,镇痛组产妇分娩期间VAS疼痛评分最高值明显降低(P<0.05)。两组产妇第一产程时间、第二产程时间、出血量、新生儿1、5 min Apgar评分、新生儿入NICU比例差异无统计学意义。两组产妇产后2、6周PPD发生率、PSSS高支持状态、GAD-7≥10分差异无统计学意义。结论初产妇接受LEA不影响产后抑郁的发生风险。

认知行为干预对伴焦虑状态突发性聋治疗的疗效分析

目的分析认知行为干预对治疗伴焦虑状态突发性聋的疗效。方法选取2020年6月—2022年6月郑州大学第一附属医院收治的突发性聋患者353例,其中低频型108例,高频型72例,平坦型81例,全聋型92例。入院24 h内独立完成焦虑自评量表(SAS)评分,标准分>50分,汉密尔顿焦虑量表(HAMA)评分,标准分>17分接受认知行为干预为A组192例,未接受认知行为干预为B组161例,依据突发性聋诊断和治疗指南(2015)进行治疗。A组患者额外接受认知行为干预治疗。结果A、B两组中,低频型患者治疗有效率分别为90.38%(47/52)、75.00%(42/56),高频型患者治疗有效率分别为64.81%(35/54)、61.11%(11/18),平坦型患者治疗有效率分别为77.27%(34/44)、48.65%(18/37),全聋型患者治疗有效疗有效率分别为76.19%(32/42)、52.00%(26/50),A组中低频型、平坦型、全聋型治疗有效率高于B组;A组治疗总有效率高于B组,差异有统计学意义(P<0.05)。结论认知行为干预可提高伴焦虑状态的低频下降型、平坦型、全聋型治疗有效率及治疗总有效率。

胚胎移植女性孕早期睡眠质量及关联因素分析

背景胚胎移植女性经受了身体和心理的双重挑战,孕早期的生活质量,尤其是睡眠质量会受到较大的影响。目的分析胚胎移植女性孕早期睡眠质量及相关影响因素。方法选取2022年6—12月于河北医科大学第二医院生殖医学科进行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)助孕成功的患者,在其移植后45 d返院复查B超时进行问卷调查,调查内容包括匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、中文简化版心理弹性量表(Connor Davidson resilience scale,CD-RISC)和社会支持评定量表。以PSQI>7分为判断睡眠障碍的标准,通过多因素Logistic回归模型分析睡眠质量与各个影响因素的关系,并使用信息增益算法对影响睡眠质量的主要因素进行影响程度评估。结果发放问卷336份,回收325份,回收率96.7%。325例IVF-ET孕妇年龄(32.46±4.52)岁,睡眠质量总分为(7.79±3.63)分,其中126例孕妇总分≤7分为睡眠正常组,199例孕妇总分>7分为睡眠障碍组(61.23%,199/325)。相关心理学评估:焦虑自评量表(43.75±8.86)分;抑郁自评量表(50.89±10.54)分;心理弹性量表总分(64.18±11.34),其中坚韧性(32.66±10.28)分,力量性(21.75±6.37)分,乐观性(9.74±3.26)分;社会支持评定量表总分为(42.27±4.93)分,其中客观支持(9.15±2.13)分,主观支持(25.30±4.26)分,对支持的利用度(7.82±1.91)分。Logistic回归结果提示,年龄越大、越焦虑,越容易出现睡眠障碍;文化程度中,以初中及以下人群作为参照,高中或中专学历的人群更不容易出现睡眠障碍;心理弹性水平越高,睡眠障碍出现概率越低(P均<0.05)。信息增益分析结果显示,影响睡眠质量的因素按影响力大小依次为心理弹性中的坚韧性(1.186)、社会支持量表中的主观支持分(0.807)、心理弹性量表中的力量性(0.806)、心理弹性量表中的乐观性(0.510)、社会支持量表中的对支持的利用度(0.422)、文化程度(0.419)、客观支持分(0.391)、职业(0.216)、婆媳关系(0.213)、SAS(0.192)、SDS(0.162)、第几次移植(0.146)、年龄(0.117)、第几次取卵(0.108)、社会支持总分(0.107)、现有子女个数(0.088)、月收入(0.082)、夫妻关系(0.051)、居住地(0.035)。结论胚胎移植女性在孕早期睡眠质量较差;患者的不良心理状态对睡眠有负面影响,而心理弹性和社会支持对睡眠质量则起到了积极的正面影响,临床可以从改善患者心理弹性状态、增加社会支持方向入手,帮助IVF-ET孕妇从孕早期开始改善睡眠质量,从而提高生活质量,保证母婴健康。

男性情志问题与肝的相关性研究

目的:通过调查男性人群生活习惯、抑郁情绪、焦虑情绪、自尊水平等,分析男性情志问题与肝的关系,为制定男性情志问题干预策略提供依据。方法:共纳入2023年3—5月符合标准的男238例,通过问卷调查方式采集基本信息、中医肝脏象情绪量表、自尊量表等资料。结果:基本信息显示,调查对象以中青年男性为主,超重及肥胖者占59.7%,喜咸、喜辛辣和喜炙烤者偏多,47.1%有胃肠问题,17.6%有心脏问题,47.9%有睡眠问题,42.9%的男性基本不运动,男性疾病情况显示前列腺炎者14.3%、前列腺增生者4.6%、早泄者10.1%。中医肝脏象情绪量表总分异常者有169例(71.0%),抑郁情绪异常者173例(72.7%),焦虑情绪异常者152例(63.9%),肝经证候异常者134例(56.3%)。在年龄、寒热、喜咸、喜炙烤、睡眠、运动、心脏问题、胃肠问题、前列腺炎、前列腺增生、阳痿等维度,中医肝脏象情绪量表得分差异有统计学意义(P<0.05);抑郁情绪、焦虑情绪与肝经证候因子正相关;自尊水平与中医肝脏象情绪量表总分、抑郁情绪、焦虑情绪、肝经证候因子负相关。结论:男性情志问题与肝的关系密切,调节男性情志应以改善生活习惯、疏肝解郁为主要方法。

基于调和阴阳理论针灸组方治疗老年肝郁化火型失眠

目的探讨基于调和阴阳理论针灸组方治疗老年肝郁化火型失眠的临床疗效。方法将老年肝郁化火型失眠患者80例按照随机数表法分为对照组与观察组,各40例。对照组采用西药治疗,观察组在对照组基础上联合调和阴阳法针灸治疗。观察2组治疗前后中医证候积分、多导睡眠图、匹兹堡睡眠质量指数量表(PSQI)、失眠严重程度指数量表(ISI)、爱普沃斯嗜睡量表(ESS)、血清单胺递质指标5-羟色胺(5-HT)、谷氨酸(GA)、神经肽Y(NPY)、γ-氨基丁酸(GABA)变化,并评价2组治疗总有效率和治疗安全性。结果观察组治疗后各项中医证候积分、睡眠潜伏期、觉醒时间、PSQI评分、ISI评分、ESS评分均低于对照组(P<0.05),睡眠总时间、快速眼动睡眠期、5-HT、GA、NPY、GABA指标均高于对照组(P<0.05);观察组治疗总有效率(92.5%,37/40)高于对照组(77.5%,31/40)(P<0.05);2组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论基于调和阴阳理论的针灸组方联合西药治疗老年肝郁化火型失眠疗效明显,能够缓解患者不适症状,减轻日间嗜睡程度,调节神经递质表达,改善睡眠质量,且不良反应少。

揿针联合硬膜外分娩镇痛对产后抑郁症的影响研究

目的:观察揿针联合硬膜外分娩镇痛对产后抑郁症(PPD)的影响。方法:选取110例初产妇为研究对象,按随机数字表法分为观察组和对照组各55例。对照组给予硬膜外分娩镇痛,观察组给予揿针联合硬膜外分娩镇痛。比较2组产妇治疗前后疼痛视觉模拟评分法(VAS)评分、爱丁堡产后抑郁量表(EPDS)评分及血清β-内啡肽(β-EP)、谷氨酸(Glu)水平,并比较2组产妇分娩方式、新生儿1 min Apgar评分及产妇PPD发生率。结果:宫口开4、6、8、10 cm时,2组VAS评分降低(P<0.05),且各时间点观察组均低于对照组(P<0.05)。宫口开10 cm时,2组血清β-EP水平升高(P<0.05),且观察组高于对照组(P<0.05);观察组血清Glu水平降低(P<0.05),对照组血清Glu水平升高(P<0.05),且观察组低于对照组(P<0.05)。2组分娩方式、新生儿1minApgar评分比较,差异均无统计学意义(P>0.05)。产后42d,2组EPDS评分升高(P<0.05),但观察组低于对照组(P<0.05)。产后42 d,观察组PPD发生率低于对照组(P<0.05)。结论:揿针联合硬膜外分娩镇痛可降低产妇PPD发生率,其机制可能与缓解分娩疼痛、调节神经递质释放有关。

海南沉香灸治疗轻度抑郁性失眠患者的疗效观察

目的探讨海南沉香灸对轻度抑郁性失眠患者的影响。方法选取2020年11月—2022年1月期间因抑郁性失眠于海南省中医院康复科门诊就诊的85例患者,按随机数字表法分为沉香灸组30例、艾灸组30例、安慰灸组25例。沉香灸组采用针刺、耳穴埋针联合海南沉香灸治疗,艾灸组采用针刺、耳穴埋针联合艾灸治疗,安慰灸组采用针刺、耳穴埋针联合安慰灸治疗。治疗2、4、8周后和随访期间,观察比较两组患者临床疗效及治疗前后汉密尔顿抑郁评分(Hamilton depression score,HAMD)、匹兹堡睡眠质量指数量表评分(Pittsburgh sleep quality index,PSQI)、抑郁自评量表评分(Self-rating depressive scale,SDS)。结果治疗后沉香灸组总有效率93.33%(28/30)、艾灸组总有效率73.33%(22/30)均明显高于安慰灸组44.00%(11/25),差异有统计学意义(P<0.05);且沉香灸组总有效率明显高于艾灸组,差异有统计学意义(P<0.05)。治疗2、4、8周后及随访期间,3组患者HAMD评分均较治疗前降低,差异有统计学意义(P<0.05);沉香灸组和艾灸组HAMD评分均低于安慰灸组,差异有统计学意义(P<0.05);治疗8周后及随访期间,沉香灸组HAMD评分低于艾灸组,差异有统计学意义(P<0.05)。治疗2、4、8周后及随访期间,3组患者PSQI评分均较治疗前降低,差异有统计学意义(P<0.05);沉香灸组和艾灸组PSQI评分均低于安慰灸组,差异有统计学意义(P<0.05);沉香灸组PSQI评分低于艾灸组,差异有统计学意义(P<0.05)。治疗2、4、8周后及随访期间,3组患者SDS评分均较治疗前降低,差异有统计学意义(P<0.05);沉香灸组和艾灸组SDS评分均低于安慰灸组,差异有统计学意义(P<0.05);治疗4、8周后及随访期间,沉香灸组SDS评分均低于艾灸组,差异有统计学意义(P<0.05)。结论沉香灸和艾灸可改善轻度抑郁性失眠患者的抑郁症状和睡眠,沉香灸对抑郁症状和睡眠改善优于艾灸。

分析优质干预对妇产科手术患者术后疼痛及睡眠质量的影响

目的:分析优质干预对妇产科手术患者术后疼痛及睡眠质量的影响。方法:选取2023年1月至2024年1月厦门大学附属第一医院妇产科收治的手术患者98例作为研究对象,按照随机数字表法分为对照组和观察组,每组49例。对照组给予常规护理干预,观察组给予优质护理干预。采用匹兹堡睡眠质量指数(PSQI)比较2组患者睡眠质量的差异,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)比较2组患者焦虑、抑郁症状改善情况,采用爱泼沃斯嗜睡量表(ESS)比较2组患者干预前后睡眠质量变化,并比较2组患者睡眠效果、睡眠感受、睡眠可持续性的差异,采用多导睡眠监测(PSG)评价2组患者的睡眠效率、快速眼动(REM)潜伏期、睡眠潜伏期、清醒次数、睡后清醒时间,并比较2组术后疼痛可耐受性及护理满意度。结果:干预后,观察组PSQI评分、SAS评分、SDS评分、ESS评分均显著低于对照组,观察组睡眠效率、REM潜伏期高于对照组,观察组睡眠潜伏期、清醒次数、睡后清醒时间显著低于对照组,观察组疼痛耐受性评分显著高于对照组,观察组护理满意度显著高于对照组,差异均有统计学意义(均P<0.05)。结论:对妇产科手术患者实施优质护理干预既可减轻术后疼痛,又可提高其睡眠质量,加快患者康复进程,缓解患者焦虑、抑郁情绪,提高睡眠效率,值得临床推广应用。