孙宏新运用柴胡加龙骨牡蛎合甘麦大枣汤治疗肿瘤性抑郁经验

肿瘤性抑郁的发病率呈逐年上升趋势,孙宏新主任医师从事恶性肿瘤的治疗工作多年,他认为此类疾病多与肝气郁滞、阴阳失调有关,主张从肝论治,以调整阴阳、畅通气机。柴胡加龙骨牡蛎汤乃医圣仲景为少阳兼烦惊之证而设,甘麦大枣汤乃仲景为脏燥而作。孙教授在临床中发现两方合用,在肿瘤性抑郁、焦虑的治疗中疗效颇佳。

Application of rational emotive behavior therapy in patients with colorectal cancer undergoing adjuvant chemotherapy

Objective:This study aimed to explore the effects of our rational emotive behavior therapy(REBT)program on symptoms,anxiety,depression,and sleep state in patients with colorectal cancer(CRC)undergoing chemotherapy.Methods:From October 2020 to May 2021,fifty-six patients with CRC in a hospital in the Hunan Province were randomly divided into an intervention group(n=28)and a control group(n=28).The patients in the intervention group completed a 6-week REBT program based on routine nursing care,including four courses:1)establish a relationship and formulate health files;2)group communications and study symptom management;3)continuously provide health knowledge and strengthen healthy behavior;and 4)review the treatment and summary.The control group maintained routine nursing care.The simplified Chinese version of the Memorial Symptom Assessment Scale Short Form(MSASeSFeSC),the Hospital Anxiety and Depression Scale(HADS),and the Pittsburgh Sleep Quality Index(PSQI)scale were used to investigate and compare the intervention effects of the two groups at baseline(T1,before the intervention),four weeks(T2),and six weeks(T3)after the intervention.Results:The intervention group was significantly improved in symptoms,anxiety,depression,and sleep state,compared with the control group.At T2,MSASeSFeSC(24.43±4.26 vs.28.07±3.91),symptom distress(17.29±4.04 vs.19.39±3.59),symptom frequency(7.14±1.51 vs.8.68±1.42),HADS(13.68±3.38 vs.15.86±3.79),anxiety(3.89±1.85 vs.5.18±2.18),and depression(9.79±2.06 vs.10.68±2.23),showed that the difference between the two groups was statistically significant(P<0.05).At T3,MSASeSFeSC(23.89±3.54 vs.30.14±3.94),symptom distress(17.61±3.52 vs.21.32±3.57),symptom frequency(6.29±1.49 vs.8.82±1.47),HADS(11.82±2.57 vs.16.29±3.13),anxiety(3.21±1.64 vs.5.61±1.77),and depression(8.61±1.52 vs.10.68±1.81),showed that the difference between the two groups was statistically significant(P<0.05).The sleep state of the intervention group was better than the control group at T3,with decreased score of PSQI[4.00(3.00,8.00)vs.9.00(7.00,12.50),Z=-3.706,P<0.001].Conclusion:The 6-week REBT program can effectively improve the symptom,anxiety,depression,and sleep state of patients with CRC undergoing chemotherapy,which could as a care plan for patients with CRC who are repeatedly admitted to the hospital for chemotherapy.

Clinical Research of Acupuncture on Malignant Tumor Patients for Improving Depression and Sleep Quality

Objective:To study the effect of acupuncture on depression and insomnia of malignant tumor patients.Methods:Eighty cases of cancer related depression and sleep disorders were randomly divided into 2 groups:treatmentl group(acupuncture n=40) and control group(Fluoxetione n=40).All patients were assessed by Self-rating Depression Scale(SDS),Hemilton Depression Rating Scale(HAMD) and Pittsburgh Sleep Quality Index(PSQI) after treatment for 30 days.Results:Before treatment the SDS and HAMD scores of the trial group were 64.12±5.34 and 20.92±2.38,those of the control group were 64.24±4.98 and 20.72±2.74,after treatment the SDS and HAMD scores of the trial group were 43.64±5.28 and 9.88±1.27 respectively,significantly lower than those of the control group(50.76±5.42 and 13.72±2.05 respectively,both P<0.05).Before treatment the PSQI score of the trial group and the control group were 14.48±1.71 and13.92±2.59,after treatment the PSQI score of the trial group was 7.92±1.22 after treatment,significantly lower than those of the control group(11.44±1.89,P<0.01).Conclusion:Acupuncture can effectively reduce malignant-related depression,improve sleep quality,and help to improve the quality of life of cancer patients.