心理干预对2型糖尿病伴发抑郁患者影响.docVIP

心理干预对2型糖尿病伴发抑郁患者影响 　【关键词】 心理干预；2型糖尿病；抑郁 　　【摘要】 目的 探讨心理干预对2型糖尿病伴发抑郁患者的影响。 方法 将60例2型糖尿病伴抑郁症状患者随机分为研究组与对照组各30例，对照组采用常规治疗，研究组在常规治疗基础上联合心理干预；采用焦虑自评量表、抑郁自评量表分别于治疗前及治疗第4w末评定临床疗效，同期检测空腹血糖、餐后2h血糖及糖化血红蛋白。 结果 治疗4w末焦虑自评量表、抑郁自评量表评分研究组明显低于对照组；研究组治疗前后比较差异有极显著性（P＜0.01）；治疗4w末空腹血糖、餐后2h血糖及糖化血红蛋白研究组明显低于对照组（P＜0.01）。 结论 心理干预能有效改善糖尿病伴发抑郁患者的抑郁症状及血糖水平。 　　【关键词】 心理干预；2型糖尿病；抑郁 　　Effects of psychointervention on patients with type Ⅱ diabetes accompanying depression 　　【Abstract】 Objective To investigative the effects of psychointervention on patients with type Ⅱ diabetes accompanying depression. Methods 60 patients were randomly divided into research and control group, the latter took routine therapy and the former did routine therapy combined with psychointervention; clinical curative effects were assessed with the Selfrating Anxiety Scale(SAS) and Selfrating Depression Scale(SDS) before treatment and at the end of the 4th week treatment, and fasting blood sugar, blood sugar in the 2nd hour after meal and glycosylation hemoglobin measured in the corresponding period. Results At the end of the 4th week, scores of the SAS and SDS were significantly lower in the research than in the control group; there was most significant difference between pre and posttreatment in the research group(Plt;0.01); at the end of the 4th week, fasting blood sugar, blood sugar in the 2nd hour after meal and glycosylation hemoglobin were significantly lower in the research than in the control group(Plt;0.01). Conclusion Psychointervention could effectively improve depressive symptom and level of blood sugar of patients with diabetes accompanying depression. 　　【Keywords】 Psychointervention; type Ⅱ diabetes; depression 　　糖尿病是一组心身性疾病，常伴有抑郁、焦虑等症状。研究［1］发现,约有15～20%的糖尿病患者伴发有抑郁，是普通人群的3倍。抑郁对糖尿病的治疗极其不利，可引起糖代谢控制不佳，治疗依从性降低，并发症的危险性增加［2］。糖尿病的常规治疗包括饮食疗法，运动疗法和药物治疗。本研究旨在探讨心理干预对糖尿病伴发抑郁患者的影响。 　　1 对象与方法 　　1.1 对象 选取2002年3月～2003年11月在我院门诊及住院的60例2型糖尿病患者为研究对象。入组标准：（1）符合1998年WHO关于糖尿病的诊断标准［3］；（2）焦虑自评量表（SAS） 及抑郁自评量表（SDS）评分≥50分；（3）无严重的糖尿病并发症，无严重躯体