社区管理高血压患者心理健康状况及其影响因素分析

目的了解社区管理高血压患者的心理健康状况及其影响因素,为制定心理干预策略提供依据。方法于2015年12月至2016年3月采用多阶段分层整群抽样方法抽取宁波市海曙区、北仑区和江北区所辖范围内当地基本公共卫生服务系统中的18岁及以上高血压患者1 284例为调查对象。采用患者健康问卷抑郁量表(PHQ-9)和焦虑筛查问卷(GAD-7)评估高血压患者的心理健康状况。采用SPSS 19.0统计软件进行高血压患者心理健康状况影响因素的单因素和多因素logistic回归分析。结果本次调查的1 284名高血压患者中,抑郁阳性率为9.58%,其中轻度抑郁的阳性率为7.87%,中重度抑郁阳性率为1.71%;焦虑阳性率为4.44%,其中轻度焦虑阳性率为3.82%,中重度焦虑阳性率为0.62%。多因素logistic回归分析结果显示,离异或丧偶(OR=2.73,95%CI:1.45~5.14)、合并脑卒中(OR=19.71,95%CI:1.89~205.61)和病程≥16年(OR=1.76,95%CI:1.02~3.05)是高血压患者抑郁的危险因素,而年龄45~59岁(OR=0.32,95%CI:0.16~0.66)、大专及以上文化程度(OR=0.33,95%CI:0.15~0.75)是高血压患者抑郁的保护因素;离异或丧偶(OR=3.73,95%CI:1.71~8.12)、合并脑卒中(OR=15.85,95%CI:1.97~127.30)和合并肿瘤(OR=19.11,95%CI:4.85~75.29)是高血压患者焦虑的危险因素,均有统计学意义(P<0.05,P<0.01)。结论应将慢性病患者心理问题筛查及干预逐步纳入社区卫生服务中,针对不同年龄、文化程度、婚姻状况、病程及合并症的高血压患者采取不同的心理干预策略。浙江省公益性技术应用研究计划项目(2015C33099

音乐干预联合丁螺环酮治疗广泛性焦虑障碍的疗效观察

Objective: To explore the clinical efficacy and side effects of buspirone treatment combined with music intervention on generalized anxiety disorder (GAD). Method: 80 enrolled GAD patients were randomly divided into intervention group (buspirone treatment combined with music intervention) and the control group (buspirone treatment only), each group had 40 patients. HAMA (Hamilton Rating Scale for Anxiety) and TESS (Treatment Emergent Symptom Scale) were assessed in the baseline and 1 week, 3 weeks and 6 weeks after each treatment to evaluate the efficacy and side effects. Results: The combined patients were scored significantly less in total HAMA score, the somatic anxiety factor and the psychic anxiety factor after 6-week treatment compared with the control patients (separately 9.63±3.78 vs 12.65±3.76，0.52±0.39 vs 0.69±2.89，0.85±0.28 vs 1.12±0.34, t＝－3.59、－2.20、－3.81, P＜0.01, P＜0.05, P＜0.01). Conclusion: Music intervention could reduce anxious symptoms largely, the clinical efficacy buspirone treatment combined with music intervention is better than the single use of buspirone when GAD patients are treated.目的  探讨音乐干预联合丁螺环酮治疗广泛性焦虑障碍的疗效和副反应。方法  将80例广泛性焦虑障碍患者随机分为音乐干预联合丁螺环酮组（干预组）40例和单用丁螺环酮组（对照组）40例，治疗6周，采用汉密尔顿焦虑量表（Hamilton Rating Scale for Anxiety, HAMA）评定疗效，采用TESS量表（Treatment Emergent Symptom Scale）评定副反应，治疗前、治疗后1周、3周、6周分别评定一次。结果  治疗6周末干预组在HAMA总分、躯体焦虑因子、精神焦虑因子评分上（分别为9.63±3.78，0.52±0.39，0.85±0.28）显著低于对照组（分别为12.65±3.76、0.69±2.89、1.12±0.34），差异具有统计学意义（t＝－3.59、－2.20、－3.81，除躯体焦虑因子P＜0.05，余P均＜0.01）。结论  音乐干预联合丁螺环酮治疗能显著改善焦虑症状，治疗广泛性焦虑障碍的效果优于单用丁螺环酮

排卵功能障碍性不孕症患者的中医五态人格及焦虑分析

Objective: Finding out the relationship between five-pattern personality and anxiety 、depression characteristics of the DOI patients. Methods: 200 DOI patients were selected in the Infertility Specialist of Guangzhou Liwan District Hospital of Chinese Medicine，at the same time, researchers choose normal women as controls. Respondents filled in the Five-pattern Personality Scales、SAS、SDS and general information questionnaire. Results: The proportion of shaoyin personality of the DOI patients(50%) is significantly higher than the normal women(22%). And no yin and yang personality was observed in patients with DOI. The SAS and SDS score of the DOI patients, listed in descending order, is as follow, taiyin personality、shaoyin personality、taiyang personality、shaoyang personality、yin and yang personality. Conclusion: The main five-pattern personality of DOI is shaoyin personality. The patients of the taiyin and shaoyin personality are more likely to have the characteristics of anxiety and depression.目的  探究排卵功能障碍性不孕症患者不同中医五态人格类型与焦虑、抑郁情绪的关联性。方法  确诊为排卵功能障碍性不孕症患者200例，同时在本院选择正常已育妇女作为对照组。采用《五态人格量表》、《焦虑自评量表（SAS）》、《抑郁自评量表（SDS）》及一般资料问卷进行调查。结果  排卵功能障碍性不孕症组中少阴型中医人格（50%）明显高于正常妇女组（22%），且没有出现阴阳平和型中医人格。不孕症组中太阳、少阳、少阴、太阴型中医人格的焦虑、抑郁总分4组间不全相等（P＜0.001）。结论  排卵功能障碍性不孕症患者以少阴型中医人格为主，且太阴、少阴型中医人格的患者更易出现高焦虑、高抑郁

Effect of Ba Zhu Decoction(BZD) on the related mechanisms of Aβ formation in 5xFAD transgenic mice

目的：巴茱合剂是本人硕士导师治疗阿尔兹海默病(AD)的经验方，前期临床研究证明，巴茱合剂能有效缓解AD患者认知功能障碍，但对巴茱合剂的作用机制尚未深入研究。本文旨在通过AD转基因动物再次验证巴茱合剂的治疗效果，并进一步探索巴茱合剂治疗AD的相关分子生物学机制。 方法：（1）选取新型APP/PS1转基因小鼠(5xFAD小鼠)作为实验对象。将3月龄5xFAD小鼠随机分为模型组(5xFAD-Control)、巴茱合剂低剂量组(5xFAD-BZD-L)、中剂量组(5xFAD-BZD-M)、高剂量组(5xFAD-BZD-H)及安理申组(5xFAD-Donep)；同窝出生野生型小鼠随机分为正常对照组(W...Objective: Bazhu Decoction (BZD), originated from my master instructor’s experience, is an effective formulae of traditional Chinese medicine for Alzheimer's disease(AD). BZD has been proved effective on patients of AD in our group’s preliminary studies. However, the mechanism of BZD on AD remains unclear. Therefore, this study aimed to investigate whether BZD has positive therapy in AD transgenic...学位：医学硕士院系专业：医学院_中医内科学学号：2452013115354

圣·约翰草提取物片治疗抑郁障碍专家共识

结合循证医学证据,本文归纳圣·约翰草提取物片治疗抑郁障碍的专家共识

Common negative emotion, behavior and nursing intervention of the Patients with congenital heart disease came from Tibet

目的 为对藏区先天性疾病患者的护理提供临床经验，本文总结了对16例患者的护理经验。方法 通过观察分析在本科住院的16例藏区先心患者的负面情绪及行为，分别在入院初期、术后、出院前采用SCL-90评分量表对患者的负性情绪及行为进行评定。针对发生率较高的负面情绪及行为提供系统的护理干预措施。结果针对性的心理干预护理能有效减少患者的负性情绪，提高其遵医行为，促进了术后康复。跟踪随访患者术后3个月、6个月、1年，发现患者康复良好，生活质量也得到提高。结论 对藏区先心患者的负性情绪提供针对性的心理护理有利于患者的康复。Objective: To provide the clinical experience of nursing care of congenital disease patients come from Tibet,this article summed up the experience of nursing care for 16 patients. Method: The 16 patients were in hospital, and were assessed with Symptom Check List-90 (SCL-90),at the time of they were just in hospital, after the operation 2 days, and before they left the hospital. The nurses did systematic nursing intervention to them, for their higher rate negative emotion and behavior. Results: The psychological intervention nursing could reduce the the negative emotion and ehavior. And could improve the compliance of patients, and romote the rehabilitation of the patients after operation. The patients had been followed-up for 3 months,6 months,1 year. They had restored to health, and quality of their life was improved. Conclusions: The psychological intervention nursing for the negative emotion and ehavior could help to the patients restore healthy, who came from Tibet

The effects and mechanism of the novel modified Kai-Xin-San on gastrointestinal comorbidity of depression in CUMS rats model

背景：随着全球经济发展和社会竞争力的逐渐激烈，抑郁症的发病率不断增高，给社会和家庭带来了巨大的负担，已经成为世界性公共卫生问题。胃肠功能紊乱作为抑郁症的躯体症之一，是抑郁症的一种共病表现，对患者的生活质量造成了很大的影响。开心散（Kai-Xin-San，KXS）是一种治疗情志疾病的古方，对抑郁症疗效确切，但对抑郁症胃肠共病的疗效和机制却少有报道。根据抑郁症以及抑郁症胃肠共病的发病机制，我们选择川芎、缬草两味中药对开心散原方进行加味组成开心散加味方（thenovelModifiedKai-Xin-San，KXS-(+)），以提高其抗抑郁效果以及改善胃肠功能。 方法：本实验采用清洁级2月龄雄性S...Objective: As the global economic development and gradually fierce social competitiveness, the incidence of depression is increasing. Depression brought a huge burden to the society and family, and it has become a worldwide public health problem. Gastrointestinal dysfunction as one of the body disease of depression, is a kind of comorbidities with depression, and depression brings significant imp...学位：医学硕士院系专业：医学院_内科学学号：2452014115349

脑卒中后遗症期患者社区康复评定量表选择初探

Objective: To choose the scales that can comprehensively assess the function of patients with stroke sequelae for the grassroots medical staff. Methods: The commonly used scales were selected. The patients with stroke sequelae were assessed by the MOS item short from health survey(SF-36), Modified Barthel Index(MBI), Brain Injury Community Rehabilitation Outcome Scales(BICRO-39)，WHO Disability Assessment Scale II(WHO-DAS II) and Anxiety and Depression Self-rating Scales(SAS and SDS). The assessment datum was conducted by Pearson correlation coefficient. Results: The data of MBI have significant correlation among the datum of WHO-DASII, SF-36 and BICRO 39 scales(P&lt;0.05). The datum of MBI doesn’t have correlation among the datum of the SAS and SDS (P&gt;0.05). Conclusions: Community doctors can choose MBI which can effectively assess the activities of daily living for the community patients with stroke sequelae. MBI also can reflect the functional levels of community patients with stroke sequelae.目的：为基层医务人员选择综合科学评价脑卒中后遗症期患者的功能水平的量表。方法：选择常用的量表：简明健康状况调查表SF-36量表、改良Barthel指数评分标准、脑损伤社区康复结果量表(BICRO-39 scales)、世界卫生组织残疾评定量表（WHODASII）、焦虑抑郁自评量表（SAS &amp; SDS）在内的六个量表的数据采集，分别与改良Barthel指数评分标准进行皮尔森相关系数（Pearson correlation coefficient）分析。结果：BI的测评结果与WHODAS II、SF-36、BICRO-39的测评结果显著相关（P值&lt;0.05）；而与SAS及SDS的测评结果不相关（P&gt;0.05）。结论：基层医生可以选择BI量表对脑卒中后遗症患者的日常生活活动能力进行评定；BI量表也可以进一步反映脑卒中后遗症患者的功能水平

Non-pharmacological therapies for patients with Alzheimer's disease

阿尔茨海默病（AD）是一种老年性持续的神经功能障碍疾病，最近提出药物和非药物治疗并举的阿尔茨海默病患者治疗新概念框架显示，阿尔茨海默病的非药物治疗能够帮助患者改善其行为、临床症状和记忆的问题。有效的非药物治疗包括芳香疗法、感官刺激、光疗、中草药治疗、膳食补充剂治疗、针灸、顺势疗法、整骨、整脊和按摩等，专注于认知、社会心理、感官、物理和环境方面的问题，能够替代或补充其他药物治疗方法，是一种安全和有效的，且行为管理中起重要作用的治疗方法。Alzheimer's disease (AD) is an age-related neurological disorders. The new conceptual framework of both drug and non-drug treatment recently shows that non-pharmacological therapies for Alzheimer's disease can help to improve its conditions, the clinical symptoms and memory problems in patients with Alzheimer's disease. The effective non-pharmacological therapies include aromatherapy, sensory stimulation, light therapy, herbal therapy, dietary supplements, acupuncture, homeopathy, osteopathy, chiropractic and massage, which focus on cognitive, psycho-social, sensory, physical and environmental aspects, and can replace or supplement other drug treatment. They are safe and effective, and plays an important role in the management of behavior

1例老年卧床患者更换陪护人员心理问题的个案护理

This paper summarizes the psychological problems and nursing points of 1 elderly bedridden patients when changing the accompanying caregivers. The main nursing problems included anxiety, fear, reverse sleep, and self pulled out gastric tube. The main points of nursing include: evaluation of patients' psychological status; targeted psychological nursing; strengthening visits; prevention of adverse events; coordination of multiple coordination; to obtain social support; basic care. The patient's psychological state was stable, and no adverse events such as extubation occurred. 本文总结了1例老年卧床患者更换陪护人员时的心理问题及护理要点。患者出现的主要护理问题有：焦虑、恐惧、睡眠颠倒、自行拔出胃管。护理要点包括：评估患者心理状态；针对性心理护理；加强巡视，预防不良事件的发生；协调多方配合，为获取社会支持；基础护理。患者心理状态平稳，未出现拔管等不良事件