心理干预对紧张型头痛患者心身症状及就医行为的影响

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目的:探讨心理干预对紧张型头痛住院军人心身症状及就医行为的影响。方法:将2000-07/2003-07解放军第四六四医院诊断为紧张性头痛的109例住院军人随机分为两组,对照组55例给予常规单纯药物治疗,研究组54例与对照组予同样药物治疗外,还有针对性地进行认知行为等心理干预治疗。在治疗前后分别用症状自评量表评定患者的情绪变化程度,并比较两组的平均住院时间。出院1年后随访,比较出院后的就医行为及疾病归因方式。结果:109例均参加了治疗前后症状自评量表评定,1年后随访,研究组脱失12例,对照组脱失9例。①治疗后研究组在躯体化(1.39±0.56)人际敏感(1.37±0.39)、抑郁(1.36±0.42)、焦虑(1.23±0.36)、恐怖(1.43±0.29)、偏执(1.31±0.65)、精神病性(1.14±0.54)及其他因子分(1.21±0.30)均低于对照组(P<0.05),只有强迫及敌对两项因子分两组比较,差异无显著性意义(P<0.05)。②研究组42例平均住院时间为(21.54±4.31)d,对照组为(32.67±5.72)d,前者明显低于后者(P<0.01)。③1年后随访发现,研究组42例因头痛而经常服药的人、因头痛而门诊就诊的5人次、因头痛而再次住院的3人次、对头痛进行躯体归因的9人,而对照组46例上述指标分别为14人、14人次11人次、21人(P<0.05);在对头痛的心理归因人数上,研究组为2人, Objective: To investigate the effect of psychological intervention on the psychosomatic symptoms and medical treatment of hospitalized soldiers with tension-type headache. Methods: A total of 109 hospitalized soldiers who were diagnosed as tension headache at the 6464 Hospital of PLA from July 2000 to July 2003 were randomly divided into two groups. The control group received conventional simple drug therapy. The study group consisted of 54 patients and control group The same drug treatment, there are targeted psychological interventions such as cognitive behavior. Before and after treatment were used to assess the degree of emotional changes in patients with self-rating scale, and to compare the average length of stay in both groups. One year after discharge, we followed up and compared the medical behaviors after discharge and the way of attribution. Results: All the 109 cases were evaluated before and after treatment. The patients were followed up after one year. The study group lost 12 cases and the control group lost 9 cases. ① After treatment, the study group had significant differences in somatization (1.39 ± 0.56) interpersonal sensitivity (1.37 ± 0.39), depression (1.36 ± 0.42), anxiety (1.23 ± 0.36), terror (1.43 ± 0.29), paranoid (1.31 ± 0.65) (1.14 ± 0.54) and other factors (1.21 ± 0.30) were lower than those in the control group (P <0.05). There was no significant difference between the two groups in compulsion and hostility (P <0.05). ② The average length of hospital stay of 42 cases in study group was (21.54 ± 4.31) days and in control group (32.67 ± 5.72 days), the former was significantly lower than the latter (P <0.01). ③ Follow-up one year later found that in the study group, 42 patients who had frequent medication because of their headache, 5 patients who were outpatient due to headache, 3 persons who were hospitalized again due to headache, 9 people who attributed body headache to headache, and 46 For example, the above indexes were 14, 14 and 11 respectively, with 21 (P <0.05); in the psychological attribution of headache, the study group was 2,
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