【摘要】 目的探讨社区综合性心理、行为干预对学龄期儿童特应性皮炎的疗效。方法采用随机对照方法,将广州市部分社区2006年2月—2008年6月诊断为儿童特异性皮炎且符合入组标准的58例患儿随机分为综合性心理、行为干预组(干预组,30例)和对照组(28例)。两组患儿均给予常规药物治疗,干预组在此基础上给予综合性心理、行为干预,时间为8周。另选择20例健康儿童作为正常对照组。比较治疗前后干预组和对照组患儿的儿童焦虑障碍自评量表(SCARED)和儿童抑郁障碍自评量表(DSRSC)评分、湿疹面积及严重度指数(EASI)、视觉模拟评分(VAS)及血清神经生长因子(NGF)、P物质(SP)水平。结果(1)治疗前干预组和对照组患儿SCARED评分(27.5±3.2)分和(28.1±2.6)分、DSRSC评分(18.2±3.4)分和(18.9±3.2)分、EASI(33.3±7.8)和(33.0±8.0)、VAS(7.3±1.3)分和(6.9±1.3)分及血清NGF(2700±289)pg/ml和(2643±292)pg/ml、SP(557±63)pg/ml和(553±58)pg/ml水平间差异无统计学意义(P>0.05),两组SCARED和DSR-SC评分均高于全国常模的划界分,血清NGF、SP水平与正常对照组(102±53)pg/ml和(150±51)pg/ml比较,差异均有统计学意义(P<0.01)。(2)治疗8周后,干预组和对照组患儿的SCARED评分(17.9±2.8)分和(25.0±3.0)分、DSRSC评分(10.2±2.4)分和(15.3±2.3)分、EASI(10.2±4.0)和(22.9±8.7)、VAS(2.6±0.9)分和(4.3±1.0)分及血清NGF(962±227)pg/ml和(2206±296)pg/ml、SP(239±41)pg/ml和(447±57)pg/ml水平间差异均有统计学意义(P<0.01)。(3)治疗后干预组痊愈2例,显效24例,进步4例,无效0例;对照组痊愈0例,显效5例,进步18例,无效5例,两组疗效间差异有统计学意义(u=5.22,P<0.01)。结论社区综合性心理、行为干预能明显改善学龄期特应性皮炎患儿的焦虑/抑郁症状和躯体症状,提高疗效。更多还原

【Abstract】 Objective To study the effect of community comprehensive psychological and behavioral intervention in treatment of atopic dermatitis for school age children.Methods Totally 58 school age children diagnosed as having atopic dermatitis,from January 2006 to June 2008,were randomly divided into two groups of intervening group (n=30) and control group (n=28).The patients in the control group were treated only with conventional therapies,while those in the intervening group received comprehensive psychological and behavioral intervention additionally for 8 weeks.And another 20 healthy children were enrolled as normal controls.The scores of screen for child anxiety related emotional disorders (SCARED) and depression self rating scale for children (DSRSC),eczema area and severity index (EASI),visual analogue scale(VAS),level of serum nerve growth factor(NGF) and substance P(SP) were assessed before and after the treatment.Results (1)Before treatment,in the intervening and control groups the scores of SCARED were respectively (27.5±3.2) and (28.1±2.6),the scores of DSRSC(18.2±3.4) and (18.9±3.2),the scores of EASI (33.3±7.8) and(33.0±8.0),the scores of VAS (7.3±1.3) and (6.9±1.3),the levels of serum NGF (2 700±289)pg/ml and (2 643±292)pg/ml,the levels of serum SP(557±63)pg/ml and (553±58)pg/ml,with no significant difference between the two groups (P>0.05).In the two groups,the scores of SCARED and DSRSC were higher than the normal limits in China,and the levels of serum NGF and SP were higher significantly than (102±53)pg/ml and (150±51)pg/ml of the normal group (P<0.01).(2)After 8 weeks treatment,in the intervening and control groups the scores of SCARED were respectively (17.9±2.8) and (25.0±3.0),the scores of DSRSC (10.2±2.4) and (15.3±2.3),the scores of EASI (10.2±4.0) and (22.9±8.7),the scores of VAS (2.6±0.9) and (4.3±1.0),the levels of serum NGF (962±227)pg/ml and (2 206±296)pg/ml,the levels of serum SP (239±41)pg/ml and (447±57)pg/ml,with significant differences between the two groups (P<0.01).(3)After treatment,in the intervening group there 2 patients who recovered,24 who got remarkable effect,4 who got improvement,and no one who did not respond; while in the control group there were no patient who recovered,5 who got remarkable effect,18 who got improvement,and 5 who did not respond (u =5.22,P<0.01).Conclusion Community comprehensive psychological and behavioral intervention can obviously reduce the anxiety/depression and physical symptoms of school age children with atopic dermatitis,and thus raise the effect.更多还原