【摘要】 目的:联合临床心理科与创伤外科对外科多发性创伤伴发急性应激障碍(ASD)患者进行研究,探寻综合医院ASD患者合理有效易操作的联合干预方法。方法:对多发性创伤后符合美国精神疾病诊断标准(DSM-IV-TR)ASD诊断的60例患者随机将30名设为联合干预组,30名设为对照组。联合干预组采用药物治疗加心理联合干预,心理联合干预方法有:情绪管理训练、自助小册子、认知疗法,针对家属的团体辅导,心理联合干预时间共4周,对照组仅采用药物治疗和一般支持治疗,在治疗前后采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、事件影响量表(IES-R)进行检测。结果:经治疗后联合干预组的HAMD量表分低于对照组,差异均有统计学意义(t=-2.780,P=0.007);HAMD减分率高于对照组,差异均有统计学意义(t=-2.833,P=0.006);联合干预组的HAMD量表分低于对照组,差异均有统计学意义(t=-3.670,P=0.001);HAMD减分率高于对照组,差异均有统计学意义(t=3.776,P=0.000);联合干预组的IES-R量表总分低于对照组,差异均有统计学意义(t=-2.120,P=0.038)。结论 :药物治疗加心理治疗联合干预更能改善多发性创伤ASD患者的情绪状态及应激症状。更多还原

【Abstract】 Objective:To examine the effect of psychotherapy and pharmacotherapy for acute stress disorder in patients with multiple trauma.Methods:Sixty inpatients with multiple trauma who met the DSM-IV diagnostic criteria for acute stress disorder were randomized to two groups.The research group(n=30)received psychotherapy and medication and the control group received medication.Psychological intervention methods were:Emotional management training,self-help booklet,cognitive therapy,group counseling for families.Clinical efficacy were assessed with Hamilton depression rating scale(HAMD),Hamilton anxiety scale(HAMA),and Impact of Event Scale-Revised(IES-R)before treatment and at the end of 4th.Results:Before treatment there were no differences in the scores of both HAMD,HAMA,and IES-R between the two groups(P >0.05).After 4 weeks treatment,the scores of HAMD,HAMA,total IES-R in both groups were lower than those before pretreatment.And the scores of the HAMA,HAMD,IES-R were lower in the research group than that in the control group(t=-3.670,-2.780,-2.120;P<0.05).Conclusion:Psychotherapy and medication may have better efficacy in the treatment of ASD patients with multiple trauma.更多还原