章丹 梁颂游

[摘要] 目的 探究團体认知行为治疗对不孕不育症患者焦虑障碍疗效。 方法 收集2018年6月～2019年6月我院收治的78例不孕不育症伴焦虑障碍患者为研究对象，2018年6～12月收治的39例患者纳为对照组（常规抗焦虑药物治疗），2019年1～6月收治的39例患者纳入为观察组（在对照组基础上联合团体认知行为治疗）。比较两组服药依从性，治疗前后焦虑症状[汉密尔顿焦虑量表（HAMA）评分评估]、社会功能[采用功能大体评定量表（GAF）评价]、认知记忆水平[韦氏记忆量表（WMS）评估]及生活质量[生活质量调查量表（SF-36）评估]。 结果 观察组服药总依从率明显高于对照组（P<0.05），治疗前两组HAMA评分、GAF评分、WMS各项评分、SF-36评分比较差异无统计学意义（P>0.05）。与治疗前比较，治疗后两组HAMA评分明显降低，观察组明显低于对照组，两组治疗后GAF评分、WMS各项评分明显升高，且观察组明显高于对照组（P<0.05）。与治疗前比较，治疗后2、4、6周两组SF-36评分明显升高，且观察组较对照组明显高（P<0.05）。 结论 团体认知行为治疗不孕不育症患者焦虑障碍有明确效果，可明显改善患者焦虑症状、社会功能和记忆认知水平，同时有效提高患者生活质量。

[关键词] 不孕不育症;焦虑障碍;疗效;团体认知行为;治疗

[中图分类号] R749.72          [文献标识码] B          [文章编号] 1673-9701（2020）17-0101-04

Study of the efficacy of group cognitive-behavior therapy against anxiety disorder of infertile patients

ZHANG Dan   LIANG Songyou

Department of Psychology， Zhongshan People's Hospital in Guangdong Province， Zhongshan   528400， China

[Abstract] Objective To explore the efficacy of group cognitive-behavior therapy（CBT） against anxiety disorder of infertile patients. Methods 78 patients with infertility and anxiety disorder admitted to our hospital from June 2018 to June 2019 were selected as the subjects of research， among whom the 39 patients admitted from June to December 2018 were taken as the control group（treated with conventional anti-anxiety drugs）， and the 39 patients admitted from January to June 2019 were taken as the observation group（treated with group CBT on the basis of the conventional anti-anxiety drugs that the control group received）. The medication compliance， the anxiety symptoms（evaluation of Hamilton Anxiety Scale scores， HAMA scores）， social function（evaluated by Global Assessment Function， GAF）， recognition memory level（evaluated by Wechsler Memory Scale， WMS） and quality of life（evaluated by short form 36 questionnaire， SF-36） before and after treatment were compared between the two groups. Results The total medication compliance rate of the observation group was significantly higher than that of the control group（P<0.05）. There was no statistically significant difference in HAMA scores， GAF scores， various WMS scores and SF-36 scores between the two groups before treatment（P>0.05）. Compared with those before treatment， the HAMA scores of the two groups decreased significantly after treatment， and those of the observation group were significantly lower than those of the control group. After treatment， the GAF scores and various WMS scores of the two groups increased significantly， and those of the observation group were significantly higher than those of the control group（P<0.05）. Compared with those before treatment， the SF-36 scores of the two groups increased significantly at 2， 4 and 6 weeks after treatment， and those of the observation group were significantly higher than those of the control group（P<0.05）. Conclusion Group CBT has definite effect on anxiety disorder of infertile patients. It can not only obviously ameliorate the patients anxiety symptoms， social function and recognition memory level， but also effectively improve their quality of life.

[Key words] Infertility; Anxiety disorder; Efficacy; Group cognitive-behavior therapy （CBT）; Treatment

不孕不育癥已成为21世纪人类第三大疾病之一，其发病率逐年增长，流行病学显示我国不孕不育发病率约为10%～15%[1]，不孕不育症作为临床常见妇科疾病，严重影响女性身心健康。研究表明不孕不育症患者治疗期间存在较大心理负担[2]，其中焦虑障碍在不孕不育症患者中较为常见，但临床对不孕不育症患者心理健康关注度较低，易忽视对患者焦虑障碍的治疗，并且目前临床对本病尚缺乏行之有效的药物方案。近期有文献报道，团体认知行为心理治疗可明显改善强迫症患者心理障碍，在缓解患者强迫症、减轻病耻感和提高生活质量方面积极作用明显[3]，而赵桂梅[4]研究证实认知行为治疗可有效减轻广泛性焦虑障碍患者抑郁焦虑情绪，并提高患者生活质量。……