胡小丹　杨开仁

[摘要] 目的 研讨抑郁障碍全病程规范化治疗和康复关键技术的研究与应用效果研究。 方法 选取2015年1月至2016年12月期间我院收治的208例抑郁障碍患者作为研究受试对象，根据随机数字法分组，对照组104例接受心理及认知康复治疗，观察组104例患者则在对照组基础上联合全病程规范化治疗，评价比较两组患者的抑郁状态缓解情况（EPDS）及相关神经免疫学指标。 结果 与干预前比较，干预后两组患者4周末及8周末的EPDS评分均明显降低，且观察组评分降低幅度更大，差异有统计学意义（P<0.05）;与干预前比较，两组患者的血清5-HT、IL-4、IL-10 等指标水平均呈现上升趋势，且观察组的上升幅度明显高于对照组，差异有统计学意义（P<0.05）;两组的IL-1β、IL-6水平较干预前均降低，观察组的IL-1β水平明显低于对照组（P<0.05），干预后两组的IL-6水平比较，差异无统计学意义（P>0.05）。 结论 全病程规范化治疗联合康复关键技术干预可有效改善患者的抑郁状态，调整血清 5-HT 、Th1及Th2 所分泌炎性細胞因子导致的失衡状态，对促进患者康复有积极作用。

[关键词] 抑郁障碍;全病程规范化治疗;康复关键技术;神经免疫学

[中图分类号] R473.74          [文献标识码] B          [文章编号] 1673-9701（2021）13-0107-04

Researches of standardized treatment for the whole course for the whole course on depressive disorder and key technologies for rehabilitation and their applications

HU Xiaodan   YANG Kairen

Department of Psychiatry， The Third Hospital of Quzhou， Zhejiang， Quzhou   324000， China

[Abstract] Objective To investigate standardized treatment for the whole course on depressive disorder and key technologies for rehabilitation and the efficacy of their application. Methods From January 2015 to December 2016， 208 patients with depressive disorder admitted to our hospital were selected as the research objects. According to the random number table method， patients in the control group（n=104） were given psychological and cognitive rehabilitation treatment， while patients in the observation group（n=104） were given standardized treatment for the whole course on the basis of the control group. The Edinburgh postnatal depression scale（EPDS） and related neuroimmunology indexes of the two groups were evaluated and compared. Results Compared with the baseline level before intervention， the EPDS scores of patients in the two groups decreased significantly at the 4th and 8th weekends after the intervention， and the scores in the observation group decreased even more， with statistically significant differences（P<0.05）. Compared with the baseline level before intervention， the levels of serum 5-HT， IL-4， IL-10 and other indexes in the two groups were shown an increasing tendency， and the increase rate in the observation group was significantly higher than that in the control group， with statistically significant differences（P<0.05）. The levels of IL-1β and IL-6 in the two groups were lower than those before intervention， and the level of IL-1β in the observation group was significantly lower than that in the control group（P<0.05）. There was no significant difference in IL-6 level between the two groups after intervention（P>0.05）. Conclusion Standardized treatment for the whole course combined with key technologies for rehabilitation intervention effectively improve the depression state of patients， adjust the imbalance state caused by inflammatory cytokines secreted by serum 5-HT， Th1 and Th2， and play a positive role in promoting the rehabilitation of patients.

[Key words] Depression disorder; Standardized treatment for the whole course; Key technologies for rehabilitation; Neuroimmunology

抑郁障碍发病机制复杂且尚无明确定论，是一组以持久性及明显表现的心境低落为突出临床症状的心境障碍性疾病。患者长期沉浸在消极、自卑、厌世的心境中，无法以进行正常的工作、社交及学习，与疾病形成恶性循环，进一步加重疾病[1]。科学有效的治疗干预手段是促进患者生理、心理及心境行积极面发展的关键推动力，因此治疗方案的选择即为关键。全病程规范化治疗是一种以患者为中心抑郁症治疗方案，将建立良良好的医护关系、对患者疾病的评估及诊断治疗作为方案的主线，而经颅直流电刺激康复技术为临床干预治疗抑郁症患者的常用手段，廣泛应用在各种类型的抑郁症患者中[2]。……