癌症患者预期性恶心和呕吐不良情绪与应激.docVIP

癌症患者预期性恶心和呕吐不良情绪与应激 　　【摘 要】 目的:观察不良情绪与预期性恶心和呕吐（Anticipatory nausea and vomiting，ANV）发生之间的关系及预期性恶心和呕吐发生患者的交感神经兴奋性和肾上腺皮质激素的变化情况。方法：采用恶心、呕吐情况调查表及ZUNG氏焦虑自评量表(SAS)、抑郁自评量表(SDS)对87例经历过一或两个化疗周期的癌症患者进行调查，以皮肤电测试仪测量其皮肤电阻水平，以放射免疫法测其唾液中皮质醇含量。结果：预期性恶心和呕吐发生组患者（n=35）恶心问卷总分（0.3±0.2）及三因子躯体不适（0.3±0.2）、消化道反应（0.5±0.3）、情绪痛苦（0.2±0.2）均高于未发生预期性恶心和呕吐组（n=52）（0.1±0.1、0.1±0.1、0.1±0.1、0.1±0.1，P 　　【关键词】 预期性恶心和呕吐；焦虑；抑郁；应激；皮肤电阻；唾液皮质醇；横断面研究 　　中图分类号：R395.1 文献标识码：A 文章编号：1000-6729(2007)08-00549-04 　　 　　Negative Emotion and Stress Reaction of Cancer Patients with Anticipatory Nausea and Vomiting 　　WANG Xia, ZHANG Fang, PAN Fang,et al 　　The Public Health College of Shandong University,Jinan 250012 　　【Abstract】 Objective: To study the relationship between anxiety, depression and anticipatory nausea and vomiting (ANV) and the response of sympathetic nerve system and hypothalamic－pituitary－adrenal axis of cancer patients with ANV.Methods: 87 patients experienced of one or two cycles of chemotherapy participated the study. Before administration of the next chemotherapy, all the subjects received the tests of scales (the nausea profile, The impatient, the second impatient toxicity respond standard of the anti－cancer medicine by WHO established , Self－rating Anxiety Scale, Self－rating Depression Scale), electronic skin resistance were recorded，and their saliva cortisol was kept and tested on the first chemotherapy day.Results:There were significantly differences in Overall, Somatic, Skin resistance, Emotion, SAS, SDS, electronic skin resistance, saliva cortisol. Compared to the patients without ANV, the patients with ANV had significantly higher scores in overall (0.3±0.2/0.1±0.1), somatic (0.3±0.2/0.1±0.1), GI (0.5±0.3/0.1±0.1), emotion（0.2±0.2/0.1±0.1）, SAS（38.0±8.7/31.6±6.0）, SDS（38.3±10.8/33.1±7.3）, saliva cortisol（6.8±2.9/5.1±2.5）（P 本文为全文原貌 未安装PDF浏览器用户请先下载安装 原版全文 　　以动物和人为被试的实验研究表明，原本是中性的刺激经过反复与细胞毒药物配对之后，会变成恶心和呕吐的条件刺激［5］。Marcial Rodrigue等研究表明，小鼠在某一环境中，经过锂剂注射后可产生厌恶反应，而注射时的环境因与锂剂注射相联系而具