The Effect Of Cognitive Behavior Therapy On Chronic Obstructive Pulmonary Disease With Anxiety

Background: GOLD-2017 defines COPD as "a persistent preventable disease of respiratory symptoms and airflow limitation caused by exposure to harmful particles or gases and / or abnormal alveoli".Acute exacerbation and complications in the course of the disease have a significant impact on the outcome and prognosis of the disease.Studies at home and abroad have found that patients with COPD not only have severe respiratory symptoms,but also suffer from recurrent attacks or prolonged illness,limited travel,reduced social activities,and large hospital expenses.With the decrease of economic income and other factors,patients with COPD are apt to form anxious psychological state.This negative emotion can also aggravate the somatic symptoms and clinical manifestations associated with various primary diseases,hinder the process of various rehabilitation training being carried out in the remission period of COPD patients,and affect the therapeutic effect of the acute exacerbation period.Lowering the patient's quality of life and exacerbating the subjective feeling of dyspnea may even lead to death in patients with COPD.However,anxiety is the most common emotional disorder in patients with COPD who receive the least attention and treatment.Therefore,to eliminate or alleviate the anxiety of patients with chronic obstructive pulmonary disease in time,to establish confidence in life and to improve self-efficacy should be paid more attention to by clinical workers.Objective: to investigate the effect of cognitive behavioral therapy(CBT)and chronic obstructive pulmonary health education(COPD)on the quality of life and health status of patients with chronic obstructive pulmonary disease complicated with anxiety.The improvement of the degree of dyspnea was compared between the two groups.Methods: from October 2017 to February 2018,30 inpatients diagnosed as chronic obstructive pulmonary disease complicated with anxiety in the Department of cadre Health,General Hospital of Tianjin Medical University were collected.Eliminate cognitive impairment,mental illness and other types of neurosis,severe somatic and pulmonary encephalopathy,and regular use of antianxiety drugs.Thirty COPD patients with anxiety were randomly divided into two groups: experimental group and control group.Hamilton anxiety scale(HAMA)score,cat score and dyspnea index(MMRC)score.Two groups of patients were treated with standardized clinical standard COPD,the control group was treated with cognitive behavioral therapy(CBT),and the patients in experimental group were treated with chronic obstructive pulmonary health education on the basis of cognitive behavioral therapy.HAMA scores,cat scores and MMRC scores were evaluated again 2 weeks and 2 months after intervention(a complete cognitive behavioral therapy cycle).The psychological state(anxiety,quality of life and health)and degree of dyspnea were compared between the two groups.Results: after the treatment,the HAMA scores of two groups were decreased,combined with COPD health education group than those in CBT group decreased significantly,there were statistically significant differences(P<0.05).After 2 weeks of treatment and after February,CBT group CAT score and MMRC score before treatment had no obvious change,combined treatment group 2 weeks after February,CAT score and MMRC score decreased significantly,there were statistically significant differences(P<0.05).Conclusion: cognitive behavioral therapy combined with chronic obstructive pulmonary health education can significantly reduce the anxiety degree of COPD patients with anxiety,and improve the quality of life,health status and breathing difficulty after intervention.It can be said that adding health education to chronic obstructive pulmonary disease on the basis of CBT therapy is more beneficial to patients than CBT alone.