| Objective:Breast cancer is the most common malignant tumor in women worldwide,and its incidence rate is increasing year by year in China.Surgical trauma,various physical discomforts and side effects caused by treatment,fear of death,recurrence and metastasis of tumors,etc.,are easy to make patients pessimistic about life and cause mental illness,also known as post-traumatic stress disorder(PTSD),which affects the patient's survival and quality of life.But most patients' PTSD is not treated in time.At present,the treatment of PTSD by medical science is mainly some psychotropic drugs.In the other hand,there are many therapies in our traditional Chinese medicine,such as Chinese medicine prescription,acupuncture and massage,auricular points,five-tone therapy,diet therapy,Baduanjin,Tai Chi,etc.Many of these therapies are effective,simply operated,painless and non-invasive,even can be operated by patients themselves,which is more acceptable to Chinese people.The goal is to summarize the various treatments of traditional Chinese medicine and make a tool that allows breast cancer patients to self-regulate PTSD,so that self-treatment within home may become true.The purpose of this study:? To study whether the self-management WeChat applet is better than traditional outpatient service;? To study whether the therapeutic effect of adding auricular points magnetic beads plaster is better than treatment that without.Methods:In this prospective randomized controlled clinical trial,176 patients with breast cancer PTSD who met the inclusion criteria were randomized into 4 groups,at a ratio of 1:1:1:1 as:Wechat applet magnetic beads group?Wechat applet without magnetic beads group?outpatient magnetic beads group?outpatient without magnetic beads group.44 patients in each group,all the patients received standard medicine treatment and TCM treatment according to syndrome differentiation.The Wechat applet magnetic beads group take integrated self-management of TCM,according to the tutorial in Wechat applet for 12 weeks,and do the magnetic beads auricular points plaster themselves.The Wechat applet without magnetic beads group take integrated self-management of TCM,according to the tutorial in Wechat applet for 12 weeks,without doing auricular points plaster.An expert team will communicate online every 2 weeks with patients who use Wechat applet to intervene.The outpatient magnetic beads group take treatment of TCM(the treatment content is the same as the WeChat applet,but it is guided by the outpatient doctor),for 12 weeks,and the doctor operate the magnetic beads auricular points plaster.The outpatient without magnetic beads group only take treatment of integrated TCM.The outpatient group went to the outpatient clinic every 2 weeks for treatment.Observe and analyse the PTSD Checklist Civilian Version(PCL-C),Self-Rating Anxiety Scale(SAS),Self-rating depression scale(SDS),Hamilton Depression Scale(HAMD),Symptom Checklist90(SCL-90),The insomnia severity index(ISI).And conduct a health economics assessment.Use SPSS 23.0 software for statistical analysis and draw conclusions.The design part of Wechat applet in this research depends on modern information technology,based on WeChat platform,designed by professional software technicians.The Wechat applet includes five modules:?Introduction to PTSD related knowledge ?PTSD related self-assessment scale ?Symptom management route ?PTSD related knowledge link?Magnetic beads auricular points plaster tutorial.Results:1.Baseline comparison:There was no significant difference in the general information and the scores of PTSD Checklist Civilian Version(PCL-C)?Self-Rating Anxiety Scale(SAS)?Self-rating depression scale(SDS)?Hamilton Depression Scale(HAMD)?Symptom Checklist90(SCL-90)?The insomnia severity index(ISI)of the four groups of patients before therapy.(P>0.05).2.Comparison of efficacy before and after intervention in the same group:After intervention,the scores of PTSD Checklist Civilian Version(PCL-C)?Self-Rating Anxiety Scale(SAS)?Self-rating depression scale(SDS)?Hamilton Depression Scale(HAMD)?Symptom Checklist90(SCL-90)?The insomnia severity index(ISI)have improved.Compared with before the intervention,the difference was statistically significant(P<0.05).3.Comparison of efficacy before and after intervention between groups:?The difference of each scale before and after intervention in the Wechat applet with magnetic beads group is larger than that in the Wechat applet without magnetic beads group,and the difference is statistically significant(P<0.05).?The difference of each scale before and after intervention in the Wechat applet with magnetic beads group is larger than that of the outpatient with magnetic beads group,in which the differences of PCL-C,SAS,SDS,HAMD,SCL-90 are statistically significant(P<0.05);The difference in ISI is not statistically significant(P>0.05).?The average difference of each scale before and after intervention in the Wechat applet without magnetic beads group is larger than that of the outpatient without magnetic beads group,in which the difference of SDS,HAMD,SCL-90 is statistically significant(P<0.05);The difference between PCL-C,SAS and ISI were not statistically significant(P>0.05).?The difference of each scale before and after intervention in the outpatient with magnetic beads group was greater than that of the outpatient without magnetic beads group.Among them,the differences of SDS,HAMD,SCL-90,and ISI were statistically significant(P<0.05);The difference of SAS,PCL-C were not statistically significant(P>0.05).4.No adverse reactions occurred in the four groups of patients during the intervention.5.Compared with outpatient integrated TCM treatment intervention,the use of self-management WeChat applet intervention saves additional treatment expenses(including registration fees,travel expenses,etc.),and reduces the energy and physical consumption of going to the hospital for registration,travel,waiting,etc..Conclusion:1.Under the guidance of TCM theory,integrated TCM treatment combined with TCM psychotherapy,TCM rehabilitation exercise,traditional music therapy,TCM diet therapy,and magnetic bead auricular points plaster therapy can significantly improve breast cancer patients' PTSD and anxiety and depression.And can significantly improve the sleep status of breast cancer patients with PTSD.2.The effect of intervention using self-management Wechat applet for breast cancer patients with PTSD is better than intervention under the guidance of outpatient doctors.It should be promoted and used in clinical work.3.The use of magnetic beads auricular points plaster has a synergistic effect on improving the unhealthy mood of breast cancer patients with PTSD.4.The health economics benefit of using self-management Wechat applet intervention is better than outpatient integrated TCM treatment. |
PDF Full Text Request