Feng Juan-Juan, Li You-Hui
Department of Rehabilitation Medicine Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Medicine (Baltimore). 2017 Jul;96(29):e7334. doi: 10.1097/MD.0000000000007334.
Little research has been done on the effects of hyperbaric oxygen (HBO) on depression and anxiety after spinal cord injury (SCI). The aim of this study was to investigate the effects of HBO on psychological problems and never function, especially on depression and anxiety in the patients with incomplete SCI (ISCI).Sixty patients with ISCI combined with depression and anxiety were randomly divided into HBO group (20 cases), psychotherapy group (20 cases), and conventional rehabilitation control group (20 cases). All patients received routine rehabilitation therapy. However, in HBO group and psychotherapy group, patients also received HBO and psychotherapy, respectively. These therapies lasted for a total of 8 weeks (once a day and 6 days per week). Before and after 8 weeks of treatment, depression and anxiety, nerve function, and activities of daily living were, respectively, evaluated according to Hamilton Depression (HAMD) scale, Hamilton Anxiety (HAMA) scale, American Spinal Injury Association score, and functional independence measure score in all patients.After 8 weeks of treatment, HAMD score was significantly lower in both HBO group and psychotherapy group than in control group (all P < .05), but there was no statistical difference in HAMD score between HBO group and psychotherapy group (P > .05). HAMA score was significantly lower in HBO group than in control group (P < .05), but there was no statistical difference in HAMA score between HBO group and psychotherapy group, and between psychotherapy group and control group (all P > .05). After 8 weeks of treatment, American Spinal Injury Association and functional independence measure scores were significantly higher in HBO group than in both psychological and control groups, and also higher in psychotherapy group than in control group (all P < .05).The effects of HBO on depression and anxiety are similar to that of psychotherapy. HBO can significantly improve nerve function and activities of daily living in the patients with ISCI, which either psychotherapy or routine rehabilitation therapy can not substitute.
关于高压氧(HBO)对脊髓损伤(SCI)后抑郁和焦虑影响的研究较少。本研究旨在探讨HBO对心理问题和神经功能的影响,尤其是对不完全性脊髓损伤(ISCI)患者抑郁和焦虑的影响。
60例合并抑郁和焦虑的ISCI患者被随机分为HBO组(20例)、心理治疗组(20例)和传统康复对照组(20例)。所有患者均接受常规康复治疗。然而,HBO组和心理治疗组患者分别还接受了HBO治疗和心理治疗。这些治疗共持续8周(每天1次,每周6天)。在治疗8周前后,分别根据汉密尔顿抑郁(HAMD)量表、汉密尔顿焦虑(HAMA)量表、美国脊髓损伤协会评分和功能独立性测量评分对所有患者的抑郁和焦虑、神经功能及日常生活活动进行评估。
治疗8周后,HBO组和心理治疗组的HAMD评分均显著低于对照组(均P<0.05),但HBO组和心理治疗组之间的HAMD评分无统计学差异(P>0.05)。HBO组的HAMA评分显著低于对照组(P<0.05),但HBO组与心理治疗组之间以及心理治疗组与对照组之间的HAMA评分均无统计学差异(均P>0.05)。治疗8周后,HBO组的美国脊髓损伤协会和功能独立性测量评分显著高于心理治疗组和对照组,心理治疗组也高于对照组(均P<0.05)。
HBO对抑郁和焦虑的影响与心理治疗相似。HBO能显著改善ISCI患者的神经功能和日常生活活动,这是心理治疗或常规康复治疗无法替代的。