| Objective:To explore the effect of Group Computer story-version Magnanimous Therapy(GCSMT)on the rehabilitation of patients with lung cancer and the relationship between the changes of brain metabolites and the therapeutic effect,so as to explore the cerebral metabolic mechanism of the therapeutic effect,and to provide empirical data for the psychological rehabilitation effect of Group Computer story-version Magnanimous Therapy and the cerebral metabolic mechanism.Methods:In this study,39 patients with advanced lung cancer were collected from our hospital department of oncology.Twenty-three patients in the intervention group were treated with GCSMT,and the duration was 2 weeks,4 times per week,and each intervention time was about 40 minutes,totaling 8 times.The changes of psychological,physiological and brain biochemical metabolism were observed by magnetic resonance spectroscopy(MRS),Psychosomatic Statue Scale for Canner Patients(PSSCP),Cancer Coping Modes Questionnaire(CCMQ),Enterprising and Magnanimous Questionnaire(EMQ),Hospital Anxiety Depression(HAD)and brain wave(alpha,beta,theta,SMR),respiration,heart rate,blood pressure before and after treatment.The control group(n=16)used the same measurement indexes and the same interval to observe the differences of mental state,physiological state and brain biochemical metabolism between the control group and the intervention group before and after treatment.Results:1.Results of psychological and social functional indicators(1)The evaluation results of Psychosomatic Statue Scale for Canner Patients(PSSCP): After 2 weeks of psychological intervention in GCSMT group, the scores of “psychological”dimension,“physical” dimension,“social function”dimension,“psychological plasticity” dimension and “total mean score” of patients with lung cancer(2.00±0.30,1.58±0.31,1.87±0.24,2.14±0.43,2.70±0.84)were lower than those of two weeks ago(2.32±0.35,1.87±0.40,2.03±0.52,2.54±0.64,3.17±0.66).According to statistics,there were significant differences in “psychological” dimension,“social function” dimension and “total mean score” before and after intervention(P< 0.05).After 2 weeks of routine clinical anticancer treatment,the scores of “psychological” dimension,“physical”dimension,“social function” dimension,“psychological plasticity” dimension and “total mean score” of patients with lung cancer in the control group(2.48±0.12,2.23±0.37,2.92±0.42,3.13±0.73)were higher than those of two weeks ago(2.42±0.19,2.11±0.43,2.83±0.53,3.02±0.75).The score of “physical”dimension(1.93±0.36)was lower than that of 2 weeks ago(1.98±0.29).According to statistics,there was no significant difference in each dimension and total average score before and after 2 weeks(P > 0.05).(2)The evaluation results of cancer coping modes questionnaire(CCMQ):After 2 weeks of psychological intervention in GCSMT group,the scores of“avoidance and depression” dimension,“surrender” dimension and “fantasy”dimension(1.73±0.35,1.72±0.27,1.75±0.35)were lower than those of two weeks ago(1.93±0.40,2.03±0.41,1.91±0.29).According to statistics,there were significant differences in the scores of “avoidance and depression” dimension and“surrender” dimension before and after intervention(P<0.05).There was no significant difference in the score of fantasy dimension(P > 0.05).The scores of“total mean score”,“face” dimension and “vent” dimension(2.08±0.14,2.98±0.35,1.84±0.37)were higher than those of two weeks ago(2.02±0.18,2.29±0.41,1.77±0.40).According to statistics,there was significant difference in the score of “face” dimension(P < 0.05),but there was no significant difference in “total mean score” and “vent” dimension(P > 0.05).After 2 weeks of routine clinical anticancer treatment,the scores of “total mean score”,“face” dimension,“avoidance and suppression” dimension and “vent” dimension of patients with lung cancer in the control group(2.11±0.19,2.55±0.33,1.95±0.33,1.70±0.40)were lower than those of two weeks ago(2.13±0.17,2.58±0.41,2.01±0.35,1.83±0.34).There was no significant difference(P > 0.05).The scores of“surrender” dimension and “fantasy” dimension(2.13±0.40,1.94±0.46)were higher than those of two weeks ago(2.06±0.35,1.92±0.41),and there was no significant difference(P > 0.05).(3)The evaluation results of the enterprising and magnanimous questionnaire(EMQ): After 2 weeks of psychological intervention in GCSMT group,the scores of “enterprising” dimension,“magnanimous” dimension and“total mean score” of patients with lung cancer(3.16±0.26,3.10±0.34,3.23±0.35)were higher than those of two weeks ago(3.00±0.30,2.87±0.41,3.13±0.31).According to statistics,there were significant differences in “total mean score”and “enterprising” dimension(P<005).There was no significant difference in the score of “magnanimous” dimension(P>0.05).After 2 weeks of routine clinical anticancer treatment,the scores of “total mean score”,“enterprising” dimension and “magnanimous” dimension of patients with lung cancer in the control group(3.02±0.24,3.04±0.25,3.00±0.43)were lower than those two weeks ago(3.06±0.20,3.07±0.25,3.05±0.39).According to statistics,there was no significant difference in total average score and each dimension(P> 0.05).(4)The evaluation results of hospital anxiety and depression scale(HAD):After 2 weeks of psychological intervention in GCSMT group,the “total mean score”,the score of “anxiety” dimension and “depression” dimension of patients with lung cancer(0.80±0.21,0.73±0.21,0.86±0.26)were lower than those of two weeks ago(1.12±0.24,0.95±0.34,1.30±0.35).According to statistics,there were significant differences(P < 0.05).After 2 weeks of routine clinical anticancer treatment,the “total mean score” and the scores of “depression” dimension of patients wiht lung cancer in the control group(1.18±0.24,1.47±0.32)were higher than those of two weeks ago(1.10±0.31,1.29±0.49).The score of “anxiety”dimension(0.88±0.29)was lower than that of two weeks ago(0.91±0.34).According to statistics,there was no significant difference in total mean score and each dimension score(P > 0.05).2.Physiological index results(1)The evaluation results of respiration,blood pressure and heart rate of patients: After 2 weeks of psychological intervention in GCSMT group,the systolic blood pressure,diastolic blood pressure,heart rate and respiration of patients with lung cancer(124.04±14.90,74.83±8.52,83.26±5.29,18.3±0.93)were lower than those of 2 weeks ago(124.91±10.78,76.13±8.99,84.26±5.99,19.17±1.97).There was no significant difference(P<0.05).After 2 weeks of routine clinical anticancer treatment,the systolic blood pressure,diastolic blood pressure,heart rate and respiration of patients with lung cancer in the control group(121.69±13.11,76.81±9.82,85.19±6.64,20.31±1.58)were lower than those of 2 weeks ago(121.75±13.52,78.38±12.35,85.25±6.58,20.44±1.82).Statistical analysis showed that there was no significant difference(P > 0.05).(2)The evaluation results of brain waves values(α,β,θ,SMR waves)in patients:After 2 weeks of psychological intervention in GCSMT group,the values of α wave,β wave,θ wave and SMR wave in patients with lung cancer(12.45±1.97,12.73±2.07,15.69±3.68,8.57±0.93)were lower than those of 2weeks ago(12.73±4.14,14.31±5.70,26.08±2.82,9.10±2.03).According to statistics,there was significant difference in the value of θ wave,but there was no significant difference in α wave,β wave and SMR wave(P>0.05).After 2 weeks of routine clinical anticancer treatment,the values of α wave,β wave and θ wave in patients with lung cancer in the control group(20.28±7.85,12.14±5.70,12.77±4.84)were lower than those of 2 weeks ago(24.72±11.97,12.18±5.66,12.89±4.64).The value of SMR wave(8.17±2.15)was higher than that of 2weeks ago(8.01±2.37).Statistical analysis showed that there was no significant difference(P > 0.05).3.The evaluation results of brain metabolites: After 2 weeks of psychological intervention in GCSMT group and control group,there was no significant difference in the ratio of NAA/Cr,Cho/Cr,m I/Cr and Glx/Cr in bilateral cingulate gyrus,hippocampus and amygdala(P>0.05).4.Clinical qualitative evaluation: :Lung cancer patients who have been treated with GCSMT believe that the treatment uses colorful and profound stories as well as real cases to enlighten and inspire people.After psychotherapy,it makes people feel broad-minded and relaxed,and can better understand the essence and true meaning of magnanimity.Medical staff believe that the treatment enables patients to cooperate more actively with the treatment and improve the medical effect and the level of medical services.Conclusion:(1)The GCSMT plays a positive role in improving the emotional,psychological,physical symptoms and social function of patients with advanced lung cancer,and can improve the patient’s treatment and doctor-patient communication.(2)The GCSMT can reduce the θ wave value of patients with advanced lung cancer and improve the sense of physical fatigue and sleepiness.(3)This study provides some ideas for the study of the brain metabolic mechanism of psychotherapy.If the sample size can be expanded for further study,it is possible to provide more accurate empirical evidence for the effect mechanism of psychotherapy. |
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