目的 分析60例晚期肺癌患者经心理干预后外周血T淋巴细胞亚群的变化,探讨不同心理干预模式对免疫状态的影响,为制定合理心理干预方案提供实验依据。方法 根据筛选条件选择60例晚期肺癌患者,随机分为常规治疗组、心理干预多阶段治疗组。常规治疗组采用常规医疗方式给予技术支持,解答患者及家属的正常提问。干预组采用常规治疗同时给予三阶段心理干预(常规心理干预期、家庭及小组情绪调控期、家庭内互助干预期),干预方法主要采用合理情绪疗法。同时,应用流式细胞仪监测两组患者在治疗前、各阶段治疗后外周血T细胞亚群。结果 基线期两组T细胞差异无统计学意义,经治疗及干预后,心理干预组的CD3⁺CD4⁺较常规治疗组增高(t=2.15, P<0.05),CD8⁺CD28^- 干预组较常规组下降(t=2.06, P<0.05),差异有统计学意义。同时,在干预组内,三阶段心理干预较单独一阶段干预后的CD3⁺CD4⁺细胞增高(t=3.51, P<0.01), CD8⁺CD28^-降低(t=2.16, P<0.05),差异具有统计学意义。结论 晚期肺腺癌患者经合理心理干预后免疫状态得到改善,心理干预时间的延长及家属社会因素的积极参与有利于进一步增强心理干预对免疫功能的改善作用。

Objective To study the change of immune system by using the T lymphocyte subsets in non-small-cell lung cancer patients with psychotherapeutic treatment. Methods Sixty patients with non small cell lung cancer in this hospital were identified. 30 received regular treatment, 30 received extra psychotherapeutic treatment. The psychotherapeutic treatment consisted of three parts: original, team training, family and team member getting along with the treatment. Cognitive behavioral therapy was used in all period. Blood samples from 60 patients were collected before and after each period and then tested for T lymphocyte subsets. Results The CD3⁺CD4⁺ levels more increased in psychotherapeutic treatment group than in regular group(t=2.15, P<0.05), and the CD8⁺CD28^-became less in treatment group than in the other(t=2.06, P<0.05). Furthermore, we also found that in the psychotherapeutic treatment group CD3⁺CD4⁺ became more with extra long psychotherapeutic treatment(t=3.51, P<0.01), CD8⁺CD28^- could become less when patients received the next two period therapy(t=2.16, P<0.05).Conclusion The psychotherapeutic treatment has good immune function in non-small-cell lung cancer.The new way to prolong the time of treatment and get the family member’s participation is better than the normal treatment.