认知行为疗法联合康复训练对前庭功能障碍患者负性情绪的影响：一项真实世界队列研究
The effect of combined cognitive behavioral therapy and rehabilitation training on negative emotions of patients with vestibular dysfunction: a real-world cohort study.
文献信息
| PMID | 42780373 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Lu Gao |
| 作者单位 | Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China. |
| 期刊 | Frontiers in public health |
| SCI 分区 | Q1 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 本研究基于真实世界临床实践，评估认知行为疗法（CBT）联合康复训练与前庭功能障碍及负性情绪改善之间的关联。
方法： 这项单中心、真实世界、回顾性队列研究于2020年8月至2024年10月在中国一家三级医院招募了100例前庭功能障碍伴负性情绪的患者。根据实际接受的治疗将患者分为两组：常规护理组（n=50）接受标准药物治疗和健康教育，联合干预组（n=50）额外接受为期3个月的CBT联合康复训练方案。主要结局包括3个月时的视觉模拟量表（VAS）、眩晕障碍量表（DHI）和躯体症状量表（SSS）评分。次要结局包括1个月时的上述量表评分，以及广泛性焦虑障碍量表-7（GAD-7）和患者健康问卷-9（PHQ-9）评分。
结果： 在3个月时，与常规护理组相比，联合干预组在VAS、DHI和SSS评分方面显示出显著更大的改善（均p<0.05）。在1个月时，联合组在DHI的情绪和功能维度上表现出早期优势。GAD-7和PHQ-9评分显示，联合组在1个月和3个月时均有显著更大的心理改善（p<0.01）。
结论： 在真实世界环境中，与常规护理相比，CBT联合康复训练与前庭功能障碍伴负性情绪患者的头晕、躯体症状及焦虑/抑郁更大程度的改善相关。大多数结局早期即改善，而头晕相关残疾的躯体成分显示组间分离较晚，这支持整合性心身照护模式的潜在价值。
英文摘要
PURPOSE: This study evaluated the association of combined cognitive behavioral therapy (CBT) and rehabilitation training with improvements in vestibular dysfunction and negative emotions based on real-world clinical practice.
METHODS: This single-center, real-world, retrospective cohort study recruited 100 patients with vestibular dysfunction and negative emotions from a tertiary hospital in China between August 2020 and October 2024. Patients were divided into two groups based on actual treatment received: the conventional care group (n = 50) received standard medication and health education, while the combined intervention group (n = 50) additionally underwent a 3-month program of CBT combined with rehabilitation training. Primary outcomes included Visual Analog Scale (VAS), Dizziness Handicap Inventory (DHI), and Somatic Symptom Scale (SSS) scores at 3 months. Secondary outcomes included the above scales at 1 month, along with Generalized Anxiety Disorder Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scores.
RESULTS: At 3 months, the combined intervention group showed significantly greater improvement in VAS, DHI, and SSS scores compared to the conventional care group (all p < 0.05). At 1 month, the combined group demonstrated early superiority in the emotional and functional dimensions of the DHI. GAD-7 and PHQ-9 scores showed significantly greater psychological improvement in the combined group at both 1 and 3 months (p < 0.01).
CONCLUSION: In real-world settings, CBT combined with rehabilitation training was associated with greater improvements in dizziness, somatic symptoms, and anxiety/depression in vestibular dysfunction patients with negative emotions compared with conventional care. Most outcomes improved early, whereas the physical component of dizziness-related disability showed a later between-group separation, which supports the potential value of integrated psychosomatic care models.