探讨沙盘游戏治疗对初产妇孕期抑郁状态的干预效果。

选取2016年10月至2017年5月，于北京市丰台区妇幼保健院参加产前检查，应用《抑郁自评量表(SDS)》进行心理测评，而被临床诊断为孕期抑郁状态的86例初产妇为研究对象。采用随机数字表法，将这86例受试者随机分为研究组(n＝43)和对照组(n＝43)。2组受试者均接受常规产前检查和心理健康知识教育。研究组受试者在此基础上，再采用沙盘游戏治疗对其孕期抑郁状态进行干预。研究组受试者完成3次沙盘游戏治疗1周后，以及对照组受试者纳入本研究1个月后，均再次采用SDS对其进行心理测评。统计学比较2组受试者孕期抑郁状态干预前、后SDS标准分。2组受试者年龄、孕龄及文化程度构成比等一般临床资料比较，差异均无统计学意义(P>0.05)。本研究通过北京市丰台区妇幼保健院伦理委员会批准，并与所有受试者均签署了临床研究知情同意书。

①2组受试者孕期抑郁状态干预前的SDS标准分比较，差异无统计学意义(t＝0.56，P＝0.577)。孕期抑郁状态干预后，研究组SDS标准分显著低于对照组，差异有统计学意义(t＝18.12，P<0.001)。研究组、对照组孕期抑郁状态干预前、后SDS标准分组内分别比较，差异均有统计学意义(t＝31.77、15.04，P<0.001)。②研究组受试者孕期抑郁状态干预前、后SDS标准分降低值为(27.9±5.8)分，显著高于对照组的(8.8±3.8)分，二者比较，差异有统计学意义(t＝18.06，P<0.001)。

沙盘游戏治疗可有效改善初产妇孕期抑郁状态，干预效果较好。因本研究纳入样本量较小，沙盘游戏治疗应用于初产妇孕期抑郁状态干预，是否值得临床推广，仍需大样本、多中心、随机对照研究进一步证实。

To explore the intervention effects of sandplay therapy on the depressive state of primipara during pregnancy.

A total of 86 cases of primiparas who attended prenatal examinations in Fengtai Maternal & Child Health Hospital of Beijing and were diagnosed as depressive state during pregnancy by Self-Rating Depression Scale(SDS) from October 2016 to May 2017 were selected as research subjects. They were divided into study group (n=43) and control group (n=43) by random number table. Every primipara in both two groups received prenatal examination and mental health education. Besides, for primiparas in study group, they received additional sandplay therapy to intervene their depressive states during pregnancy. One week after 3 times of sandplay therapy in study group, and one month after the enrollment of control group, all primiparas received the second time of SDS test. The standard scores of SDS in two groups before and after intervention were compared by statistical methods. There were no significant differences between two groups in ages, gestational ages and constitute ratio of education levels and so on (P>0.05). This study was approved by the Ethics Committee in Fengtai Maternal & Child Health Hospital of Beijing and every primipara signed informed consent of clinical research.

①There was no significant difference between two groups in standard scores of SDS before intervention (t=0.56, P=0.577). While the standard score of SDS in study group after intervention was obviously lower than that in control group, and the difference was statistically significant (t=18.12, P<0.001). After intervention, intra-group comparison, the standard scores of SDS in study group and control group both were statistically lower than those before intervention, and both the differences were statistically significant (t=31.77, 15.04; P<0.001). ②The standard score of SDS in study group decreased by (27.9±5.8) scores before and after intervention, which was significantly higher than (8.8±3.8) scores in control group, and the difference was statistically significant (t=18.06, P<0.001).

Sandplay therapy can effectively improve the depressive state of primipara during pregnancy. For this study, since the sample size is small, it still needs larger-sample, multi-center and randomized controlled study to confirm whether sandplay therapy used in the intervention of depressive state of primipara during pregnancy is worthy of clinical promotion.