探讨多学科合作模式的生理调控、心理调节、音乐调理(PPM)干预措施，与仅应用PPM中3项措施之一，治疗孕产期心身障碍(PSD)的临床效果。

选择2017年3月至5月，在天津市滨海新区大港妇女儿童保健中心等6家医疗机构的孕产妇心身健康门诊研究基地，进行产前检查被确诊为罹患孕产期PSD的95例孕妇为研究对象。采取抽签方式进行随机抽样，将95例孕妇分为PPM治疗组(n＝25，采取PPM治疗措施)，生理调控干预组(n＝25，仅采用PPM治疗中的生理调控干预措施)，心理调节干预组(n＝22，仅采用PPM治疗中的心理调节干预措施)及音乐调理干预组(n＝23，仅采用PPM治疗中的音乐调理干预措施)，共计4组。4组治疗时间均为3周。治疗结束后，采用统计学方法比较PPM治疗组分别与3个单一干预措施组孕妇治疗后的主诉躯体功能障碍主要症状变化、自主神经系统(ANS)功能状态变化及汉密顿焦虑量表(HAMA)评分值差异。本研究遵循的程序符合上述各医疗机构人体试验委员会制定的伦理学标准，得到其伦理委员会批准，征得受试对象知情同意，并与之签署临床研究知情同意书。

① 4组孕妇治疗前一般临床资料、ANS功能状态及HAMA评分值比较，差异均无统计学意义(P>0.05)。② 4组孕妇完成治疗后，主诉躯体功能障碍主要症状变化比较结果显示，PPM治疗组的治疗效果，较生理调控干预组、心理调节干预组及音乐调理干预组均好，并且差异均有统计学意义(P<0.001)，PPM治疗组孕妇的主诉躯体功能障碍主要症状多数为全部消除，少数为部分消除或缓解。③治疗结束后，PPM治疗组与3个单一干预措施组孕妇的ANS功能状态构成比分别比较，差异均有统计学意义(P<0.001)，PPM治疗组孕妇ANS功能状态全部为平衡状态，而3个单一干预措施组孕妇仍主要为紊乱状态；PPM治疗组孕妇HAMA评分值，均分别较3个单一干预措施组孕妇低，并且差异均有统计学意义(P<0.001)。

采取多学科合作模式的PPM干预措施(基于围生保健和产科)，治疗孕产期PSD疗效显著，对孕妇的焦虑、抑郁亦有治疗作用。对于孕产期PSD孕妇仅采用PPM治疗中3项措施之一的单一干预措施治疗方案的疗效欠佳。

To investigate clinical effects of treating psychosomatic disorder (PSD) in pregnancy by using the physiological regulation, psychological adjustment and music conditioning (PPM) treatment under the multidisciplinary cooperation mode and by using only one of three measures above of PPM treatment.

A total of 95 pregnant women who were confirmed as PSD in pregnancy when performing the prenatal examinations from March to May 2017 in the research bases in psychosomatic health outpatients for pregnant women of six medical institutions such as Dagang Maternal and Child Care Center, Binhai New Area, Tianjin, etc., were chosen as research subjects. The 95 cases were randomly sampled by lotting, and were assigned to four groups, namely, PPM treatment group (n=25, adopted PPM treatment), physiological regulation intervention group (n=25, adopted physiological regulation measure), psychological adjustment intervention group (n=22, adopted psychological adjustment measure), and music conditioning intervention group (n=23, adopted music conditioning measure). After finishing 3 weeks of treatment for 4 groups, the statistical method was used to compare the differences between PPM treatment group and other three groups with single intervention measure, respectively, in cardinal symptoms of physical dysfunction as the chief complaint, functional status of autonomic nervous system (ANS), and scores of Hamilton Anxiety Scale (HAMA). The procedure followed by this study met the ethical standards set by the Human Trial Board of the above mentioned medical institutions, it was approved by their Ethics Committees and agreed by the study subjects, and the informed consent of clinical research was signed with them.

① There were no significant differences among 4 groups of pregnant women before treatment in general clinical data, functional status of ANS and HAMA scors (P>0.05). ②After treatment for 4 groups of pregnant women, the comparison results of changes of cardinal symptoms of physical dysfunction as the chief complaint showed that: The therapeutic effect of PPM treatment group was better than that of each group with single intervention measure, respectively, and all the differences were statistically significant (P<0.001), and the cardinal symptoms of physical dysfunction as the chief complaint in PPM treatment group was eliminated completely for majority cases, and partially removed or relieved for minority cases. ③Constituent ratio of ANS functional status was compared between PPM treatment group and each group with single intervention measure after treatment, respectively, and all the differences were statistically significant (P<0.001), and ANS functional statuses of pregnant women in PPM treatment group were all the balanced ones, however, pregnant women in other 3 groups with single intervention measure were still mainly the disordered ones. HAMA scores of pregnant women in PPM treatment group was lower than that of each group with single intervention measure after treatment, respectively, and all the differences were statistically significant (P<0.001).

The therapeutic effect was significant in treating PSD in pregnancy by using PPM treatment (based on perinatal health care and obstetrics) under the multidisciplinary cooperation mode, which also had the therapeutic effect on anxiety and depression of pregnant women. Treating PSD in pregnancy only by using single intervention measure of one of three measures of PPM treatment had poor therapeutic effect.