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目的:探讨认知行为疗法对肺结核患者心理压力的减轻作用及对其生命质量的影响。方法:按照两水平的整群随机设计原则，于2018年9—11月，共纳入20个社区卫生服务中心的461例肺结核患者，将其整群随机分配至干预组和对照组，干预组进行2个月的认知行为疗法干预，对照组进行常规随访。分别失访3和4例，最终纳入454例，分别为230和224例。比较两组患者焦虑、抑郁及生命质量评分的差异，焦虑、抑郁及生命质量的评价分别采用广泛焦虑量表（GAD-7）、患者健康问卷（PHQ-9）及36条目简短生命质量（SF-36）量表。同时期两组患者比较采用独立样本n t检验，同组患者干预前后的比较采用配对样本n t检验。n 结果:（1）干预组患者干预后焦虑、抑郁评分低于干预前，差异均有统计学意义［GAD-7量表评分：（5.93±2.56）分比（7.57±5.27）分，n t=-4.245，n P<0.01；PHQ-9评分：（6.02±2.67）分比（8.13±6.01）分，n t=-4.866，n P<0.01］；生命质量评分高于干预前，差异有统计学意义［（74.31±13.22）分比（58.46±12.71）分，n t=13.108，n P0.05）］。（2）不同焦虑、抑郁程度患者中，干预组轻、中度焦虑患者干预前GAD-7量表评分分别为（7.29±1.21）、（11.99±1.31）分，干预后分别为（5.54±1.71）、（9.17±1.55）分；干预组轻、中度抑郁患者干预前PHQ-9评分分别为（7.01±1.47）、（11.88±1.12）分，干预后分别为（4.42±1.22）、（8.39±2.33）分。仅干预组轻度和中度焦虑或抑郁患者GAD-7量表评分、PHQ-9评分低于本组干预前，差异有统计学意义（轻度焦虑者GAD-7量表评分：n t=8.056；中度焦虑者GAD-7量表评分：n t=10.020；轻度抑郁者PHQ-9评分：n t=13.558；中度抑郁者PHQ-9评分：n t=8.852，均n P<0.01）。n 结论:认知行为疗法可以减轻有轻度焦虑、抑郁症状的肺结核病患者的心理压力，改善患者的生命质量。“,”Objective:To explore the effect of cognitive-behavioral therapy on psychological stress and quality of life in patients with pulmonary tuberculosis.Methods:According to two-level cluster random design 461 patients with tuberculosis from 20 communities in Pizhou county of Jiangsu province were selected in the study from September 2018 to November 2018. The intervention group received cognitive-behavioral therapy for two months, while control group received routine follow-up. Anxiety, depression and quality of life were assessed by GAD-7, PHQ-9 and SF-36 scales, respectively. At the same time, the comparison between the two groups was conducted by independent samplen t test, and the difference between the two groups before and after treatment was analyzed by paired sample n ttest.n Results:A total of 454 participants were finally included in this analysis; there were 230 cases in the intervention group and 224 cases in the control group. In the intervention group the scores of anxiety and depression after intervention were significantly lower than the baseline scores [(7.57±5.27)n vs. (5.93±2.56), n t=-4.245, n P<0.01; (8.13±6.01)n vs. (6.02±2.67);n t=-4.866, n P<0.01], and the quality of life score was significantly higher than the baseline score [(58.46±12.71)n vs. (74.31±13.22); n t=13.108, n P0.05]. However, only for patients with mild and moderate anxiety and depression symptoms in the intervention group, the anxiety and depression scores were decreased after intervention [(7.29±1.21)n vs. (5.54±1.71), (11.99±1.31) n vs. (9.17±1.55); (7.01±1.47) n vs. (4.42±1.22), (11.88±1.12) n vs. (8.39±2.33);n t=8.056, n t=10.020, n t=13.558, n t=8.852,all n P<0.01].n Conclusion:Cognitive-behavioral therapy can relieve the psychological pressure and improve the quality of life in pulmonary tuberculosis patients with mild or moderate anxiety/depression symptoms.