天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (6): 669-673.doi: 10.11958/j.issn.0253-9896.2015.06.025

• 药物临床观察 • 上一篇    下一篇

草酸艾司西酞普兰辅助心理干预对冠心病并发抑郁症的疗效分析

李艳鑫 1， 王宪沛 1， 2， 李文 1， 曹虹 1， 陈鲁玉 1   

  1. 1河南省胸科医院心内科 （邮编 450000）； 2河南省人民医院心内科
  • 收稿日期:2014-11-28 修回日期:2015-01-13 出版日期:2015-06-15 发布日期:2015-06-10
  • 通讯作者: 李艳鑫 E-mail:1280545675@qq.com
  • 基金资助:
    国家自然科学基金项目 （U1204801)； 河南省科技厅科技攻关项目(142102310427)

Analysis of auxiliary effect of oxalic acid Ai Sciplan auxiliary effect assisted with psychological#br# intervention on coronary heart disease complicated with depression

LI Yanxin1, WANG Xianpei1,2, LI Wen1, CAO Hong1, CHEN Luyu1   

  1. 1 Henan Provincial Chest Hospital, Zhengzhou 450000, China； 2 Henan Province People’ s Hospital

  • Received:2014-11-28 Revised:2015-01-13 Published:2015-06-15 Online:2015-06-10

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摘要：

目的 探析草酸艾司西酞普兰辅助心理疗法治疗冠心病并发抑郁症的疗效及预后。方法 将 136 例冠心病合并抑郁症患者随机均分为对照组和研究组。对照组给予常规药物治疗， 研究组在此基础上加用草酸艾司西酞普兰并辅以心理疗法， 疗程 6 个月。治疗前、 治疗 1 周、 1 个月、 3 个月、 6 个月时采用 HAMD 量表测定 HAMD 评分。治疗前和治疗 6 个月后， 采用循环酶法检测同型半胱氨酸（Hcy）、 超敏 C 反应蛋白（hs-CRP）水平； 采用世界卫生组织生活质量评定量表（WHOQOL-BREF）评估患者生存质量。治疗 6 个月后， 评估患者心绞痛和抑郁症状改善情况。并随访患者心血管事件发生情况。结果 2 组 HAMD 评分在治疗后均呈下降趋势， 其中研究组治疗后各时点 HAMD 评分均低于治疗前； 对照组除治疗后 1 周与治疗前差异无统计学意义外， 其余时点均低于治疗前； 治疗后各时点研究组均低于对照组。2 组治疗后 Hcy、 hs-CRP 水平较治疗前下降， 且研究组低于对照组。2 组治疗后WHOQOL-BREF 量表生理健康、 心理状态、 社会关系、 周围环境的评分均高于治疗前， 研究组均高于对照组。研究组心绞痛、 抑郁症状改善情况均优于对照组， 心绞痛、 心肌梗死、 心律失常、 心力衰竭、 心源性猝死等心血管事件发生率明显低于对照组 （χ2=9.396， P < 0.05）。结论 草酸艾司西酞普兰联合心理疗法治疗冠心病合并抑郁症疗效显著， 预后较好。

关键词: 冠心病, 抑郁症, 心理疗法, 治疗结果, 预后, 草酸艾司西酞普兰

Abstract: 　Objective To investigate the curative effects of oxalic acid Ai Sciplan in assisting psychological therapy for coronary heart disease accompanied with depression. Methods A total of 136 patients of coronary heart disease with depression were randomly divided into control group and treatment group. The routine drug treatment was given to control group. Treatment group was given oxalic acid Ai Sciplan which is assisted by the psychological therapy based on the routine drug treatment schedule for six months. HAMD score before treatment, one-week, one-month, 3-month and 6-month after treatment were compared between two groups. Homocysteine (Hcy) and high sensitive C reactive protein (hs- CRP) levels were detected by circulating enzymatic method before treatment and 6- month after treatment. The WHO quality of life scale (WHOQOL-BREF) was used to assess the quality of life in two groups of patients. The improvements of angina and depressive symptoms were evaluated after 6-month treatment. The cardiovascular events were followed up in two groups. Results HAMD scores significantly decreased after treatment in both groups (P < 0.05). HAMD scores at all different time points were significantly lower after treatment than those before treatment in treatment group. In control group, HAMD scores at different time points were also significantly lower after treatment than those before treatment, except time point of one week after treatment. The levels of Hcy and hs-CRP were decreased after treatment in two groups, and the levels were lower in treatment group than those of control group. Values of WHOQOL-BREF score, mental status, social relations and the sur⁃
rounding environment scores were higher after treatment in both groups. Also they are higher in treatment group than that of control group. The angina and depressive symptoms were improved in treatment group. The incidences of angina, myocardial infarction, arrhythmia, heart failure, sudden cardiac death and other cardiovascular events were significantly lower in treatment group than those of control group (χ2=9.396, P < 0.05). Conclusion Escitalopram oxalate combined with psychological therapy shows a significant beneficial effect and a better prognosis in the treatment of coronary heart disease and depression.

Key words: coronary disease, depressive disorder, psychotherapy, treatment outcome, prognosis, oxalic acid Ai Sciplan