稳定期慢性阻塞性肺疾病合并抑郁焦虑综合性干预的临床探讨

目的：探讨对稳定期慢性阻塞性肺疾病（COPD）合并抑郁焦虑的患者进行抗抑郁焦虑综合性干预的作用。方法：随机将68例COPD合并抑郁焦虑患者分为两组，对照组仅予常规治疗，治疗组在常规治疗基础上加以帕罗西汀12＂服及综合性干预，并随访1年，收集两组患者1年前后抑郁焦虑评分：两组患者1年前后肺功能、ACT评分、6rain步行距离并得出各自差值；收集两组当年急性发作次数，进行各自统计学分析。结果：治疗组1年后抑郁焦虑评分明显减低（P〈0．001），对照组无改善（P〉0．05）；治疗组肺功能、ACT评分、6min步行距离1年前后差值较对照组有显著差异（P〈0．05），当年急性发作次数治疗组较对照组明显减少（P〈0．05）。结论：对COPD稳定期合并抑郁焦虑进行综合性干预可改善患者的肺功能．提高运动耐力．减少急性加重次数，从而减少患者的住院率及医疗负担。

Effects of integrated intervention on depression and anxiety in clinically stable chronic obstructive pulmonary disease

Objective： To investigate the effects of integrated intervention on depression and anxiety in patients with clinically stable chronic obstructive pulmonary disease （COPD）. Methods： Sixty-eight COPD patients with depression and anxiety were randomly assigned to receive usual treatment （control group ） or in combination with paroxetine and integrated intervention （ treatment group）. This entailed assessment of anxiety and depression, lung function, ACT score, 6-minute-walk test and the number acute exacerbations prior to and following a 1-year therapy. Results： Treatment group, but not control group, had a marked improvement in depression and anxiety score （ both P 〈 0.05 ）. Treatment group yielded a statistically significant difference in pulmonary function, ACT score and 6-minute-walk test and the number of acute exacerbations within the treatment period （ all P 〈 0.05 ） . Conclusion ： Integrated intervention on depression and anxiety significantly improves pulmonary function and exercise tolerance and reduces the number of acute exacerbations leading to diminished hospitalization and medical costs in clinically stable COPD patients with depression and anxiety.