κ阿片受体在焦虑症中作用的研究进展

焦虑症,又称为焦虑性神经症,属常见精神疾病,可通过压力引发,常伴随于抑郁症和药物滥用。焦虑症发病机制目前尚未明了,同时现有的抗焦虑药物因共济失调、嗜睡、认知障碍等不必要的不良反应,使之对焦虑患者的治疗效果并不显著。强啡肽/κ阿片受体在焦虑症的发生过程中具有重要作用,本文将通过现有的临床前动物模型数据来概述强啡肽/κ阿片受体在焦虑症中的作用,以期为以后研究焦虑症的学者提供参考。     

焦虑症和高血压病共病患者30例临床分析

目的探讨焦虑症和高血压病共病患者的临床特征方法使用自制的一般情况调查表,收集30例焦虑症和高血压病共患者和30例同期住院的单纯焦虑症患者的社会人口学资料病情特征资料及HAMA焦虑量表总分进行统计分析结果焦虑症和高血压病共病患者的平均发病次数、平均病程、平均住院日及平均年龄显著高于单纯焦虑症患者,焦虑症和高血压病共病患者的临床症状显著重于单纯焦虑症患者,焦虑症和高血压病共病患者的出院疗效显著差于单纯焦虑症患者。结论焦虑症和高血压病共病患者的临床症状重、治疗疗效差,易复发。     

中医论治中风后焦虑症的临床研究进展

中风后焦虑症是一种发病率较高的中风后遗症,该疾病的诱发原因目前仍未完全明确,且临床治疗方法较多,因而中风后焦虑症患者的临床治疗和康复越来越受到临床医师的关注。随着近年来临床上对于中风后焦虑症研究的逐渐深入,关于该疾病的治疗方法、影响因素和发病原因等都取得了明显发展。就中医论治中风后焦虑症的临床研究进展进行了分析,现报道如下。     

西酞普兰联合抗焦虑药治疗重度焦虑症的疗效观察

重度焦虑症是一种以严重焦虑情绪为主要表现的神经症，常伴有头晕、胸闷、心悸、呼吸困难、口干、尿频、尿急、出汗、震颤和运动性不安等，焦虑并非实际威胁所引起，其紧张程度与现实情况不相称。在我国由于多种原因致焦虑症始终未受到足够重视，直到1981年，我国的分类方案才将此单独列出。近年来随着焦虑症发病率的逐渐升高，我国对焦虑症的认识和治疗也有了较大发展，     

冠心病、瓣膜病合并焦虑症患者的诊疗分析

目的分析冠心病与瓣膜病合并焦虑症患者的诊治特点。方法统计分析冠心病合并焦虑症患者172例,瓣膜病合并焦虑症患者84例。患者经汉密尔顿焦虑量表(HAMA)评分,确诊并行抗焦虑治疗。结果行抗焦虑治疗患者,围术期焦虑症状控制满意,术后6个月焦虑症基本痊愈;未行抗焦虑治疗的轻症患者,围术期焦虑症加重,术后6个月焦虑症无改善,未行抗焦虑治疗的中度焦虑症患者,焦虑症持续加重,未行手术治疗,最终心脏功能失代偿死亡。结论心血管病合并焦虑症的早期诊断、积极的药物、心理、手术的综合治疗,对于此类患者的围手术期处理及预后有重要意义。     

口腔门诊患者牙科焦虑症的调查分析

目的研究口腔门诊患者牙科焦虑症发生的情况,探讨与牙科焦虑症发生的相关因素,为牙科焦虑症的预防和治疗提供临床依据。方法采用改良式牙科焦虑量表对200例口腔门诊患者进行牙科焦虑症调查,并对相关因素进行分析。结果牙科焦虑症的发生与患者的学历和初复诊相关,其中不同学历患者以及初诊、复诊患者DA的比较有统计学意义(P<0.05),而不同性别患者和有无牙科就诊经历患者DA的比较无统计学意义(P>0.05)。结论牙科焦虑症在临床中常见,不同学历、初诊或复诊、对牙科焦虑症的发生均有影响。     

语言沟通及心理护理在焦虑症患者护理中的效果观察

目的探究语言沟通及心理护理在焦虑症患者护理中的应用效果。方法选取我院收治的焦虑症患者84例(收治时间为2017年1月1日至2018年1月1日期间),将其依据护理模式的不同作为分组条件,将84例焦虑症患者分为对照组(42例)、观察组(42例)。其中对照组焦虑症患者在给予药物治疗的基础上,给予常规护理模式;而观察组焦虑症患者中,在对照组的基础上,加以语言沟通、心理护理。对比2组焦虑症患者的焦虑、抑郁自评量表以及护理满意度。结果护理前,观察组焦虑症患者和对照组焦虑症患者的SAS评分对比结果并无太大的差异性(P>0.05)。但是经过护理干预后,观察组焦虑症患者不良情绪得到明显的改善,与对照组相比SAS、SDS评分下降程度较高,差异具有统计学意义:P<0.05。两组焦虑症患者的护理满意度评分差异同样具有临床意义,组间数据具有对比性:P<0.05。结论对于焦虑症患者而言,虽然应用药物治疗能起到一定的临床作用,但是通过护理服务,利用语言、心理护理从而改善患者的病情,使得患者不断的自我调整,恢复健康。     

抗焦虑天然药物研究进展

焦虑症是一种由中枢神经系统功能紊乱引起的常见精神疾病,由于近年来发病率不断增高,引起社会的广泛关注。目前临床上常用的西药在治疗焦虑症时存在不良反应多、依赖性强、易复发等缺点;而天然药物具有疗效明显、毒副作用小等优点,能够很好地避免西药治疗焦虑症的诸多不足,因此成为当前研发抗焦虑新药的热点。对近年来国内外抗焦虑天然药物,尤其是单味药研究的最新进展进行了综述,以便为进一步的研究工作提供理论依据。     

北京市中学生焦虑症状况调查

目的调查北京市中学生人群焦虑症情况。方法利用微信"问卷星"问卷调查平台,对北京市地区中学生人群进行了调查研究,所有提交问卷调查IP地址均来自北京市区内。结果共完成226份中学生调查资料,包括初中生38人与高中生188人,年龄12~18周岁。96.9%(219/226)的人了解焦虑症,3.1%(7/226)的人不了解焦虑症。79.6%(180/226)认为自己有焦虑症,20.4%(46/226)认为自己没有焦虑症。存在焦虑症(SAS≥50分)的人数为30人,占13.3%。全组调查学生的SAS范围25~76分,平均(39.43±0.65)分。初中组SAS均值(39.11±1.88)分,高中组均值(39.49±0.68)分,组间无统计学意义(P0.05)。结论焦虑症是中学生最常见的心理疾病,学习压力是中学生产生焦虑症的主要原因,其他原因包括过度的自尊及自卑心理,家庭环境等因素。社会各界需要更多关注青少年焦虑症。     

误为心绞痛发作的焦虑性障碍

焦虑症常伴有心悸、胸闷、气短、出汗、尿频、尿急、面色苍白等植物神经症状。现将近几年神经内科接诊的、因明显心血管系统症状而被误诊为心绞痛发作的焦虑症患者资料报告如下。     

An evaluation of paroxetine in generalised social anxiety disorder

It is estimated that social anxiety disorder affects approximately 13.3% individuals within the community at some point in their lifetime and is associated with significant functional impairment. A variety of drug groups have demonstrated efficacy in treating social anxiety disorder, including selective serotonin reuptake inhibitors (SSRIs). Paroxetine is an SSRI approved by the FDA and Health Canada for the treatment of a variety of psychiatric conditions. Paroxetine has been the most studied agent in social anxiety disorder and has been shown to be effective in short-term, fixed- and flexible-dose placebo-controlled trials, as well as in long-term treatment. The pharmacotherapy of social phobia will be reviewed, with a special focus on investigations with paroxetine.     

Selective serotonin reuptake inhibitors in the treatment of paediatric anxiety disorders: a review

Anxiety disorders (obsessive-compulsive disorder, social phobia/selective mutism, panic disorder, separation anxiety, generalized anxiety disorder, simple phobia and post-traumatic stress disorder) are the most prevalent psychiatric disorders in children and adolescents. The selective serotonin reuptake inhibitors (SSRIs)--citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline--have demonstrated efficacy in treating anxiety disorders in adults. Although less information is available on the use of these agents in the paediatric population, research into the SSRIs for childhood anxiety disorders is increasing. This article reviews current literature, including case reports as well as open and controlled trials, on the effectiveness and tolerability of the SSRIs in the paediatric population. It also discusses developmental differences in children that should be considered in the utilisation of the SSRIs in paediatric patients.     

艾司西酞普兰治疗焦虑症、抑郁症的疗效观察

目的观察艾司西酞普兰治疗焦虑症及抑郁症的疗效。方法对焦虑症和抑郁症患者各50例(分别为焦虑症组和抑郁症组)进行艾司西酞普兰6周开放性治疗,剂量10~15mg/d。治疗后比较2组疗效及汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)评分,并观察不良反应。结果焦虑症组总有效率为79.6%,抑郁症组总有效率为82.0%,2组差异无统计学意义(P>0.05)。2组治疗后HAMD、HAMA评分均改善(P<0.01),且2组间治疗前后HAMD、HAMA评分比较差异无统计学意义(P>0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。且不良反应轻微。结论艾司西酞普兰治疗焦虑症与抑郁症同样有效,可视为一种抗焦虑症的有效药物。     

An evidence-based review of the clinical use of sertraline in mood and anxiety disorders

Sertraline is a selective serotonin reuptake inhibitor that has been used and studied extensively throughout the world and found to be safe and well tolerated in numerous patient populations, including those with either psychiatric and/or medical comorbidities. Randomized clinical trials have shown that it is an effective treatment for depressive and anxiety disorders and its efficacy is unaffected by psychiatric comorbidity. In non-comorbid patients, sertraline is effective for the acute treatment of major depressive disorders and prevention of relapse or recurrence. It is effective for acute treatment and longer-term management of social anxiety disorder, posttraumatic stress disorder,panic disorder, and generalized anxiety disorder. In adults and in pediatric patients, it is an effective short-term and long-term treatment for obsessive compulsive disorder.Sertraline has a good tolerability profile and has low fatal toxicity. In summary, sertraline is as effective as other antidepressants over a wide range of indications but may offer tolerability benefits as well as efficacy in patients with psychiatric and/or medical comorbidities and certain subtypes of depression.     

Generalized anxiety disorder: comorbidity,comparative biology and treatment

Generalized anxiety disorder (GAD) is a severe and chronic anxiety disorder characterized by uncontrollable worrying and somatic anxiety (tension, insomnia and hypervigilance). It is a common condition, with lifetime prevalence rates for DSM-IV GAD in the general population of approx. 5-6% being reported. In addition, like other anxiety disorders, GAD also shows comorbidity with depression and most of the other anxiety disorders. This article reviews data on the prevalence of GAD, its comorbidity with depression, and its social and economic impact. Proposed neurobiological mechanisms for GAD are discussed, since an understanding of these may help in the development of future therapies. Finally, current pharmacological and non-pharmacological treatment options for GAD are reviewed, with particular attention being paid to published clinical-trial data.     

基于UHPLC-Q-Exactive Orbitrap MS和网络药理学探讨归脾丸抗焦虑作用机制

目的 阐明归脾丸中的化学成分,并初步探究其抗焦虑作用机制。方法 采用超高效液相色谱-四极杆-静电场轨道阱高分辨质谱(UHPLC-Q-Exactive Orbitrap MS)技术对归脾丸中化学成分进行准确定性,并结合网络药理学和分子对接分析归脾丸抗焦虑的重要成分、关键靶点及通路。结果 鉴定出苯丙素类、黄酮及其苷类、萜类及其苷类、生物碱类、有机酸类、挥发油类、寡糖酯类、氨基酸类、其他类等9类共116种化合物,网络药理学和分子对接深入挖掘得到归脾丸抗焦虑的9个重要成分、10个核心靶点和15条焦虑症相关信号通路。结论 预测归脾丸可能通过调节5-HT、GABA等神经递质的水平,HPA、HPG等内分泌系统以及降低炎症因子的表达发挥抗焦虑作用,充分体现了多成分、多靶点、多通路协同作用发挥抗焦虑作用的特点。     

A major change of prescribing pattern in absence of adequate evidence: benzodiazepines versus newer antidepressants in anxiety disorders

We performed a systematic review of controlled trials on anxiety disorders treatment (generalized anxiety disorder, panic disorder, social phobia and post-traumatic stress disorder) published from 1980 to 2006, and identified trials comparing the efficacy of benzodiazepines (BZD) with that of antidepressants, in particular comparisons between BZD and newer antidepressants. Among 969 publications, 274 double-blind randomized controlled studies remained after using our exclusion criteria. These studies comprised altogether 439 comparisons. There were in total 23 comparisons of antidepressants versus BZD. Among these, 22 compared the efficacy of older antidepressants versus BZD, whereas only 1 concerned the comparison of a newer antidepressant versus BZD. It showed comparable efficacy between venlafaxine and diazepam in the treatment of generalized anxiety disorder. Our study shows that the major change of prescribing pattern from BZD to newer antidepressants in anxiety disorders has occurred in absence of comparative data of high level of proof.     

A review of the epidemiology and approaches to the treatment of social anxiety disorder

This review presents current literature on the epidemiology and treatment of social anxiety disorder (social phobia). This illness has been demonstrated to be the most common anxiety disorder with a 1-year prevalence of 7 to 8% and a lifetime prevalence of 13 to 14% in patients aged between 15 and 54 years. Social anxiety disorder can be classified into 2 subtypes, discrete and generalised. Morbidity is high with this disorder, and 70 to 80% of patients have co-morbid mental disorders. Although effective treatments are available, social anxiety disorder is under-recognised and under-treated. Treatments that have been systemically studied and have shown efficacy in patients with social anxiety disorder include pharmacotherapy (selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, reversible inhibitors of monoamine-A and benzodiazepines) and short term psychotherapies (cognitive behaviour therapy, social skills training and exposure in vivo therapy). Beta-blockers are useful in treating performance-related anxiety. Few published data are available on the treatment of social anxiety disorder with a combination of pharmacotherapy and psychotherapy. We conclude this review by discussing proposed algorithms for treating both subtypes of social anxiety disorder.     

Recognizing the patient with social anxiety disorder

Social anxiety disorder is a prevalent and highly disabling condition, affecting 7-13% of the population at some point in their lives. Most sufferers are not diagnosed however, even after visiting a healthcare professional. Social anxiety disorder need not be a difficult condition to diagnose. Characteristic features of the disorder include blushing as the principal symptom and an early age of onset. Social anxiety disorder is also easily distinguished from other anxiety disorders by the situations in which patients experience fear and avoidance; for the patient with social anxiety disorder, these situations always involve social interaction or scrutiny by other people. The consequences of untreated social anxiety disorder include social isolation, impaired educational attainment and career progression, depression, and alcohol abuse. Rating scales such as the Liebowitz Social Anxiety Scale (LSAS) give a consistent measure of severity of social anxiety disorder and so help physicians assess their patients' need for treatment and their improvement. Social anxiety disorder is an eminently treatable condition, as demonstrated by treatment-induced reduction in LSAS scores in clinical trials and by individual case histories. Appropriate therapy can give patients relief from their distressing and disabling symptoms and allows them to make substantial improvements to their quality of life.