艾司西酞普兰联合综合心理干预治疗慢性阻塞性肺疾病合并焦虑抑郁疗效观察

目的观察艾司西酞普兰联合综合心理干预治疗慢性阻塞性肺疾病(COPD)合并焦虑抑郁患者的疗效。方法将2018年5—10月江门市第三人民医院诊治的60例COPD合并焦虑抑郁患者随机分为干预组及对照组各30例,所有入组者予COPD常规药物治疗,干预组在此基础上予艾司西酞普兰联合综合心理干预,采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评估2组患者焦虑、抑郁状况,慢性阻塞性肺疾病评估测试(CAT)量表评估COPD对患者健康及预后影响严重程度,比较2组患者治疗前及治疗1个月、3个月、6个月后HAMA评分、HAMD评分、CAT评分,分析治疗6个月内2组患者慢性阻塞性肺病急性加重率,应用TESS不良反应量表监测药物不良反应。结果治疗前2组HAMA评分、HAMD评分、CAT评分比较差异均无统计学意义(P均>0.05);治疗1,3,6个月后2组HAMA评分、HAMD评分、CAT评分均明显下降(P均<0.05),且干预组HAMA评分、HAMD评分、CAT评分均明显低于对照组(P均<0.05);6个月内干预组患者COPD急性加重率3.3%(1/30)明显低于对照组23.3%(14/30),差异有统计学意义(P<0.05);干预组药物不良反应总发生率40.0%(12/30)与对照组36.7%(11/30)比较差异无统计学意义(P>0.05)。结论艾司西酞普兰联合综合心理干预不仅可有效缓解COPD患者的焦虑抑郁情绪,提高患者生活质量,还可降低COPD急性加重率,且药物安全性好。

Observation on the curative effect of escitalopram combined with comprehensive psychological intervention on COPD combined with anxiety and depression

Objective It is to observe the curative effect of escitalopram combined with comprehensive psychological intervention in patients with chronic obstructive pulmonary disease(COPD)combined with anxiety and depression.Methods 60 patients with COPD combined with anxiety and depression who were hospitalized and treated in the Third People’s Hospital of Jiangmen from May 2018 to October 2018 were randomly divided into an intervention group and a control group,30 patients in each group.All the enrolled patients were given conventional therapy for COPD,and the intervention group was given escitalopram combined with comprehensive psychological intervention based on the control group.The anxiety and depression of the patients in the two groups were evaluated by Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),and the severity of the impact of COPD on the health and prognosis of the patients was evaluated by chronic obstructive pulmonary disease evaluation test(CAT)scale.The HAMA scores,HAMD scores,and CAT scores were compared before treatment and after treatment for 1 month,3 months and 6 months between the two groups.The acute exacerbation rate of COPD in the two groups was analyzed within 6 months of treatment.The TESS Adverse Reaction Scale was used to monitor adverse drug reactions.Results There was no significant difference in HAMA score,HAMD score,and CAT score between the two groups before treatment(P>0.05);HAMA scores,HAMD scores,and CAT scores of the two groups were decreased significantly after treatment for 1,3,and 6 months(P<0.05),and the HAMA scores,HAMD scores,and CAT scores of the intervention group were significantly lower than those of the control group(P<0.05).The acute exacerbation rate of COPD within 6 months in the intervention group was 3.3%(1/30),which was significantly lower than that 23.3%(14/30)in the control group(P<0.05).The total incidence of adverse drug reactions in the intervention group was 40.0%(12/30),which was not statistically different from that 36.7%(11/30)in the control group 36.7(P>0.05).Conclusion Escitalopram combined with comprehensive psychological intervention can not only effectively relieve the anxiety and depression,improve the quality of life of patients with COPD,but also reduce the acute exacerbation rate of COPD,and the drug safety is good.