疏肝解郁安神法联合“双心”医学模式对PCI术后焦虑抑郁的影响

目的:观察疏肝解郁安神法联合"双心"医学模式对冠心病经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后焦虑抑郁(以下简称双心)患者的临床疗效。方法:选择冠心病PCI术后伴抑郁和/或焦虑的患者120例,随机分为对照组、双心组及中药组,每组40例,3组均给予PCI术后规范化治疗,双心组在规范化治疗基础上口服盐酸帕罗西汀片,同时给予健康教育、心理治疗、运动疗法等非药物干预;中药组在双心组治疗基础上联合疏肝解郁安神中药膏方,疗程12周;比较3组治疗前后在临床症状、心绞痛发作频率及最长持续时间,焦虑自评量表(self-rating anxiety scale,SAS)评分或抑郁自评量表(self-rating depression scale,SDS)评分的变化,评估其临床疗效。结果:治疗8周后中药组和双心组患者临床症状改善明显,中药组有效率为87.5%,双心组有效率为72.5%,均明显高于对照组的12.5%,差异有统计学意义(P0.01),其中中药组优于双心组,两组比较差异有统计学意义(P0.05);治疗后中药组和双心组心绞痛发作的频率及持续时间减少,比较差异有统计学意义(P0.05);治疗后中药组和双心组患者SAS、SDS评分较对照组均降低,差异有统计学意义(P0.05)。结论:疏肝解郁安神法联合双心疗法可明显减少冠心病PCI术后双心患者心绞痛的发作次数、缓解其焦虑抑郁程度。

The Influence of Soothing the Liver to Relieve Depression and Tranquilizing the Mind in Combination with "Double Heart" Medical Model on Anxiety and Depression after PCI

Objective:To observe the clinical curative effect of soothing the liver to relieve depression and tranquilizing the mind in combination with "double heart" medical model on anxiety and depression(hereinafter referred to as) after percutaneous coronary intervention(PCI).Methods:One hundred and twenty patients with anxiety and/or depression after PCI,and randomly divided into the control group,the double heart group and Chinese medicine group,with 40 cases in each group.All the patients in the 3 groups were given standardized treatment after PCI,while the ones in the double heart group were added Paroxetine Hydrochloride Tablets,together with health education,psychological therapy,exercise therapy and other non drug intervention at the same time.The ones in Chinese medicine group were added paste of soothing the liver to relieve depression and tranquilizing the mind based on the treatment of the double heart group.The course lasted for 12 weeks,then the 3 groups' changes of clinical symptoms,angina frequency and duration,self-rating anxiety scale(SAS) scores,self-rating depression scale(SDS) scores before and after the treatment were compared,and their clinical curative effects were estimated.Results:After 8 weeks' treatment,the clinical symptoms in Chinese medicine treatment group and the double heart were significantly improved.The effective rate of the Chinese medicine group was 87.5％,while that of the double heart group was 72.5％,which was significantly higher than the control group's 12.5％,the difference was statistically significant (P ＜ 0.01);The Chinese medicine group was better than the double heart group,the difference between the two groups was statistically significant(P ＜ 0.05).After the treatment,angina attack frequency and duration in Chinese medicine treatment group and the double heart were reduced;The Chinese medicine group was better than the double heart group,the difference between the two groups was statistically significant(P ＜ 0.05).The SAA and SDS scores in Chinese medicine treatment group and the double heart were reduced compared with the control group;The Chinese medicine group was better than the double heart group,the difference between the two groups was statistically significant (P ＜ 0.05).Conclusion:Method of soothing the liver to relieve depression and tranquilizing the mind in combination with "double heart" medical model has a remarkable clinical curative effect on reducing the frequency of angina pectoris and the degree of anxiety and depression in patients with coronary heart disease after PCI.