度洛西汀合并菩提树放松治疗广泛性焦虑障碍的疗效及心率变异性的改变

目的：观察度洛西汀合并菩提树放松技术治疗广泛性焦虑障碍（GAD）的疗效及对心率变异性的影响。方法2013年3月～2014年3月间，根据ICD-10中GAD诊断标准选择124例GAD患者作为研究对象，利用随机数字表分为干预组（n＝62）和对照组（n＝62）。干预组固定接受度洛西汀（20mg／d）合并菩提树放松治疗，2次／周，连续8周；对照组仅接受度洛西汀（20mg／d）治疗。分别于干预前和干预后第2、4、6、8周末用SAS、HAMA评定疗效，用治疗中需处理的不良反应症状量表（ TESS）评定药物的不良反应，对心率变异性（heart rate variability，HRV）的低频（low frequency，LF）与高频（high frequency，HF ）比值（LF／HF）进行观察。结果1．两组干预后SAS和HAMA评分较干预前显著降低干预前：对照组（63．52×14．25）分，（30．26×11．25）分，干预组（64．35×14．33）分，（29．83×10．85）分，干预8周后：对照组（30．23×6．68）分，（9．28×3．20）分，干预组（25．14×5．59）分，（7．70×2．87）分]（均P＜0．05）。组间疗效差异有统计学意义（χ^2=4．09， P＜0．05），两组不良反应差异无统计学意义（P＞0．05）。2．干预组LF／HF较对照组减低，特别是第13，14，15，16次干预后，两组间差异有统计学意义（ t 13-16＝－2．806，－2．725，－3．572，－2．272；P 13-16＝0．006，0．007，0．001，0．025），焦虑严重指数值与LF／HF值呈显著正相关（ r＝0．342， P＜0．05）。结论度洛西汀合并菩提树放松技术能有效提高GAD患者的心率变异性，疗效更好。

Efficacy of duloxetine combined with Bodhi Tree relaxation technique in the treatment of the generalized anxiety disorder and influence of heart rate variability

Objective To observe the efficacy of duloxetine combined with Bodhi Tree relaxation tech-nique in the treatment of generalized anxiety disorder （ GAD ） and the influence of heart rate variability （ HRV ） . Methods According to the standard of ICD-10,124 GADs were selected as study objects from March 2013 to March 2014. They were randomly divided into intervention group and control group. The intervention group fixedly received duloxetine （ 20 mg/day） and Bodhi Tree relaxation therapy,2 times / week,for 8 weeks;and the control group received only Duloxetine （20 mg/day） treatment. All patients were assessed with SAS,HAMA and Treat-ment Emergent Symptom Scale（ TESS） at the baseline and at the end of the 2nd ,4th ,6th ,8th week of the treatment to evaluate the efficacy and side effects. The LF/HF of HRV were observed. Results 1.In both groups,SAS score and HAMA score remarkably decreased after intervention than before treatment（ before intervention：control group （63.52×14.25,30.26×11.25） intervention group （64.35×14.33,29.83×10.85）;after 8 weeks：control group （30.23×6.68,9.28×3.20） intervention group （25.14×5.59,7.70×2.87）, P〈0.05）. There was statistical signifi-cant between the two groups in the therapeutic effects （χ^2=4.09, P〈0.05） ,and no significant difference between the two groups on the TESS （P〉0.05）. 2. The ratio of LF/HF showed significantly decrease in the intervention group than those in the control groupt 13-16=-2.806,-2.725,-3.572,-2.272;P13-16=0.006,0.007,0.001,0.025）.The value of anxiety se-verity index and LF/HF was positively correlated （ r=0.342, P〈0.05）.Conclusion Duloxetine combined with Bodhi Tree relaxation technique can effectively improve the heart rate variability in patients,curative effect is better.