冠心病相关抑郁症的中西医结合治疗研究

目的: 观察以益气活血解郁立法，以自拟通心解郁方治疗冠心病相关抑郁症的临床疗效。方法:选取冠心病相关抑郁症患者70例。随机分为中药组与对照组各35例。中药组采用通心解郁方加减，对照组采用氟西汀，两组均维持冠心病基础西药治疗，以8周为一个疗程。观察病人治疗前后相关症状证候、心电图、汉密尔顿抑郁量表评分（HAMD）、抑郁自评量表评分（SDS）及中医单项症状积分的变化。结果：两组病例在心绞痛疗效、证候疗效、HAM和SDS量表评分，以及中医单项症状疗效评分方面，较治疗前均有明显差异（P<0.05），并且中药组优于对照组。结论：两种方法均能改善患者的抑郁症状，并且中药组优于对照组；中药组在改善冠心病心绞痛症状的同时，还能够改善患者全身其他症状，并能改善抑郁症评分，减轻患者抑郁症状，降低抑郁症对冠心病的影响，表明中医药治疗治疗冠心病相关抑郁症具有明显的优势。

Coronary Heart Disease-Related Depression Integrative Medicine Research

Objective:To assess the clinical efficacy of Tongxinjieyufang in treating coronary heartdisease-related depression. Methods:70 coronary heart disease patients with comorbid depression were randomly assigned into two groups: 35 for traditional Chinese medicine group treated with Tongxijieyufang and 35 for control group treated with fluoxetine. Both groups were maintained with their regular coronary heart disease pharmacotherapies. The study course was 8 weeks and the patient symptoms, electrocardiographic changes, hamilton depression rating scale (HAMD), self-rating depression scale score (SDS) and traditional Chinese medicine (TCM) single symptom score were assessed before and after treatment. Results: Both groups demonstrated significant improvements (P<0.05) on measures of angina pectoris, HAMD and SDS scores, the efficacy of TCM symptom score individual aspects, the Tongxinjieyufang group had better improvements than fluoxetine group. Conclusions: Both treatments improved depressive symptoms, with Tongxinjieyufang group showing a bigger improvement. Tongxinjieyufang not only improved the symptoms of angina pectoris, but also improved depression scores, reduced the impact of depression on coronary heart disease, suggesting that traditional Chinese medicine has obvious advantage in the treatment of coronary heart disease-related depression.