老年慢性阻塞性肺病合并抑郁焦虑患者的药物与心理治疗

目的:探讨老年慢性阻塞性肺病合并抑郁焦虑患者的药物与心理治疗。方法:选择我院2014年3月-2016年3月收治的老年慢性阻塞性肺病合并抑郁焦虑患者110例为研究对象,采用随机数表法将患者分为观察组(n=55)和对照组(n=55)。予以对照组常规治疗,观察组在对照组基础上加用药物与心理治疗,疗程为6个月。比较两组治疗前后PaCO_2、PaO_2、6分钟步行距离(6-minute walk distance,6MWD),分析两组治疗前后抑郁自评量表(Self-Rating Depression Scale,SDS)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)评分。结果:治疗前观察组PaCO_2为(70.2±8.9)mmHg,对照组(69.5±8.4)mmHg,差异无统计学意义(t=0.424,P0.05);治疗后观察组PaCO_2为(33.5±4.7)mmHg,显著低于对照组的(46.5±9.1)mmHg,差异有统计学意义(t=-9.413,P0.05);治疗前观察组PaO_2、6MWD分别为(50.1±2.3)mmHg、(241.4±11.2)m,对照组为(50.6±2.7)mmHg、(243.5±10.8)m,差异无统计学意义(t=1.045,1.001,P0.05);治疗后观察组PaO_2、6MWD分别为(80.6±7.6)mmHg、(325.4±12.3)m,显著高于对照组的(68.3±9.2)mmHg、(297.3±16.8)m,差异有统计学意义(t=7.644,10.008,P0.05);治疗前观察组SDS分数、SAS分数分别为(59.3±3.9)分、(55.2±3.6)分,对照组为(58.9±4.3)分、(56.2±4.8)分,差异无统计学意义(t=0.511,1.236,P0.05);治疗后观察组SDS分数、SAS分数均显著低于对照组,差异有统计学意义(t=40.881,32.656,P0.05)。结论:舒利迭加用心理干预治疗可显著提升患者呼吸功能,缓解患者抑郁焦虑,是老年慢性阻塞性肺病合并抑郁焦虑患者的理想选择。

Drug and Psychotherapy of Elderly Patients with Chronic Obstructive Pulmonary Disease Complicated with Depression and Anxiety

Objective:To investigate the drug and Psychotherapy of elderly patients with chronic obstructive pulmonary disease(COPD) complicated with depression and anxiety.Methods:A total of 110 elderly patients with chronic obstructive pulmonary disease complicated with depression and anxiety from March 2014 to March 2016 were selected as the research object,and they were divided using a random number table method into the observation group(n =55)and control group(n =55).The control group was given conventional treatment and nursing,while the observation group wwas treated with drug and psychotherapy on the basis of treatment of the control group,the course of treatment was 6 months.Two groups were compared before and after treatment in PaCO2,PaO2,6 minutes walking distance (6-minute walk,distance,6 MWD),SDS(Self-Rating Depression Scale,self rating Depression Scale (SAS),Self-Rating Anxiety Scale,self rating Anxiety Scale)score.Results:Before treatment,the PaCO2 of the observation group was (70.2 ± 8.9) mmHg,and the control group (69.5 ± 8.4) mmHg,the difference was not statistically significant (P ＞ 0.05);After treatment,the observation group PaCO2 (33.5 ± 4.7) mmHg,was significantly lower than that in the control group(46.5±9.1)mmHg,(t =-9.413,P＜0.05);Before treatment,the PaO2 and 6MWD of the observation group were (50.1±2.3)mmHg,(241.4±11.2)m,and the control group was (50.6±2.7)mmHg,(243.5± 10.8) m,the difference was not statistically significant(t =-1.045,-1.001);after treatment,the observation group PaO2 (80.6± 7.6 mmHg),6MWD(325.4±12.3 mmHg)were significantly higher than that in the control group(68.3 ±9.2 mmHg),(297.3±16.8 mmHg)(t=7.644,10.008;P＜0.05);Before treatment,the SDS score and SAS score of the observation group were(59.3±3.9),(55.2±3.6),and the control group was (58.9±4.3),(56.2±4.8),the difference was not statistically significant (P ＞ 0.05);After treatment,SDS scores,SAS scores were significantly lower than the control group(t =-40.881,-32.656;P＜0.05).Conclusion:Seretide with psychological intervention can significantly improve the respiratory function of patients,alleviate the patients with depression and anxiety,which is the ideal choice for elderly patients with chronic obstructive pulmonary disease complicated with depression and anxiety.