舍曲林联合心理疗法治疗46例冠心病合并抑郁症患者的临床研究

目的 探讨舍曲林联合心理疗法治疗冠心病(CHD)合并抑郁症患者的临床疗效,评估其抑郁程度,为临床治疗提供科学理论依据。 方法 本文选择湖州市第三人民医院2014年7月—2016年4月收治的91例冠心病合并抑郁症患者随机分为观察组(n=46)和对照组(n=45)。对照组给予CHD常规治疗及心理干预,观察组在对照组的基础上联合盐酸舍曲林治疗。观察比较2组临床疗效,汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)及症状自评量表(SCL-90)评分,应用SPSS 17.0进行统计学处理分析。 结果 观察组治疗总有效45例(97.83%),显著高于对照组的39例(86.67%)(Z=2.496,P=0.013)。治疗后2周、12周,2组HAMD、SDS评分均显著下降(P<0.05),且观察组显著低于对照组(P<0.05)。SCL-90评分比较,观察组治疗后2周躯体化、抑郁、焦虑、敌对、恐怖及偏执得分均显著下降(P<0.05),治疗后12周8项指标得分均下降(P<0.05);对照组治疗后12周躯体化、抑郁、焦虑及恐怖差异存在统计学意义(P<0.05)。观察组躯体化、抑郁、焦虑及恐怖得分均显著低于对照组(P<0.05)。 结论 舍曲林联合心理疗法治疗CHD合并抑郁症临床疗效显著,可有效降低HAMD、SDS、SCL-90评分,改善抑郁症状,值得推广应用。 

Clinical study of sertraline combined with psychotherapy in the treatment of coronary heart disease complicated with depression

Objective To investigate the clinical effect of sertraline combined with psychotherapy in the treatment of coronary heart disease (CHD) complicated with depression, evaluate the degree of depression and provide scientific basis for clinical treatment. Methods Ninety-one patients admitted to our hospital from July, 2014 to April, 2016 were randomly divided into observation group (n=46) and control group (n=45).The control group received CHD conventional therapy and psychological intervention, while the observation group received additional sertraline treatment on the basis of the control group.The clinical efficacy, SDS, HAMD and SCL-90 score were compared between the two groups.SPSS 17 was used for statistical analysis. Results The total effective rate of the observation group was 97.83% (45/46), which was significantly higher than that of 86.67% (39/45) in the control group (Z=2.496, P=0.013).After 2 and 12 weeks of treatment, the HAMD and SDS scores of the two groups were significantly decreased (P < 0.05), and the observation group was significantly lower than that of the control group (P < 0.05).By SCL-90, the somatization, depression, anxiety, hostility, terror and paranoid scores were all significantly decreased after 2 weeks of treatment (P < 0.05), and 8 indicators continued to decline after 12 weeks of treatment (P < 0.05).There were statistical differences in somatization, depression, anxiety and phobia scores after 12 weeks of treatment in the control group (P < 0.05).The scores of somatization, depression, anxiety and terror in the observation group were significantly lower than those in the control group (P < 0.05). Conclusion It has a significant clinical efficacy of sertraline combined with psychotherapy in the treatment of coronary heart disease complicated with depression.It can effectively reduce the HAMD, SDS and SCL-90 score, and improve the depressive symptoms.It is worthy of popularization and application.