氟哌噻吨美利曲辛加心理干预治疗慢性阻塞性肺疾病急性加重期合并焦虑抑郁患者的疗效观察

目的观察氟哌噻吨美利曲辛加心理干预治疗慢性阻塞性肺疾病(COPD)急性加重期合并焦虑抑郁患者的临床疗效。方法采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)对173例COPD患者进行调查,对HAMA≥7分或HAMD≥8分的COPD患者61例进行观察治疗,其中单独抑郁30例(17.3%),单独焦虑11例(6.4%),焦虑合并抑郁20例(11.6%)。随机分为干预组31例,对照组30例。干预组给予COPD规范化治疗+氟哌噻吨美利曲辛片+心理干预;对照组给予COPD规范化治疗+安慰剂。2组均在治疗前后进行HAMD、HAMA评分及肺功能测定。结果 (1)2组治疗后HAMA、HAMD总分及各因子评分比较,干预组均低于对照组(除焦虑心境、抑郁心境外),差异均有统计学意义(P<0.05,P<0.01)。对照组精神焦虑和焦虑/躯体化评分较治疗前显著降低,差异有统计学意义(P<0.05),干预组治疗后HAMA、HAMD总分及各因子评分均低于治疗前,差异有统计学意义(P<0.01或P<0.05)。(2)2组治疗后FEV_1、FEV_1%均较治疗前有所改善,差异有统计学意义(P<0.05),治疗前后2组间FEV_1、FEV_1%、FEV_1/FVC差异均无统计学意义(P>0.05)。结论规范化治疗+氟哌噻吨美利曲辛片+心理干预能明显改善COPD患者的情绪障碍、躯体症状,是一种有效的治疗方法。

Combined the flupentixol melitracen tablets with psychological intervention on treatment of anxiety and depression in the chronic obstructive pulmonary disease with acute exacerbation

Objective To invest（？）gate the therapeutic effect of combination the flupentixol melitracen tablets with psychological intervention on anxiety and depression in the chronic obstructive pulmonary disease（COPD） with acute exacerbation. Methods According to the HAMA and HAMD scoring,there were 173 cases of COPD were enrolled.The HAMA≥7 points or HAMD≥8 points in 61 cases of COPD patients were selected,included 30 cases with depression（17.3%）,11 cases with anxiety（6.4%）,and 20 cases with anxiety and depression（11.6%）.61 patients were randomly divided into intervention group（n =31 ）and control group（n =30）.Administration of standardized treatment plus psychological intervention in intervention group,while control group was administrated standard treatment plus placebo.Two groups were conducted before and after treatment HAMD,HAMA score and lung function.Results（1 ） After treatment,the HAMA,HAMD total score and factor scores in the intervention group were lower than those in the control group（except for anxiety mood,depression mood）the differences were statistically significant（P0.05,P0.01 ）.In control group,the anxiety and anxiety/somatization scores were significantly lower than those before treatment,the difference was statistically significant（P0.05）.In intervention group after treatment,the HAMA,HAMD total score and factor scores were lower than before treatment,the difference was significance（P0.01 or P0.05）.（2） After treatment,the FEV_1,FEV_1%were improved than pre treatment in both two groups,the difference was statistically significant（P0.05）,while no statistical difference of those indexes between two groups（P0.05）.Conclusion It demonstrated that the standard treatment plus flupentixol melitracen tablets and psychological intervention could significantly improve the COPD patients with mood disorders,somatic symptoms.