抗焦虑抑郁治疗及心理干预对彝族2型糖尿病伴情绪障碍患者血糖控制的影响

目的评价抗焦虑、抑郁药物治疗及心理干预对伴焦虑、抑郁情绪的彝族2型糖尿病患者的治疗效果。方法将88例伴抑郁、焦虑情绪障碍的2型糖尿病患者分为彝族常规治疗组28例，彝族抗焦虑、抑郁治疗组30例，汉族抗焦虑、抑郁治疗组30例，各组均予以糖尿病常规治疗，汉族及彝族抗焦虑、抑郁治疗组辅以帕罗西汀20mg于每天早餐后顿服，并发睡眠障碍者予以阿普唑仑0．4mg于每晚睡前服用1次，并由心理中心医生给予心理辅导治疗。分别于治疗前、治疗6周后测定焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分和空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbAlc）水平。结果各组患者治疗前后SAS、SDS评分及FPG、2hPG水平比较，差异均有统计学意义（P〈0．05）。彝族抗焦虑、抑郁治疗组疗效优于彝族常规治疗组；而汉族抗焦虑、抑郁治疗组疗效优于彝族抗焦虑、抑郁治疗组，差异均有统计学意义（P〈0．05）。结论伴焦虑、抑郁情绪的彝族2型糖尿病患者使用抗焦虑、抑郁药物治疗结合心理干预疗效优于单纯糖尿病常规治疗，加强彝族糖尿病患者自身管理，采取综合治疗措施尤为必要。

Influence of antidepressant treatment and psychological intervention on blood glucose control of Yi T2DM patients as- sociated with emotional disorder

Objective To evaluate the effect of antianxiety treatment,antidepressant treatment and psychological inter- vention on Yi patients with type 2 diabetic mellitus （T2DM） occompanied with anxious and depressed emotion. Methods Totally 88 T2DM patients with depressive disorder and anxiety disorder were divided into Yi＇s routine group （n=28）, Yi＇s antidepressant and antianxiety treatment group （n=30） and Han＇s antianxiety and antidepressant treatment group （n=30）. Conventional treatment of diabetes was adopted in all groups. The Yi＇s and Han＇s antianxiety and antidepressant treatment group were assisted with 20 mg paroxetine administrated after breakfast every day, the patients complicated with sleep disorder were with 0.4 mg Alprazalam ad- ministrated once daily before sleep and added with psychological guidance from physician in psychology center. The values of Zung Self-rating Anxiety Scale （SAS） and Zung Self-rating Depression Scale （SDS） and the levels of fasting plasma glucose （FPG）, 2-hour plasma glucose（2hPG）,the glyucosylated hemogobin Alc（HbAlc） before treatment and 6 weeks after treatment were measured. Results The comparison of the SAS score,SDS score and FPG level,2hPG level in,all groups before and after treat- ment had statistically significant difference （P〈0.05）. The efficacy of Yi＇s antianxiety and antidepressant treatment group was better than that of Yi＇s routine group ;while the efficacy of Han＇s antianxiety and antidepressant treatment group was better than that of Yi＇s antianxiety and antidepressant treatment group with statistically significant difference （P〈0.05）. Conclusion Antianxiety and antidepressant treatment combined with psychological intervention is more effective than single routine diabetic treatment for Yi＇s T2DM patients with anxiety and depressive disorder, so it is necessary to strengthen the self-management of Yi patients with diabetes and adopt comprehensive treatment.