双心治疗模式对高血压并焦虑/抑郁患者负面情绪及血压晨峰的影响研究

Impact of Psycho-cardiology Treatment Mode on Negative Emotion and Morning Blood Pressure Surge in Hypertension Patients Accompanied with Anxiety/Depression

目的探讨双心治疗模式对高血压并焦虑/抑郁患者负面情绪及血压晨峰(MBPS)的影响。方法选取2017-04-01至2018-01-01在内蒙古自治区人民医院心血管内科及内蒙古自治区精神卫生中心住院的高血压并焦虑/抑郁患者119例,采用随机数字表法分为对照组(n=58)和研究组(n=61)。对照组患者给予苯磺酸氨氯地平治疗,研究组患者在对照组治疗基础上给予草酸艾司西酞普兰治疗;两组患者均连续治疗2个月。比较两组患者治疗前、治疗2周、治疗2个月汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分及治疗前后24 h动态血压、MBPS差值,并观察两组患者不良反应发生情况。结果 (1)时间与方法在HAMA评分、HAMD评分上存在交互作用(P<0.05);时间、方法在HAMA评分、HAMD评分上主效应显著(P<0.05);研究组患者治疗2周及治疗2个月HAMA评分、HAMD评分低于对照组(P<0.05),且治疗2周及治疗2个月HAMA评分、HAMD评分呈下降趋势(P<0.05)。(2)两组患者治疗前后24 h平均收缩压差值、白昼平均收缩压差值、夜间平均收缩压差值、夜间平均舒张压差值比较,差异无统计学意义(P>0.05);研究组患者治疗前后24 h平均舒张压差值、白昼平均舒张压差值、MBPS差值高于对照组(P<0.05)。(3)两组患者治疗期间均未出现明显不良反应。结论双心治疗模式可有效缓解高血压并焦虑/抑郁患者负面情绪,降低MBPS,改善血压变异性。

Objective To investigate the impact of psycho-cardiology treatment mode on negative emotion and morning blood pressure surge(MBPS)in hypertension patients accompanied with anxiety/depression.Methods From2017-04-01to2018-01-01,a total of119hypertension patients accompanied with anxiety/depression were selected in the Department of Cardiovascular Medicine,the People's Hospital of Inner Mongolia Autonomous Region and Mental Health Center of Inner Mongolia Autonomous Region,and they were divided into control group(n=58)and study group(n=61)according to random number table.Patients in control group received amlodipine besylate,while patients in study group received escitalopram oxalate combined with amlodipine besylate;both groups continuously treated for2months.HAMA score and HAMD score before treatmet,2weeks and2months after treatment,24-hour dynamic blood pressure monitoring results and MBPS before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment.Results(1)There was statistically significant interaction in HAMA score and HAMD score between time and method(P<0.05);main effects of time and method were statistically significant in HAMA score and HAMD score(P<0.05);HAMA score and HAMD score in study group were statistically significantly lower than those in control group2weeks and2months after treatment(P<0.05),moreover HAMA score and HAMD score in study group showed descending trend2weeks and2months after treatment(P<0.05).(2)No statistically significant differences of difference of24-hour mean SBP,daytime mean SBP,nighttime mean SBP,nighttime mean DBP before and after treatment was found between the two groups(P>0.05);difference of24-hour mean DBP,daytime mean DBP and MBPS before and after treatment in study group were statistically significantly higher than those in control group(P<0.05).(3)No one in the two groups occurred any obvious adverse reactions during treatment.Conclusion Psycho-cardiology treatment mode can effectively relieve the negative emotion and reduce the MBPS in hypertension patients accompanied with anxiety/depression,is helpful improve the blood pressure variability.