抗抑郁、抗焦虑治疗对老年糖尿病患者血糖水平的影响

Effects of anti depression and anti-anxiety on blood sugar level of senile diabetic patients

目的:探讨抗抑郁、抗焦虑治疗对伴有抑郁焦虑症状的老年糖尿病患者血糖水平的影响。方法:选择伴有抑郁焦虑症状的老年2型糖尿病43例。纳入标准:符合世界卫生组织诊断标准的2型糖尿病并伴有抑郁焦虑症状。排除标准:严重肝肾疾病、Ⅲ度以上心力衰竭、心脏传导功能障碍等病例及其他疾病引起的精神障碍。将43例患者分为对照组23例和治疗组20例。对照组给予常规治疗,治疗组在常规治疗的同时加用抗抑郁抗焦虑药物———小剂量二盐酸氟哌噻吨与小剂量盐酸四甲蒽丙胺的合剂治疗,观察两组治疗前及治疗后3周抑郁、焦虑自评量表(SDS,SAS)评分及血糖水平的改变。结果:①对照组:SDS,SAS评分治疗后较治疗前有所降低(P>0.05);空腹血糖、餐后2h血糖(2hpostprandialbloodglucose,PBG2h)治疗后较治疗前有较明显下降(t=2.102～2.197,P<0.05)。②治疗组:SDS、SAS评分治疗后较治疗前明显降低(t=2.491～2.507,P<0.05);空腹血糖、PBG2h治疗后较治疗前明显改善犤分别下降(4.15±2.91),(4.48±3.19)mmol/L犦,差异有显著性意义(t=2.528～2.540,P<0.05)。③治疗组与对照组相比,治疗后3周的SDS,SAS评分及空腹血糖、PBG2h水平均有明显降低(t=2.973～3.074,P<0.01及t=2.370～2.396,P<0.05)。

AIM:To explore the effects of anti depression and anti anxiety on blood sugar level of senile diabetic patients companied with anxiety and depression. METHODS:A total of 43 senile type 2 diabetic patients accompanied with anxiety or depression were selected.Including criterion:The patients were coincided to type 2 diabetes mellitus combined with depression and anxiety according to diagnostic standard of WHO.Excluding criterion: Severe hepatorenal disease,heart failure above Ⅲdegree,conduction dysfunction of the heart and other disease induced by psychonosema were excluded.A total of 43 patients were divided into control group(n=23) and treatment group (n=20).Patients in the control group were treated as normal,but in the treatment group,patients were treated by normal method and drug of anti depression and anti anxiety,which was the mixture of microdosage dihydrochloride flupenthixol and microdosage hydrochloric melitracene.Changes of self-rating depression scale(SDS) score, self rating anxiety scale(SAS) score and blood sugar level were evaluated in the two groups before and 3 weeks after treatment. RESULTS:①SDS and SAS scores in the control group were lower after treatment (P >0.05),and fasting blood glucose(FBG) and 2 hour postprandial blood glucose(PBG2h) were decreased obviously after treatment(t=2.102 to 2.197,P< 0.05). ②SDS and SAS scores in the treatment group were lower after treatment(t=2.491 to 2.507,P < 0.05),and FBG and PBG2h were decreased obviously after treatment[(4.15±2.91), (4.48±3.19) mmol/L], and there were significant differences(t=2.528 to 2.540,P < 0.05). ③SDS,SAS scores,FBG and PBG2h in the treatment group were decreased obviously 3 weeks after treatment compared with the control group(t=2.973 to 3.074,P < 0.01 ;t=2.370 to 2.396,P < 0.05) respectively. CONCLUSION:Senile diabetic patients companied with anxiety and depression are treated with anti anxiety,anti depression drug and usual treatment together, and the effect of the combination is better than simple usual treatment, besides anxiety,depression and blood sugar value are improved.