抗抑郁药物对农村社区冠心病并发抑郁的治疗意义

The Clinical Implications of Antidepressant Therapy on CHD Complicated with Depression in a Rural Community

目的：研究抗抑郁药物对农村社区冠心病（CHD）合并抑郁的治疗特点、效果和临床意义。方法；将63例CHD并发抑郁患者随机分为综合治疗组（抗抑郁药物治疗加常规治疗）和对照组（常规治疗），两组的年龄、CHD症状和病情轻重、抑郁程度、心功能分级等均相仿。前者给予CHD常规治疗加黛立新早、中午各一粒，严重失眠者晚上加服安定片5mg，连续服用安定片不超过1周，后者予CHD常规治疗。观察2周～3个月，观察结果进行组间和组内比较。结果：大多数患者属高龄和文盲。3个月观察因对照组疗效差致大量病人转诊其他医院而失访，观察失败。2周观察综合治疗组接受治疗的依从性、抑郁症状和参加社会活动能力的改善及临床疗效都明显好于对照组。结论：抗抑郁药物对农村社区冠心病并发抑郁患者的治疗有其特点。非常有益，可显著降低负性情绪。改善对治疗的依从性、临床症状和生活质量，而副反应无增加。

Objective：To investigate the effects and characteristics of antidepressant therapy on CHD subjects complicated with depression in a newly industralized rural community and to evaluate its clinical implications. Methods： 63 cases of CHD complicated with depression were divided into comprehensive therapy（antidepressant therapy plus routine therapy） and routine therapy groups. The scores of Zung Self-rating Depression Scale（SDS） and clinical outcomes were compared within and between the two groups after 2 weeks and after 3 months. Results： Most patients were senile and illiterate. The 3-month observation failed for lots of patients lost in the routine therapy group due to bad curative effect. The SDS scores of the comprehensive therapy group were significantly lower than the routine therapy group after 2 weeks, while the extent of joining social activity, the compliance to treatment and clinical outcomes were significantly better than the routine therapy group. Conclusion： Antidepressant therapy has it＇s own characteristics in a rural community, could significantly lower the degree of negative＇ emotions, improve clinical outcomes and quality of life without increased side-effect, is beneficial to the CHD patients complicated with depression.