抗抑郁剂联合心理干预治疗心血管神经症对照研究

A control study of antidepressants plus mental intervention in cardiovascular neurosis

目的探讨抗抑郁剂联合心理干预治疗心血管神经症患者焦虑抑郁情绪的临床疗效。方法将132例心血管神经症患者随机分为两组,研究组62例,应用抗抑郁剂联合心理干预治疗,对照组70例,应用心内科常规心血管药物治疗。观察6w。于治疗前及治疗第1w、2w、4w、6w末采用汉密顿焦虑量表及汉密顿抑郁量表评定焦虑抑郁情绪,并进行对比分析。结果研究组治疗1w末汉密顿焦虑量表评分较治疗前有显著下降(P<0.05),治疗2w末起两组汉密顿焦虑量表及汉密顿抑郁量表评分均较治疗前有显著下降(P<0.01);治疗4w末、6w末研究组均较对照组下降显著(P<0.01)。治疗6w末研究组抗焦虑显效率为82.26%、抗抑郁显效率为79.03%,对照组分别为41.43%、42.86%;研究组均显著高于对照组(P<0.01)。结论抗抑郁剂联合心理干预能显著改善或缓解心血管神经症患者焦虑抑郁情绪,疗效显著优于单用心血管药物治疗。

Objective To explore the clinical efficacy of antidepressants plus mental intervention in the treatment of anxietydepression emotion of cardiovascular neurosis. Methods 132 patients with cardiovascular neurosis were randomly divided into research group（n= 62） receiving antidepressants plus psychotherapy and control group（n=70） doing routine cardiovascular drugs for 6 weeks. Anxiety and depression emotions were evaluated with the Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale （HAMD） before treatment and at the and of the 1^st, 2^nd, 4^th and 6^th week treatment, and comparisons and analyses conducted. Results At the end of the 1^st week,the HAMA score significantly lowered compared with pretreatment in the research group（P〈0.01）;at theend of the 2^nd week,scores of both the HAMA and HAMD of the two groups significantly lowered compared with pretreatment（P〈0. 001） ;those lowered more siginificantly in the research than in the control group at the end of the 4^th and 6^th week（P〈0.01）. At the end of the 6^th week,excellence rates of antianxiety and antidepression were 82.26% and 79.03% in the research group and 41.43% and 42.86% in the control group,respectively;those of the research group were significantly higher than of the control group（P〈0.01）. Conclusion Antidepressants plus psychotherapy can significantly improve or relieve anxiety-depression emotion of patients with cardiovascular neurosis and its efficacy is better than single cardiovascular drugs.