心理干预对不稳定型心绞痛患者的疗效评价

Evaluations of curative effects of mental interventions in patients with unstable angina pectoris

目的在药物治疗的基础上,评价心理干预对不稳定型心绞痛患者的疗效。方法将50例伴有不同程度焦虑情绪的不稳定型心绞痛患者随机分为两组各25例,两组均接受内科常规药物治疗,干预组患者同时给予心理干预治疗,观察1mo,随访1a。于治疗前及治疗后1mo末采用焦虑自评量表评定患者的焦虑状况,比较治疗后及随访期间两组心血管事件发生情况。结果治疗1mo末,干预组心绞痛缓解总有效率96.0%,对照组为76.0%(χ2=3.99,P<0.05);心电图ST段变化干预组总有效率88.0%,对照组为68.0%(χ2=3.99,P<0.05)。治疗1mo末两组焦虑自评量表评分均较治疗前有显著性下降(P均<0.01),但干预组较对照组下降更显著(t=13.243,P<0.01);干预组住院天数显著低于对照组(t=11.625,P<0.0.1);治疗后干预组心血管事件发生率显著低于对照组(P<0.05)。结论心理干预可减轻或缓解不稳定型心绞痛患者的焦虑等负性情绪,缩短住院时间,减少心血管事件,改善预后。

Objective To evaluate the curative effects of mental intervention in patients with unstable angina pectoris based on pharmacotherapy. Methods 50 unstable angina patients with varying degrees of anxious emtions were randomly divided into intervention（n=25） receiving routine pharmacotherapy plus mental intervention and control group（n=25） doing only routine pharmacotherapy, observed for one month and followed up one year. Anxious status was assessed with the Self-rating Anxiety Scale（SAS） before treatment and at the end of 1 month treatment and developments of cadiovacular events were compared between the 2 groups after treatment and during follow-up. Results At the end of 1 month treatment, SCL-90 scores of both groups lowered more significantly compared with pre-treatment（both P〈0.01）,those did more significantly of the intervention than of the control group（P〈0. 01）; both hospital days and incidences of cadiovacular events after treatment were significantly lower of the intervention than of the control group（P〈0.01 or 0.05）. Conclusion Mental interventions can lessen or release anxiety of negative emotions of patients with unstable angina pectoris, shorten length of stay, reduce cadiovacular events and improve prognosis.