合并焦虑抑郁急性冠脉综合征患者的心理干预研究

Mental intervention in acute coronary syndrome accompanied by anxiety-depression

目的探讨心理干预对急性冠脉综合征(ACS)伴有焦虑、抑郁症状患者的临床疗效。方法选择ACS伴有焦虑、抑郁症状的患者148例,随机分为对照组(n=74)和干预组(n=74),所有病例均给予规范的心血管药物治疗(包括抗血小板、抗凝、血管紧张素酶抑制剂、β受体阻滞剂、硝酸酯、他汀类药物),干预组在此基础上加用心理干预治疗(即采用"双心疗法"),包括药物治疗(氟哌噻吨美利曲辛)和认知治疗、行为干预、生物反馈放松治疗。观察3个月后两组ACS症状的改善情况以及不良反应。结果干预组ACS症状改善率高于对照组(94.59%vs.78.38%,P<0.05);两组用药期间均未见药物不良反应,无意外死亡病例。结论常规治疗联合心理干预对合并有焦虑、抑郁症状的ACS患者更有效,且安全性良好。

Objective To discuss the curative effect of psychology intervention to the patients with acute coronary syndrome （ ACS ） accompanied by anxiety-depression symptoms. Methods The patients （ n=148 ） were randomly divided into control group and intervention group （ each n=74 ） . All patients were given normative routine treatment with cardiovascular drugs （ antiplatelet drugs, anticoagulants, angiotensin-eonverting enzyme inhibitor, β -receptor blocker, nitrate and statins ） , and intervention group was additionally given psychology intervention （ double-heart therapy ） including drug treatment （ fiupentixol melitracen ） , cognitive therapy, behavioral intervention and biofeedback relaxation treatment. The alleviation of ACS symptoms and incidence of adverse reactions were observed in two groups after 3 months. Results The recovery rate of ACS symptoms was higher in intervention group than that in control group （ 94.59% vs. 78.38%, P〈0.05 ） . There were no adverse drug reactions and accidental death cases during medication period in two groups. Conclusion The combination of routine therapy and psychology heart therapy is more effective and safer than routine therapy alone in the patients with ACS accompanied by anxiety-depression symptoms.