舍曲林合并生物反馈疗法对冠心病患者焦虑抑郁及心肌酶的影响

The effect of sertraline combined with EEG biofeedback therapy on depression anxiety and myocardial enzyme inthe patients with coronary heart disease

目的探讨舍曲林合并脑电生物反馈疗法对冠心病患者焦虑抑郁及心肌酶的影响。方法将80例伴有焦虑抑郁的冠心病患者随机分为研究组和对照组各40例，均给予舍曲林100～200mg／d治疗，研究组同时接受生物反馈治疗，疗程8周。治疗前后检测心肌酶水平，同时采用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评定患者焦虑抑郁状态。结果（1）有效率比较：治疗8周后，研究组和对照组有效率分别为95．0％和77．5％，差异有统计学意义（P〈0．05）。（2）焦虑抑郁比较：治疗2、4、8周后2组HAMA、HAMD量表评分均较治疗前降低（P〈0．05），治疗后第4、8周研究组HAMA、HAMD量表评分均与对照组有统计学差异（P〈0．05）。（3）心肌酶比较：治疗8周后2组心肌酶5项指标均较治疗前改善（P〈0．05），研究组CK—MB水平与对照组差异有统计学意义（P〈0．05）。2组不良反应比较无统计学差异（P〉0．05）。结论 生物反馈疗法合并舍曲林能明显改善冠心病患者的焦虑抑郁状态及心肌酶水平，值得临床推广应用。

Objective To explore the effect of sertraline combined with EEG biofeedback therapy on anxiety and depression and myocardial enzymes in the patients with coronary heart disease. Methods 80 patients with coronary heart disease complicated with were randomly divided into study group and control group with 40 cases in each group. They were both treated with sertraline 100-200 mg/d , and study group received biofeedback therapy for 8 weeks.The detection of myo- cardial enzymes, the Hamilton Anxiety Scale （HAMA） and Hamihon Depression Scale （HAMD） assessment were conduc- ted. Results （ 1 ） The efficiency comparison ： after 8 weeks treatment, the efficiency rate of study group and control group were 95.0% and 77. 5% respectively, and the difference was of statistical significance （P〈0. 05）. （2） The anxiety and de- pression： HAMA, HAMD score were lower than those before therapy （P〈0.05） , and the differences of HAMA, HAMD score between the two groups after 4 and 8 weeks were statistically significant （P〈0. 05 ）. （3） Comparison of myocardial enzymes： after 8 weeks, treatment, myocardial enzyme of two groups were improved （P〈0. 05） , but difference of in the level of CK-MB of study group and control group was statistically significant （ P〈0. 05）. There was no significant difference in side reaction between the two groups （P〉0. 05）. Conclusions EEG biofeedback therapy combined with sertraline can significantly improve the symptoms of anxiety and depression in the patients with coronary heart disease and myocardial en- zyme levels, it is worthy of clinical application.