2型糖尿病与焦虑抑郁关系的随机对照研究

Randomized controlled study of the relationship between T2DM and anxiety and depression

目的探讨焦虑抑郁与2型糖尿病(T2DM)的关系及抗焦虑抑郁治疗对T2DM预后的影响。方法将确诊为2型糖尿病的87例患者(糖化血红蛋白HbA1c≥6.5%,空腹血糖FPG≥7.0mmol/L,口服糖耐量试验时2小时血糖≥11.1mmol/L)作为研究组,选择同期该院体检的健康人群91例作为对照(正常组)。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评定两组焦虑、抑郁状态。采用随机数字表法将T2DM患者中存在焦虑、抑郁的患者分为治疗组和对照组,焦虑、抑郁治疗组分别服用抗焦虑、抗抑郁药物进行治疗,两者的对照组均服用安慰剂。结果研究组焦虑状态者检出19例(21.8%),抑郁状态者检出24例(27.6%);正常组焦虑、抑郁检出人数均为2例(2.2%),两组焦虑、抑郁检出率差异均有统计学意义(P<0.05)。研究组SAS和SDS评分分别为(35.9±7.1)分、(38.1±9.0)分,正常组分别为(23.1±3.5)分、(24.1±6.6)分,差异有统计学意义(P均<0.05)。治疗12周后,治疗组SAS和SDS评分分别为[(40.5±5.7)分、(43.0±6.1)分],较对照组低[(52.9±3.7)分、(60.6±4.5)分],差异有统计学意义(P<0.05);治疗组FPG、餐后2小时血糖(2hPG)、HbA1c均较对照组低(P均<0.05)。结论T2DM患者中抑郁、焦虑症状检出率及SAS、SDS评分均高于正常人群,对T2DM并发焦虑、抑郁的患者进行抗焦虑或抗抑郁治疗后,患者FPG、2hPG、HbA1c均有所降低,提示抗焦虑抑郁治疗可能有助于T2DM的治疗。

Objective To explore relationship between T2DM with anxiety and depression,and observe the effect of anti - anxiety and depression treatment for T2DM cure. Methods A total of 87 patients with T2DM(HbA1c≥6. 5% ,FPG≥7. 0mmol/ l and 2h PG≥11. 1mmol/ l)were selected as study group and 91 healthy adults were selected as normal group. Self - rating Anxiety Scale(SAS) and Self - rating Depression Scale(SDS)were used to evaluate the status of anxiety and depression. The patients of T2DM with anxiety and depression were randomly divided into two groups respectively. The treatment group of anxiety and depression were treated with anti- anxiety,antidepressant drugs respectively and the control group were given placebo. Results 19 patients with anxiety and 24 patients with depression were detected in study group,and both 2 patients with anxiety and depression were checked out in normal group. The differences of detection rates were statistically significant(P < 0. 05). The SAS and SDS scores were[(35. 9 ± 7. 1), (38. 1 ± 9. 0)]and[(23. 1 ± 3. 5),(24. 1 ± 6. 6)]in study group and normal group,respectively. And there were significant statis-tical differences between two groups. The SAS and SDS scores,FPG,2h PG,HbA1c of treatment group were lower than control group after treatment(P < 0. 05). Conclusion The detection rates of anxiety and depression are higher than normal people in T2DM patients and the treatment of anti - anxiety and depression may be helpful in the treatment of T2DM.