解郁通脉汤治疗冠脉支架术后抑郁症68例临床观察

Clinical observation of Jieyu Tongmai decoction on 68 cases of depression after coronary stenting

[目的]观察解郁通脉汤治疗冠脉支架(PCI)术后抑郁症的临床疗效。[方法]将68例冠脉支架术后抑郁症患者随机分为治疗组与对照组各34例。治疗组为常规治疗基础上加用自拟解郁通脉汤,对照组为常规治疗基础上加用艾司西酞普兰,观察两组患者治疗前后中医证候积分、汉密尔顿抑郁量表(HAMD)评分,西雅图心绞痛量表(SQA)评价,生活满意度量表评定(LSR)相关情况。[结果]中医证候积分比较治疗组显著优于对照组,总有效率为92.85%,与对照组(77.77%)比较有统计学意义(P<0.05);HAMD评分治疗组和对照组治疗8周后得分相当,两组无统计学差异(P>0.05),但两组HAMD因子评分比较在睡眠障碍及焦虑有统计学意义(P<0.05);SAQ治疗组和对照组治疗后的各个值与治疗前相比均有改善(P<0.05);LSR评定,治疗后两组LSR评分均较治疗前有显著提高(P<0.05)。[结论]抗抑郁治疗对于患者的冠心病症状有缓解作用,减少胸痛的发作次数及频率,并且能够改善患者认知,增强依从性,对预后有帮助。解郁通脉汤治疗冠脉支架术后抑郁症与单纯西药治疗对于情绪的改善疗效相当,中药疏肝解郁、活血通脉法能够更有效改善患者的抑郁、胸闷憋气、睡眠障碍等症状。解郁通脉汤治疗冠脉支架术后抑郁症疗效稳定、毒副作用低、依从性高,能有效提高患者生活满意度。

[Objective] To observe Jieyu Tongmai decoction on depression in patients with clinical efficacy after coronary stenting.[Methods] The 68 cases of coronary stent patients with depression were randomly divided into treatment group and control group with34 cases in each group; treatment group with self-made Jieyu Tongmai decoction on the basis of conventional therapy; the control group conventional treatment combined with sertraline hydrochloride, and two groups were observed before and after treatment in patients with traditional Chinese medicine syndrome integral, the Hamilton Depression Inventory scale（HAMD） score, Seattle Angina Questionnaire（SQA） evaluation, life satisfaction scale（LSR） situation. [Results] Traditional Chinese medicine syndrome integral comparison of treatment group was significantly better than the control group, the total efficiency of 92.85%, and compared with the control group（77.77%） was statistically significant（P 〈0.05）; HAMD score in the treatment group and the control group after 8 weeks of treatment,scores, no significant difference between two groups（P〉 0.05）, but the two groups HAMD factor scores in a statistically significant sleep disturbance and anxiety（P〈0.05）; SAQ treatment group and each group after treatment were compared with before treatment improved the control（P 〈0.05）; LSR evaluation, LSR in the two groups after treatment there were significant improved（P 〈0.05）. [Conclusion]Antidepressant treatment for coronary heart disease patients with symptomatic relief effect, reduce the number and frequency of episodes of chest pain, and can improve patients cognitive, and enhance compliance to help prognosis; Jieyu Tongmai decoction in the treatment of depression after coronary stenting with simple Western medicine treatment for emotional rather; traditional Chinese medicine Shugan Jieyu, Huoxue Tongmai method can more effectively improve the patients with depression, shortness of breath, sleep disorders and other symptoms; Jieyu Tongmai decoction in the treatment of depression after coronary stenting with stable curative effect, low toxicity, high compliance, can effectively improve the life satisfaction of patients.