心理干预加抗抑郁治疗在难治性高血压伴抑郁患者治疗中的作用

The clinical research of psychological intervention and anti depression treatment in patients with refractory hypertension and depression

目的:探讨心理干预及抗抑郁药物治疗在难治性高血压伴抑郁患者治疗中的作用。方法:选择63例难治性高血压伴抑郁患者随机分为观察组35例,对照组28例,对照组采用常规降压治疗,观察组在对照组基础上加用心理干预及抗抑郁药物多虑平治疗。门诊观察8周,比较两组治疗后的降压效果及HADS评分变化。结果:8周后观察组HADs评分由(35±1.85)分下降至(23±1.65)分;在治疗4周时,观察组血压(175±10.5)/(100±9.5)mm Hg(1 mm Hg=0.1333 k Pa)降至(150±11.5)/(90±8.5)mm Hg,较对照组显著下降(P<0.05);在治疗8周时,两组血压继续下降,但较第4周下降水平比较,差异无统计学意义(P>0.05)。结论:心理干预及抗抑郁药物治疗对伴发抑郁情绪的高血压患者能改善抑郁症状,且对血压的控制较单纯降压药物治疗效果更好。

Objective To investigate the effects about psychological intervention and antidepressant drug therapy in the treatment of refractory hypertension patients with depression. Method 63 patients were randomly divided into the observation group of35 cases,28 cases in the control group,the control group using conventional antihypertensive therapy,based on control group,the observation group were gived psychological and antidepressant doxepin. After 8 weeks,the antihypertensive effect and HADS score of two groups were compared after treatment. Results After 8 weeks in observation group,HADs score by（ 35 ± 1. 85） drop to（ 23 ±1. 65）; after 4 weeks of treatment,the observation group of blood pressure by（ 175 ± 10. 5） /（ 100 ± 9. 5） mm Hg（ 1 mm Hg =0. 1333 k Pa） drop to（ 150 ± 11. 5） /（ 90 ± 8. 5） mm Hg,compared with the control group decreased significantly（ P〈0. 05）. after 8weeks of treatment,the two groups of blood pressure continuely droped,but compared with decreaced blood pressure level in fourth weeks,the difference was not statistically significant（ P〈0. 05）. Conclusion Psychological intervention and anti depression treat-ment can improve depressive symptoms and control blood pressure in patients with refractory hypertension and depression.