“双心治疗”在心血管疾病合并焦虑抑郁状态患者中的治疗效果

Efficacy of pchycardiological therapy in patients with cardiovascular diseases and depression and anxiety

目的初步观察“双心疗法”在治疗心血管疾病合并焦虑抑郁状态患者中的治疗效果。方法选取2016年~2018年于北京航天总医院住院治疗的合并焦虑、抑郁状态的心脏病患者130例,随机数表法分成双心治疗组(65例)及普通治疗组(65例),普通治疗组仅给与心脏疾病常规治疗,双心治疗组在心脏疾病常规治疗基础上给与心理治疗(主要为抗焦虑抑郁药物)。在同期住院的患者中按随机数表法选取65例排除焦虑抑郁状态的心脏病患者作为对照组。随访12个月,记录各组患者心脏疾病的预后情况,包括高血压病患者的血压控制效果,冠心病患者发作胸闷的次数,心力衰竭患者的再住院次数、阵发性房颤患者的发作情况,及所有患者计划外门诊急诊次数。结果双心治疗组高血压病患者的血压控制效果明显好于普通治疗组,差异有统计学意义(89.6%vs.71.0%,P=0.012);经双心治疗,冠心病患者的胸闷发作及阵发性房颤患者的房颤发作平均次数均明显低于普通治疗组,差异有统计学意义(4.12±1.53 vs.7.89±2.45,P=0.002;1.68±1.24 vs.2.78±1.88,P=0.023),且明显降低心力衰竭患者的再住院次数,差异有统计学意义(0.73±0.93 vs.1.05±1.34,P=0.014)。此外,随访过程中合并焦虑抑郁状态的心脏病患者的计划外门诊次数明显高于对照组(2.87±2.12 vs.1.64±1.67,P=0.001),而双心治疗组明显低于普通治疗组,差异有统计学意义(2.15±1.41 vs.3.27±2.09,P=0.038)。结论“双心治疗”可明显改善心血管疾病合并焦虑抑郁状态患者的预后。

Objective To explore the efficacy of pchycardiological therapy in patients with cardiovascular diseases and depression and anxiety.Methods One hundred and thirty patients,who suffered from cardiovascular diseases(CVDs)and depression and/or anxiety,were randomly divided into pchycardiological therapy group(PT-group)and conventional therapy group(CT-group)equally.Patients in CT-group received routine clinical treatment only,and base on that,patients in PT-group were added with psychological intervention(antidepressant drugs or anti-anxious drugs).Besides the two groups,another 65 CVD-patients without depression and anxiety made up control group,receiving only routine treatment.All the patients were followed for 12 months.And then data related to prognosis of patients with CVDs were recorded,including 1)the curative effect in patients with hypertension(HBP),2)frequency of angina attacks in patients with coronary heart disease(CHD),3)re-hospitalization in patients with heart failure(HF),4)atrial fibrillation(AF)attacks in patients with paroxysmal AF,5)unplanned outpatient and emergency visits.Results The curative effect of HBP in PT-group was better than in CT-group(89.6%vs.71.0%P=0.012).By psychological intervention,the angina attacks of CHD patients in PT-group were less than in CT-group(4.12±1.53 vs.7.89±2.45 P=0.002).Similarly,because of psychological intervention,patients with paroxysmal AF in PT-group suffered less AF attacks(1.68±1.24 vs.2.78±1.88 P=0.023).Psychological intervention helped to reduce the re-hospitalization odds in HF-patients with depression and/or anxiety(0.73±0.93 vs.1.05±1.34 P=0.014).5)CVD-Patients with depression and/or anxiety had more unplanned outpatient and emergency visits than those who were free from depression and/or anxiety(2.87±2.12 vs.1.64±1.67 P=0.001).Conclusion Pchycardiological therapy for patients with CVDs and depression and/or anxiety can obviously improve the clinical efficacy.