舍曲林联合放松疗法对维持性血液透析尿毒症患者抑郁状态及生活质量的影响

Effects of sertraline combined with relaxation therapy on depression and quality of life in patients with uremia undergoing maintenance hemodialysis

目的探讨舍曲林联合放松疗法对维持性血液透析尿毒症患者抑郁状态及生活质量的影响。方法选取2016年9月—2018年9月保定市第一中心医院收治的84例维持性血液透析尿毒症患者,采用随机数字表法分为舍曲林组和联合组,每组42例。舍曲林组给予舍曲林口服治疗;联合组给予舍曲林联合放松疗法。比较两组干预前后汉密尔顿抑郁量表(HAMD)、健康调查简表(SF-36)评分,以及不良反应发生情况。结果两组干预前HAMD评分比较,差异无统计学意义(P>0.05)。联合组干预后HAMD评分低于舍曲林组(P<0.05)。两组干预后HAMD评分较干预前下降(P<0.05)。两组干预前生理机能、生理职能、躯体疼痛、总体健康、生活活力、社会功能、情感职能及精神健康等SF-36评分比较,差异无统计学意义(P>0.05)。联合组干预后SF-36评分高于舍曲林组(P<0.05)。两组干预后SF-36评分较干预前升高(P<0.05)。两组干预期间嗜睡、头晕、多汗、便秘发生率及总发生率比较,差异无统计学意义(P>0.05)。结论舍曲林联合放松疗法对维持性血液透析尿毒症患者抑郁状态有积极的防治作用,而且能够有效改善患者的生活质量,其疗效安全可靠。

Objective To investigate the effects of sertraline combined with relaxation therapy on depression and quality of life in patients with uremia undergoing maintenance hemodialysis.Methods A total of 84 patients with uremia undergoing maintenance hemodialysis admitted to our hospital from September 2016 to September 2018 were randomly divided into sertraline group and combined group,with 42 cases in each group.The sertraline group was given oral sertraline treatment,and the combined group was given relaxation therapy on the basis of sertraline treatment.The scores of Hamilton Depression Scale(HAMD17)and Health Status Questionnaire(SF-36)before and after intervention were compared between the two groups.The occurrence of adverse reactions during the intervention was observed and compared.Results There was no significant difference in HAMD17 score between the two groups before intervention(P>0.05).The HAMD17 score of the combined group was lower than that of the sertraline group after intervention(P<0.05).Besides,HAMD17 scores in both groups were decreased after intervention(P<0.05).There was no significant difference in the scores of physical functioning,role limitations due to physical health problems, bodily pain, general health, vitality, social functioning, role limitations due to emotionalproblems, and mental health based on SF-36 between the two groups before intervention (P > 0.05). Afterintervention, the above scores in the combined group were higher than those in the sertraline group (P < 0.05),though these scores in both groups were increased (P < 0.05). There was no significant difference in the incidencesof sleepiness, dizziness, sweating, constipation and the overall incidence of adverse reactions between the twogroups during intervention (P > 0.05). Conclusions Sertraline combined with relaxation therapy has a positive effecton the prevention of depression in patients with uremia undergoing maintenance hemodialysis, and can effectivelyimprove the quality of life of patients. Thus, sertraline combined with relaxation therapy is safe and reliable.