双心医学在冠心病伴发心理疾病患者中的应用效果

Application Effect of Psychocardiology on Patients with Coronary Heart Disease Accompanied by Psychological Disorders

目的 探索在基层社区卫生服务中心开展“双心医学模式”治疗冠心病合并心理疾病患者的效果。方法 选择2021年10月-2022年10月在本中心就医的冠心病患者采用焦虑症筛查量表(GAD-7)和抑郁症筛查量表(PHQ-9)筛选出符合要求的100例冠心病伴发抑郁症状者作为研究对象,随机分为研究组及对照组,对研究组进行集中心理干预和个体心理疏导。观察指标为量表分值、治疗效果、左室射血分数(left ventricular ejection fraction,LVEF)和脑钠肽(Brain Natriuretic Peptide,BNP)。结果 研究组通过双心医学模式治疗后PHQ-9结果明显优于对照组(P<0.05);研究组GAD-7结果明显优于对照组(P<0.01);研究组患者临床治疗总有效率明显高于对照组(P<0.01);研究组LVEF(67.35±6.35)恢复明显好于对照组(P<0.01);研究组BNP恢复明显好于对照组(P<0.01)。结论 双心医学门诊对冠心病伴发心理疾病患者进行心理干预能有效缓解冠心病患者的焦虑和抑郁症状,可以提高冠心病患者症状缓解率和治疗有效率,可以促进患者心功能改善;值得在社区医院推广。

Objective To explore effect of"psychocardiology model"in grassroots community health service centers for patients with coronary heart disease and psychological disorders.Methods The paper chose 100 patients with coronary heart disease accompanied by depression treated at our center from October 2021 to October 2022 as study objects,and divided them into study group and control group randomly with Anxiety Screening Scale(GAD-7)and Depression Screening Scale(PHQ-9).Study group was treated with centralized psychological intervention and individual psychological counseling,observation indexes included scale scores,treatment effect,left ventricular Ejection fraction(LVEF)and brain natriuretic peptide(BNP)of study group and control group before and after intervention.Results PHQ-9 results(5.42±0.18)in study group were significantly better than(7.22±0.15)in control group after treatment with psychocardiology model(P<0.05).GAD-7 results in study group were(5.27±0.28),significantly better than(7.32±0.13)in control group,(P<0.01).Total effective rate of clinical treatment in study group(96.75%)was significantly higher than control group(68.15%)(P<0.01).LVEF recovery in study group was(67.35±6.35),significantly better than(56.57±6.47)in control group,(P<0.01).Recovery of BNP in study group was(22.56±5.22),significantly better than(45.33±4.42)in control group(P<0.01).Conclusion Psychological intervention can alleviate anxiety and depression symptoms of patients with coronary heart disease accompanied by psychological disorders effectively,improve symptom relief rate,treatment effect and heart function of patients,which is worthy of promotion in community hospital.