Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.

Sociopsychological impact factors of depression patients during the COVID-19 epidemic period

Objective:To investigate the impact factors of the COVID-19 epidemic on the mental health of patients with depression.Methods:The relevant data of 242 residents aged 18-50 years in a certain area were collected,118 patients and 124 healthy people were analyzed by general information questionnaire,the PsychoSocial Index(PSI)questionnaire,Social Support Rating Scale(SSRS)and Symptom Checklist 90(SCL-90).Compare the differences in social and psychological factors between the two groups.Then use logistic regression to evaluate the social and psychological influencing factors of depression patients during the epidemic.Results:Two results of logistic regression analysis showed that marital status,occupational status,abnormal pathological behavior,and utilization of support were still significantly associated with depression.Compared to working,unemployed/unemployed/retired,students are closely related to depression,followed by abnormal pathological behavior and utilization of support.Conclusion:Under the epidemic,depression groups lacking social relationships should actively pay attention to their mental health status and comprehensively enhance their social and psychological support.To avoid the exacerbation of psychological and psychological symptoms caused by the epidemic.

Predictive power of abnormal electroencephalogram for post-cerebral infarction depression

Electroencephalography is a sensitive indicator for measuring brain condition, and can reflect early changes in brain function and severity of cerebral ischemia. However, it is not yet known whether electroencephalography can predict development of post-cerebral infarc- tion depression. A total of 321 patients with ischemic stroke underwent electroencephalography and Hamilton Depression Rating Scale assessment to analyze the relationship between electroencephalography and post-cerebral infarction depression. Our results show that electroencephalograms of ischemic stroke patients with depression exhibit low-amplitude alpha activity and slow theta activity. In con- trast, electroencephalograms of ischemic stroke patients without depression show fast beta activity and slow delta activity. ＂Ihese findings confirm that low-amplitude alpha activity and slow theta activity can be considered as independent predictors for post-cerebral infarction depression.

Early prediction of major depression in chronic hepatitis C patients during peg-interferon α-2b treatment by assessment of vegetative-depressive symptoms after four weeks

AIM: To study the predictive value of the vegetative- depressive symptoms of the Zung Depression Rating Scale for the occurrence of depression during treatment with peg-interferon α-2b of chronic hepatitis C (CHC) patients. METHODS: The predictive value of vegetative- depressive symptoms at 4 wk of treatment for the occurrence of a subsequent diagnosis of major depressive disorder (MDD) was studied in CHC patients infected after substance use in a prospective, multi- center treatment trial in Belgium. The presence of vegetative-depressive symptoms was assessed using the Zung Scale before and 4 wk after the start of antiviral treatment. RESULTS: Out of 49 eligible patients, 19 (39%) developed MDD. The area under the ROC curve of the vegetative Zung subscale was 0.73, P = 0.004. The sensitivity at a cut-point of > 15/35 was 95% (95% CI: 74-100). The positive predictive value equalled 44% (95% CI: 29-60). CONCLUSION: In this group of Belgian CHC patients infected after substance use, antiviral treatment caused a considerable risk of depression. Seven vegetativedepressive symptoms of the Zung scale at wk 4 of treatment predicted 95% of all emerging depressions, at a price of 56% false positive test results.

Assessment of Stress Cognitive Control and Executive Function with Stress Control Rating Scale (ECOSTRESS) and Low Resolution Brain Electromagnetic Tomography (LORETA) (In Portuguese People in Situations of Unemployment and Economic Insufficiency)

This article reviews the constructs of stress, appraisal, coping, according to a transactional perspective, and executive function, and presents a stress control rating scale (ECOSTRESS), which design is founded in these constructs. This psychometric tool is useful in the assessment of cognitive control of stress, correlated with the function of dorsolateral prefrontal cortex. It has been validated for its use in the assessment of Portuguese people in situations of stress related to unemployment and economic insufficiency. Also, within the context of the cognitive control of stress, it is highlighted the usefulness of low resolution brain electromagnetic tomography (LORETA).

Development of a Scale to Evaluate the Depressive State among Elderly Patients in General Wards

This study aims to develop a scale to evaluate depressive states among elderly patients in general wards, and verify the reliability and validity of the scale. Based on the results of interviews with nurses, we developed a draft of a scale comprised of 48 questions (NDE48). The Geriatric Depression Scale short version (GDS15), and the Zung Self-rating Depression Scale (SDS) were administered to 54 elderly patients. Two groups of nurses completed the NDE48 on different days. After performing an explanatory factor analysis, the NDE48 was simplified to a 16 question item scale (NDE16), comprising three factors. The correlation coefficient between GDS15 and NDE16 was 0.41 (p = 0.00191), and between SDS and NDE16 was 0.30 (p = 0.02633). Alpha coefficient of the total score of NDE16 was 0.88. For inter-rater reliability, the correlation coefficient was 0.57 (p = 0.00005). The findings suggest that the NDE16 will be highly useful when nurses evaluate depressive states among elderly inpatients.

Fluvoxamine in Treatment of Depression in Russian Patients: An Open-Label, Uncontrolled and Non-Randomized Multicenter Observational Study

Background: Fluvoxamine, a selective serotonin reuptake inhibitor is widely used in the treatment of depression, one of the most common disorders prevalent in Russia. However, studies demonstrating its efficacy and safety in routine settings in Russia are scarce. Methods: This prospective, uncontrolled, open-label study was conducted at 11 centers in Russia. Total 293 patients (aged ≥ 18 years), meeting DSM-IV criteria for depression and scoring ≥ 17 on 17-item Hamilton Rating Scale of Depression (HAMD-17) received fluvoxamine 50 - 300 mg for 6 weeks. Primary efficacy measures included change from baseline in the HAMD-17 and Clinical Global Impression (CGI) scores. Secondary efficacy measure was evaluation of sleep quality changes on HAMD-17 subscale. Safety was assessed by monitoring of adverse drug reactions (ADRs). Results: Mean age of patients was 42.7 years and the majority of them were women (72%). At the end of treatment (day 42), clinically significant reduction was observed in mean HAMD-17, CGI-severity of illness and HAMD-17 sleep sub-score from 23.1, 4.5 and 3.9 at baseline to day 42;change from baseline (Δ) was: Δ-17.3 [95% CI: -18.0;-16.7]), Δ-2.1 and Δ-3.4 [95% CI: -3.53;-3.20]), respectively. At day 42, 20.8% patients reported as normal (not at all ill) on the CGI-severity scale and 85% patients reported as “much improved” or “very much improved” on the CGI-change in severity and quality of life scores. Nausea (12.6%) and somnolence (5.1%) were the most frequently reported ADRs. No deaths or serious ADRs were reported but eight patients discontinued treatment due to ADRs. Conclusion: Treatment with fluvoxamine under routine settings showed marked improvement in Russian patients with depression as measured by HAMD-17 and CGI ratings and was thus efficacious as well as safe and well-tolerated.

Prevalence of Depression in Pre-Dialytic Chronic Kidney Disease Patients Attending at a Tertiary Care Hospital in Bangladesh

Background: Depression is a common and serious medical illness around the world. It occurs more frequently in patients with chronic illness than in the general population. It is a common psychiatric problem in patients with chronic kidney disease (CKD). Objective: To assess the level of depression in pre-dialytic CKD patients attending at a tertiary care hospital in Bangladesh. Methodology: This cross sectional study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2020 to June 2020. A total of 100 pre-dialytic CKD patients were selected by convenience sampling technique and their level of depression was assessed by Zung Self-Rating Depression Scale (ZSDS). Data were collected by existing questionnaire with face to face interview and analyzed by statistical test. Results: The mean age of the participants was 49.70 ± 11.80 years. Among them 64% were male, 95% were muslim, 98% were married, 65% were completed secondary/above higher secondary level education, 65% were unemployed and 55% were lived in urban area. It was observed that 65% participants were economically dependent to their family, only 6% were engaged in regular exercise, 14% had family history of depression, 8% were smoker and 12% were alcohol/drug abuser. According to the Zung Self-Rating Depression Scale (ZSDS) we found 29% participants were mildly depressed, 39% participants were moderately depressed and 18% participants were severely depressed. Prevalence of depression was 86% in pre-dialytic CKD patients. Of them, 7% was in CKD stage-I, 17.4% was in CKD stage-II, 19.8% was in CKD stage-III, 22.1% was in CKD stage-IV and 33.7% was in CKD stage-V. Conclusion: Depression is highly prevalent in pre-dialytic CKD patients and more frequent in the advanced stages of CKD.

Development of a Scale to Evaluate Depressive States among Elderly Patients in General Wards —Verification of the Contents to Improve the Accuracy of the Scale

Purpose: This study aims to verify the validity of the contents of the Nurse Administered Depression Scale for Elderly Inpatients16 (NDE16) using the Delphi approach in order to further improve the accuracy of the NDE16, a scale for rating potential depressive states in elderly inpatients through the observations reported by nurses. Methods: Participants were nurses working in general wards for longer than 3 years and who expressed consent to the study participation. Data were collected using the Delphi method (3 times). Responses are scored from 1 to 5 (3 - 5 points as positive) using the Likert method. The standard criteria for inclusion in the further evaluation are “mean ≥ 3.0”, “standard deviation < 1.0”, “median ≥ 3.0”, and “IQR ≤ 1.0”. Items that meet all the criteria at the third survey are employed as question items in the final questionnaire. Results: The respondents were 139 females, 10 males, and 1 unknown, aged 25 to 65. The collection rates of the three surveys were 75% to 82%. Based on the results of the first survey, wordings of 9 questions were modified. Since Question 13 “Queries are not really responded to.” did not meet the criteria (IQR = 2) at the third survey, we excluded this question and named the revised scale NDE15. Discussion: The reason why Question 13 did not meet the criteria could be due to the difficulty in distinguishing “Expressing thought suppression” from the state of cognitive decline in dementia. Further studies are needed to determine cutoff points.

海南沉香灸治疗轻度抑郁性失眠患者的疗效观察

目的探讨海南沉香灸对轻度抑郁性失眠患者的影响。方法选取2020年11月—2022年1月期间因抑郁性失眠于海南省中医院康复科门诊就诊的85例患者,按随机数字表法分为沉香灸组30例、艾灸组30例、安慰灸组25例。沉香灸组采用针刺、耳穴埋针联合海南沉香灸治疗,艾灸组采用针刺、耳穴埋针联合艾灸治疗,安慰灸组采用针刺、耳穴埋针联合安慰灸治疗。治疗2、4、8周后和随访期间,观察比较两组患者临床疗效及治疗前后汉密尔顿抑郁评分(Hamilton depression score,HAMD)、匹兹堡睡眠质量指数量表评分(Pittsburgh sleep quality index,PSQI)、抑郁自评量表评分(Self-rating depressive scale,SDS)。结果治疗后沉香灸组总有效率93.33%(28/30)、艾灸组总有效率73.33%(22/30)均明显高于安慰灸组44.00%(11/25),差异有统计学意义(P<0.05);且沉香灸组总有效率明显高于艾灸组,差异有统计学意义(P<0.05)。治疗2、4、8周后及随访期间,3组患者HAMD评分均较治疗前降低,差异有统计学意义(P<0.05);沉香灸组和艾灸组HAMD评分均低于安慰灸组,差异有统计学意义(P<0.05);治疗8周后及随访期间,沉香灸组HAMD评分低于艾灸组,差异有统计学意义(P<0.05)。治疗2、4、8周后及随访期间,3组患者PSQI评分均较治疗前降低,差异有统计学意义(P<0.05);沉香灸组和艾灸组PSQI评分均低于安慰灸组,差异有统计学意义(P<0.05);沉香灸组PSQI评分低于艾灸组,差异有统计学意义(P<0.05)。治疗2、4、8周后及随访期间,3组患者SDS评分均较治疗前降低,差异有统计学意义(P<0.05);沉香灸组和艾灸组SDS评分均低于安慰灸组,差异有统计学意义(P<0.05);治疗4、8周后及随访期间,沉香灸组SDS评分均低于艾灸组,差异有统计学意义(P<0.05)。结论沉香灸和艾灸可改善轻度抑郁性失眠患者的抑郁症状和睡眠,沉香灸对抑郁症状和睡眠改善优于艾灸。

认知行为干预对伴焦虑状态突发性聋治疗的疗效分析

目的分析认知行为干预对治疗伴焦虑状态突发性聋的疗效。方法选取2020年6月—2022年6月郑州大学第一附属医院收治的突发性聋患者353例,其中低频型108例,高频型72例,平坦型81例,全聋型92例。入院24 h内独立完成焦虑自评量表(SAS)评分,标准分>50分,汉密尔顿焦虑量表(HAMA)评分,标准分>17分接受认知行为干预为A组192例,未接受认知行为干预为B组161例,依据突发性聋诊断和治疗指南(2015)进行治疗。A组患者额外接受认知行为干预治疗。结果A、B两组中,低频型患者治疗有效率分别为90.38%(47/52)、75.00%(42/56),高频型患者治疗有效率分别为64.81%(35/54)、61.11%(11/18),平坦型患者治疗有效率分别为77.27%(34/44)、48.65%(18/37),全聋型患者治疗有效疗有效率分别为76.19%(32/42)、52.00%(26/50),A组中低频型、平坦型、全聋型治疗有效率高于B组;A组治疗总有效率高于B组,差异有统计学意义(P<0.05)。结论认知行为干预可提高伴焦虑状态的低频下降型、平坦型、全聋型治疗有效率及治疗总有效率。

胚胎移植女性孕早期睡眠质量及关联因素分析

背景胚胎移植女性经受了身体和心理的双重挑战,孕早期的生活质量,尤其是睡眠质量会受到较大的影响。目的分析胚胎移植女性孕早期睡眠质量及相关影响因素。方法选取2022年6—12月于河北医科大学第二医院生殖医学科进行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)助孕成功的患者,在其移植后45 d返院复查B超时进行问卷调查,调查内容包括匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、中文简化版心理弹性量表(Connor Davidson resilience scale,CD-RISC)和社会支持评定量表。以PSQI>7分为判断睡眠障碍的标准,通过多因素Logistic回归模型分析睡眠质量与各个影响因素的关系,并使用信息增益算法对影响睡眠质量的主要因素进行影响程度评估。结果发放问卷336份,回收325份,回收率96.7%。325例IVF-ET孕妇年龄(32.46±4.52)岁,睡眠质量总分为(7.79±3.63)分,其中126例孕妇总分≤7分为睡眠正常组,199例孕妇总分>7分为睡眠障碍组(61.23%,199/325)。相关心理学评估:焦虑自评量表(43.75±8.86)分;抑郁自评量表(50.89±10.54)分;心理弹性量表总分(64.18±11.34),其中坚韧性(32.66±10.28)分,力量性(21.75±6.37)分,乐观性(9.74±3.26)分;社会支持评定量表总分为(42.27±4.93)分,其中客观支持(9.15±2.13)分,主观支持(25.30±4.26)分,对支持的利用度(7.82±1.91)分。Logistic回归结果提示,年龄越大、越焦虑,越容易出现睡眠障碍;文化程度中,以初中及以下人群作为参照,高中或中专学历的人群更不容易出现睡眠障碍;心理弹性水平越高,睡眠障碍出现概率越低(P均<0.05)。信息增益分析结果显示,影响睡眠质量的因素按影响力大小依次为心理弹性中的坚韧性(1.186)、社会支持量表中的主观支持分(0.807)、心理弹性量表中的力量性(0.806)、心理弹性量表中的乐观性(0.510)、社会支持量表中的对支持的利用度(0.422)、文化程度(0.419)、客观支持分(0.391)、职业(0.216)、婆媳关系(0.213)、SAS(0.192)、SDS(0.162)、第几次移植(0.146)、年龄(0.117)、第几次取卵(0.108)、社会支持总分(0.107)、现有子女个数(0.088)、月收入(0.082)、夫妻关系(0.051)、居住地(0.035)。结论胚胎移植女性在孕早期睡眠质量较差;患者的不良心理状态对睡眠有负面影响,而心理弹性和社会支持对睡眠质量则起到了积极的正面影响,临床可以从改善患者心理弹性状态、增加社会支持方向入手,帮助IVF-ET孕妇从孕早期开始改善睡眠质量,从而提高生活质量,保证母婴健康。

男性情志问题与肝的相关性研究

目的:通过调查男性人群生活习惯、抑郁情绪、焦虑情绪、自尊水平等,分析男性情志问题与肝的关系,为制定男性情志问题干预策略提供依据。方法:共纳入2023年3—5月符合标准的男238例,通过问卷调查方式采集基本信息、中医肝脏象情绪量表、自尊量表等资料。结果:基本信息显示,调查对象以中青年男性为主,超重及肥胖者占59.7%,喜咸、喜辛辣和喜炙烤者偏多,47.1%有胃肠问题,17.6%有心脏问题,47.9%有睡眠问题,42.9%的男性基本不运动,男性疾病情况显示前列腺炎者14.3%、前列腺增生者4.6%、早泄者10.1%。中医肝脏象情绪量表总分异常者有169例(71.0%),抑郁情绪异常者173例(72.7%),焦虑情绪异常者152例(63.9%),肝经证候异常者134例(56.3%)。在年龄、寒热、喜咸、喜炙烤、睡眠、运动、心脏问题、胃肠问题、前列腺炎、前列腺增生、阳痿等维度,中医肝脏象情绪量表得分差异有统计学意义(P<0.05);抑郁情绪、焦虑情绪与肝经证候因子正相关;自尊水平与中医肝脏象情绪量表总分、抑郁情绪、焦虑情绪、肝经证候因子负相关。结论:男性情志问题与肝的关系密切,调节男性情志应以改善生活习惯、疏肝解郁为主要方法。

“通督治郁”针刺法对卒中后抑郁患者汉密尔顿抑郁量表各项评分的影响

目的探讨“通督治郁”针刺法治疗卒中后抑郁(PSD)患者的临床疗效以及对患者17项版汉密尔顿抑郁量表(HAMD-17)中各因子和项目评分的影响。方法回顾性收集2022年1月—2023年1月安徽中医药大学第二附属医院脑病六科住院或门诊诊断为PSD患者的资料,应用“通督治郁”针刺法进行治疗,比较治疗前后患者HAMD-17总分及项目评分、因子评分变化情况。结果本研究共纳入122例患者,治疗后疗效确切,无不良反应发生。治疗后,患者兴趣与工作、胃肠道症状、性症状和体质量减轻与治疗前比较,差异无统计学意义(P>0.05),其他HAMD-17项目评分与治疗前比较,差异有统计学意义(P<0.05)。治疗后,除因子2(体质量因子)外,患者HAMD-17各因子评分均较治疗前降低,差异有统计学意义(P<0.05)。结论“通督治郁”针刺法可明显改善PSD患者焦虑/躯体化症候群、睡眠障碍症候群、认知障碍症候群和阻滞症候群症状,是一种安全、有效的治疗方法。

清瘿散改善桥本甲状腺炎合并亚临床甲减患者抑郁焦虑状态及抗体紊乱的随机对照研究

[目的]观察清瘿散对于肝郁脾虚型桥本甲状腺炎合并亚临床甲减患者的抑郁焦虑状态的改善作用,及其对血清抗甲状腺过氧化物酶抗体、抗甲状腺球蛋白抗体的影响。[方法]采用前瞻性设计,将2021年7月至2022年6月在上海市中医医院甲状腺病专科门诊明确诊断为肝郁脾虚型桥本甲状腺炎(HT)合并亚临床甲减(SCH)患者154例。根据不同治疗方案,用随机数字表法分为两组,试验组以清瘿散联用优甲乐治疗(77例),对照组以单药优甲乐治疗(77例),治疗周期12周。观察治疗前后两组患者抑郁及焦虑自评量表(SDS、SAS)计分、甲状腺疾病生活质量(SF-36)计分和血清抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体浓度(TgAb)、促甲状腺素(TSH)浓度变化。[结果]治疗12周后,试验组SDS、SAS评分较治疗前下降显著多于对照组(P<0.01)、试验组SF-36评分较治疗前提升,显著高于对照组(P<0.05);试验组血清TPOAb、TgAb较治疗前显著下降(P<0.01),对照组治疗前后均未见显著变化;两组治疗后血清TSH均较前显著下降(P<0.01)。试验组总有效率为86.4%,显著高于对照组42.6%,两组间有显著差异(P<0.01)。[结论]清瘿散加小剂量优甲乐治疗12周可显著改善肝郁脾虚型HT合并SCH患者抑郁及焦虑状态、提高患者生活质量,降低血清TSH、TPOAb、TgAb水平,临床疗效优于单药小剂量优甲乐治疗方案。

抑郁症患者血清短链脂肪酸水平与症状及生化指标的相关性

目的 探索抑郁症患者血清短链脂肪酸与生化指标及症状的相关性。方法 本研究共纳入50例住院的抑郁症患者为病例组,并同期海报招募了42名健康志愿者为对照组。采用气相色质谱法检测所有被试者血清中5种短链脂肪酸含量,包括乙酸、丁酸、戊酸、异戊酸和己酸。采用ELISA法检测血脂、血糖、胆汁酸、肌酐、尿素、尿酸、甲状腺素等生化指标。采用流式细胞法检测血液中的免疫指标(白细胞、中性粒细胞、淋巴细胞、单核细胞、中性粒细胞百分比、淋巴细胞百分比、单核细胞百分比)。采用HAMD-17、HAMA-14他评量表以及PHQ-9、GAD-7、PSQI、SDS等自评量表评估抑郁症的临床症状。使用Spearman相关分析计算短链脂肪酸与血液免疫细胞、血糖血脂、甲状腺素等生化指标和临床症状量表的相关性。结果 病例组血清短链脂肪酸中乙酸、戊酸、异戊酸含量显著高于对照组(P<0.05)。相关性分析表明,在抑郁症患者中升高的乙酸与单核细胞百分比呈显著正相关(r=0.39,P<0.01);戊酸与尿酸呈负相关(r=-0.33,P<0.05),与葡萄糖(r=0.31,P<0.05)和GAD7(r=0.31,P<0.05)呈正相关;异戊酸与肌酐(r=0.29,P<0.05)、尿素(r=0.30,P<0.05)、HAMA中的精神焦虑因子(r=0.28,P<0.05)均呈正相关;丁酸与TSH呈正相关(r=0.34,P<0.05),与淋巴细胞数量呈负相关(r=-0.39,P<0.01);己酸与甘油三酯(r=0.36,P<0.05)、总胆固醇(r=0.42,P<0.01)、低密度脂蛋白(r=0.42,P<0.01)、HAMD中睡眠因子(r=0.30,P<0.05)均呈正相关。结论 抑郁症患者血清短链脂肪酸中乙酸、戊酸、异戊酸水平升高,可能与血糖、血脂、血常规、甲状腺功能相互作用,共同对抑郁症的发生产生影响。

疏肝理气解郁方联合西药治疗卒中后抑郁临床研究

目的:观察疏肝理气解郁方联合西药治疗卒中后抑郁的临床疗效及对T淋巴细胞亚群的影响。方法:选择2023年1—12月收治的卒中后抑郁患者104例,按随机数字表法分为治疗组、对照组各52例。对照组给予常规西药治疗,治疗组在对照组基础上加用疏肝理气解郁方治疗,2组均治疗8周。比较2组治疗前后中医证候积分、抑郁症状评分[汉密尔顿抑郁量表(HAMD)评分、抑郁自评量表(SDS)评分]及T淋巴细胞亚群水平,并评估2组临床疗效及不良反应发生情况。结果:治疗组总有效率92.31%,高于对照组76.92%(P<0.05)。治疗后,2组中医证候积分、SDS评分、HAMD评分及CD8^(+)水平均较治疗前降低(P<0.05),CD3^(+)、CD4^(+)水平升高(P<0.05);治疗组中医证候积分、SDS评分、HAMD评分及CD8^(+)水平低于对照组(P<0.05),CD3^(+)、CD4^(+)水平高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:疏肝理气解郁方联合西药治疗卒中后抑郁效果良好,能够减轻患者抑郁症状,调节T淋巴细胞亚群水平,安全性较高。

腹针配合左升右降微针调气法治疗抑郁症的临床观察

【目的】观察腹针配合左升右降微针调气法治疗抑郁症的临床疗效。【方法】将60例抑郁症患者随机分为观察组和对照组,每组各30例。观察组给予腹针联合左升右降微针调气法治疗,对照组给予盐酸舍曲林片治疗。共治疗6周。治疗6周后,评价2组临床疗效,观察2组患者治疗前后汉密尔顿抑郁量表(HAMD)评分的变化情况,以及抑郁自评量表(SAS)评分的情况。并评价2组的安全性及不良反应的发生情况。【结果】(1)治疗后,2组患者的HAMD评分明显改善(P<0.05),且观察组在改善HAMD评分方面明显优于对照组,差异有统计学意义(P<0.05)。2组患者HAMD评分治疗前后差值比较,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的SDS评分明显改善,且观察组在改善SDS评分方面明显优于对照组,差异有统计学意义(P<0.05)。2组患者SDS评分治疗前后差值比较,差异有统计学意义(P<0.05)。(3)观察组总有效率为100.00%(30/30),对照组为83.33%(25/30)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(4)观察组与对照组的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】腹针配合左升右降微针调气法治疗抑郁症,可以明显改善患者的临床症状,疗效显著。

疏肝解郁胶囊联合阿戈美拉汀对抑郁症患者汉密尔顿抑郁量表评分及孤啡肽、白细胞介素-2的影响

目的探讨疏肝解郁胶囊联合阿戈美拉汀对抑郁症患者汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分及孤啡肽(Orphanin-FQ,OFQ)、白细胞介素-2(Interleukin-2,IL-2)的影响。方法收集诊治为抑郁症的患者90例,随机分为对照组与试验组,每组45例,对照组仅给予阿戈美拉汀口服治疗,试验组采用联合疗法,给予疏肝解郁胶囊联合阿戈美拉汀口服治疗,治疗3个月,观察治疗前后中医证候积分、HAMD评分及血清OFQ及IL-2变化,对治疗疗效进行评定。结果两组治疗前饮食、精神、大小便、夜寐、舌脉积分比较差异无统计学意义(P>0.05),治疗后较治疗前积分下降(对照组t=19.104、33.773、22.839、18.861、17.178,试验组t=43.690、48.830、45.737、39.032、31.847),且试验组下降幅度大于对照组(t=32.593、15.532、20.189、23.032、16.500),差异具有统计学意义(P<0.05)。两组治疗前HAMD评分比较差异无统计学意义(P>0.05),治疗后较治疗前评分下降(对照组t=5.531,试验组t=8.930),且试验组下降幅度大于对照组(t=5.360),差异具有统计学意义(P<0.05)。两组治疗前血清OFQ及IL-2水平比较差异无统计学意义(P>0.05),治疗后较治疗前血清OFQ及IL-2水平下降(对照组t=7.099、4.204,试验组t=13.099、7.411),且试验组下降幅度大于对照组(t=6.677、5.531),差异具有统计学意义(P<0.05)。试验组治疗总有效率为93.33%(42/45),高于对照组77.78%(35/45),差异具有统计学意义(P<0.05)。结论疏肝解郁胶囊联合阿戈美拉汀治疗抑郁症能明显降低HAMD评分及血清OFQ、IL-2水平,治疗疗效优于单用阿戈美拉汀,疗效肯定。

分析行为转变理论健康指导护理对淋巴瘤患者心理负担及睡眠质量的影响

目的:分析行为转变理论健康指导护理对淋巴瘤患者心理负担及睡眠质量的影响。方法:选取2022年6月至2023年6月厦门大学附属第一医院收治的经病理学检查确诊的淋巴瘤患者80例作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。2组均给予综合治疗,对照组实施常规健康宣教及护理干预,观察组则实施行为转变理论健康指导护理干预。在护理前、护理1周后,采用匹兹堡睡眠质量指数(PSQI)比较2组患者睡眠质量的差异,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)比较2组患者焦虑、抑郁症状改善情况,并监测2组患者的睡眠情况。结果:干预后,观察组SAS评分、SDS评分、PSQI评分均显著低于对照组,观察组护理后的睡眠时长、睡眠效率显著高于对照组,观察组觉醒时间显著短于对照组,差异均有统计学意义(均P<0.05)。结论:在淋巴瘤患者临床治疗中开展行为转变理论健康指导护理,能有效减轻患者的心理负担,缓解负性情绪,并改善睡眠质量,值得临床推广应用。