氟哌噻吨美利曲辛联合右佐匹克隆片治疗慢阻肺患者长期焦虑伴失眠症状的效果观察

分析氟哌噻吨美利曲辛联合右佐匹克隆片治疗慢阻肺患者长期焦虑伴失眠症状的效果。方法:选取2022年08月~2023年01月本院门诊治疗的60例慢阻肺长期焦虑伴失眠症状患者,随机均分两组。在治疗期间分别配合氟哌噻吨美利曲辛联合右佐匹克隆片治疗和单纯右佐匹克隆片治疗,对比两组患者的治疗效果。结果:研究组患者治疗有效率为96.67%,肺功能指标中,FEV1(0.82±0.14)、FEV1/FVC(62.63±3.62)、心率(83.48±0.74),焦虑得分(15.82±4.14)、抑郁得分(16.38±4.54)、睡眠时间(1.28±0.65)、睡眠效率(1.33±0.62)、睡眠障碍(1.42±0.13)、催眠药物使用(1.28±0.31)、5-羟色胺含量(151.26±18.44)mg/L、脑源性神经营养因子(19.31±1.87)ng/L、r-氨基丁酸(0.68±0.09)mmol/L、并发症发生率为13.33%;对照组患者治疗有效率为60.0%,肺功能指标中,FEV1(0.79±0.13)、FEV1/FVC(55.45±3.52)、心率(92.95±0.63),焦虑得分(18.55±4.45)、抑郁得分(19.86±5.12)、睡眠时间(1.79±0.62)、睡眠效率(1.62±0.52)、睡眠障碍(1.82±0.11)、催眠药物使用(1.76±0.12)、5-羟色胺含量(135.42±15.28)mg/L、脑源性神经营养因子(14.66±2.34)ng/L、r-氨基丁酸(0.58±0.11)mmol/L、并发症发生率为33.33%。组间差异显著(P<0.05)。结论:对慢阻肺长期焦虑伴失眠症状患者实施氟哌噻吨美利曲辛联合右佐匹克隆片治疗的效果显著,可以有效改善患者呼吸功能,缓解焦虑情绪,改善患者睡眠,且治疗有较高的安全性。

氟哌噻吨美利曲辛联合右佐匹克隆片治疗慢阻肺患者长期焦虑伴失眠症状疗效

目的 回顾性分析氟哌噻吨美利曲辛联合右佐匹克隆片治疗慢阻肺患者长期焦虑伴失眠症状疗效。方法 选取该院2020年1月—12月治疗的88例慢阻肺合并长期焦虑伴失眠症状患者,依据治疗方式的不同将这些入选者分成对照组与观察组,各组44例。对照组采取氟哌噻吨美利曲辛单独治疗,观察组采取氟哌噻吨美利曲辛联合右佐匹克隆片治疗,比较二组疗效。结果 治疗一个疗程后,观察组的治疗总有效率显著高于对照组,差异有统计学意义(P<0.05);观察组在治疗后第4周的心理状态评分、兹堡睡眠质量量表(PSQI)评分等均显著优于对照组,差异有统计学意义(P<0.05);二组不良反应率比较差异无统计学意义(P>0.05)。结论 慢阻肺合并长期焦虑伴失眠症状患者应用氟哌噻吨美利曲辛联合右佐匹克隆片治疗,能够获得显著的治疗效果,可以大幅度改善患者的睡眠质量,降低其不良心态,同时药物治疗后没有引起严重不良反应,安全性高,值得推荐。

小柴胡汤辨证治疗复杂病机焦虑医案1则

小柴胡汤首次记载于《伤寒论》。张机(字仲景)运用小柴胡汤治疗外感、杂病、妇人病等疾病有良好疗效,并且以小柴胡汤为基础列举了诸多柴胡类证,创立了一系列柴胡类方,而各方的适应证也是在小柴胡汤证的基础上不断演变产生的。中医认为,焦虑归于“郁证”范畴,常因肝郁气滞,枢机不利所致,常使用小柴胡汤等类药治疗。郁证日久,其病机往往会发生改变,这时需要及时加减调整方剂才能取得理想的疗效。深圳市中医院肝病科童光东教授治疗长期郁证患者颇有经验,在掌握少阳枢机不利,肝郁脾虚为本的基础上,兼顾病久继发的气阴两虚、营卫不和、虚火上炎等复杂病机,在小柴胡汤的基础上进行灵活配伍,治疗郁证疗效显著。文章介绍一则童教授用小柴胡汤成功治疗郁证的案例,以期为临床治疗郁证提供思路。

延续护理方案对焦虑和抑郁患者家庭和社区康复的影响

目的研究延续护理方案对提高长期慢性焦虑和抑郁患者家庭和社区康复中的应用价值。方法选择2015年3月—2017年3月于本院就诊的长期慢性焦虑和抑郁患者共120例,随机分为对照组和观察组两组,每组各60例,对照组采用常规护理,观察组采用延续护理(4C模式),随访6.0个月,对比康复效果。结果观察组再住院率和并发症发生率均显著低于对照组(P<0.05)。观察组焦虑和抑郁自评量表评分(SAS和SDS)均显著低于对照组(P<0.05),各项治疗依从性得分和生活质量评分显著高于对照组,差异均有统计学意义(P<0.05)。结论通过给患者提供延续护理方案可进一步有效缓解长期慢性焦虑和抑郁患者在家庭和社区康复过程中的应用效果,有较好的推广意义。

Prevalence of depression and anxiety in patients with chronic digestive system diseases: A multicenter epidemiological study

AIM To investigate the prevalence of depression and anxiety in patients with chronic digestive system diseases.METHODS A total of 1736 patients with chronic digestive systemdiseases were included in this cross-sectional study, including 871 outpatients and 865 in-patients. A selfdesigned General Information for Patients of the Department of Gastroenterology of General Hospitals questionnaire was used to collect each patient's general information, which included demographic data(including age, sex, marital status, and education) and disease characteristics(including major diseases, disease duration, principal symptoms, chronic pain, sleep disorder, and limited daily activities).RESULTS The overall detection rate was 31.11%(540/1736) for depression symptoms alone, 27.02%(469/1736) for anxiety symptoms alone, 20.68%(359/1736) for both depression and anxiety symptoms, and 37.44%(650/1736) for either depression or anxiety symptoms. Subjects aged 70 years or above had the highest detection rate of depression(44.06%) and anxiety symptoms(33.33%). χ2 trend test showed: the higher the body mass index(BMI), the lower the detection rate of depression and anxiety symptoms(χ2trend = 13.697, P < 0.001; χ2trend = 9.082, P = 0.003); the more severe the limited daily activities, the higher the detection rate of depression and anxiety symptoms(χ2trend = 130.455, P < 0.001, χ2trend = 108.528, P < 0.001); and the poorer the sleep quality, the higher the detection rate of depression and anxiety symptoms(χ2trend = 85.759, P < 0.001; χ2trend = 51.969, P < 0.001). Patients with digestive system tumors had the highest detection rate of depression(57.55%) and anxiety(55.19%), followed by patients with liver cirrhosis(41.35% and 48.08%). Depression and anxiety symptoms were also high in subjects with comorbid hypertension and coronary heart disease. CONCLUSION Depression and anxiety occur in patients with tumors, liver cirrhosis, functional dyspepsia, and chronic viral hepatitis. Elderly, divorced/widowed, poor sleep quality, and lower BMI are associated with higher risk of depression and anxiety.