艾司西酞普兰联合心理干预对2型糖尿病合并焦虑抑郁患者抑郁焦虑症状及血糖水平的影响
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摘要
目的:探讨艾司西酞普兰联合心理干预对2型糖尿病合并焦虑抑郁患者抑郁焦虑症状及血糖水平的影响。方法:选择2014-01～2016-01在我院进行治疗的2型糖尿病合并焦虑抑郁患者60例为研究对象,按随机数字表法分为二组,分别为研究组I、研究组II,每组患者30例。研究组I患者采用艾司西酞普兰、常规降糖药联合心理干预治疗,研究组II患者采用艾司西酞普兰、常规降糖药治疗,对照组为我市中心医院进行治疗的2型糖尿病合并焦虑抑郁患者30例。对三组患者的临床疗效、治疗前后的空腹血糖(FBG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、汉密尔顿抑郁量表(HAMD)、生活质量综合评定问卷表(GQOLI-74)、副反应量表(TESS)进行评分比较。结果:①研究组I临床总有效率为96.67%(29/30),研究组II患者临床总有效率为80.00%(24/30),对照组临床总有效率为70.00%(21/30),组间比较差异有统计学意义(P<0.05)。②三组患者治疗后的FBG、2hPBG、HbA1c比较差异有统计学意义,且研究组I、研究组II的FBG、2hPBG、HbA1c均低于对照组(P<0.05)。③三组患者的HAMD、GQOLI-74评分比较差异有统计学意义(P>0.05),且研究组I各项评分均低于研究组II且低于对照组。三组患者的TESS评分比较差异无统计学意义。结论:艾司西酞普兰联合心理干预治疗2型糖尿病合并焦虑抑郁患者的临床疗效显著,能够改善患者的抑郁焦虑症状及血糖水平,且不良反应少,用药安全性好,值得临床应用推广。
Objective: To investigate the effect of esmolalopram combined with psychological intervention on depression and anxiety symptoms and blood glucose levels in patients with type 2 diabetes combined with anxiety and depression. Methods: 60 patients with type 2 diabetes combined with anxiety and depression in our hospital from January 2014 to January 2016 were selected and divided into two groups according to the random digital table method, which were study group I, study group II, with 30 cases in each group. Patients in study group I were treated with escitalopram and conventional hypoglycemic drugs. Patients in study group II were treated with escitalopram and conventional hypoglycemic drugs, and 30 patients with type 2 diabetes combined with anxiety and depression were treated in the control group. The clinical efficacy of three groups of patients, fasting blood glucose(FBG), postprandial 2 H blood sugar(2 hPBG), glycated hemoglobin(HbA1 c), Hamilton Depression Scale(HAMD), quality of life comprehensive assessment questionnaire(GQOLI-74), and side reaction scale(TESS) were compared. Results:①The total effective rate of study group I was 96.67%(29/30), and the clinical total effective rate of the study group II was 80%(24/30), and the total clinical effective rate of the control group was 70%(21/30), and the differences between the groups were statistically significant(P<0.05). ②The difference of FBG, 2 hPBG and HbA1 c after treatment in the three groups was statistically significant, and the FBG, 2 hPBG and HbA1 c of II in the study group were lower than those of the control group(P<0.05). ③The differences of HAMD and GQOLI-74 scores between the three groups were statistically significant(P>0.05), and the scores of study group I in the study group were lower than those in the study group II and lower than those in the control group. There was no significant difference in TESS score between the three groups. Conclusion: The clinical efficacy of esmolalopram combined with psychological intervention in the treatment of type 2 diabetes with anxiety and depression is significant. It can improve the symptoms and blood glucose level of the patients with depression and anxiety, with less adverse reactions and good safety. It is worthy of clinical application.
Objective: To investigate the effect of esmolalopram combined with psychological intervention on depression and anxiety symptoms and blood glucose levels in patients with type 2 diabetes combined with anxiety and depression. Methods: 60 patients with type 2 diabetes combined with anxiety and depression in our hospital from January 2014 to January 2016 were selected and divided into two groups according to the random digital table method, which were study group I, study group II, with 30 cases in each group. Patients in study group I were treated with escitalopram and conventional hypoglycemic drugs. Patients in study group II were treated with escitalopram and conventional hypoglycemic drugs, and 30 patients with type 2 diabetes combined with anxiety and depression were treated in the control group. The clinical efficacy of three groups of patients, fasting blood glucose(FBG), postprandial 2 H blood sugar(2 hPBG), glycated hemoglobin(HbA1 c), Hamilton Depression Scale(HAMD), quality of life comprehensive assessment questionnaire(GQOLI-74), and side reaction scale(TESS) were compared. Results:①The total effective rate of study group I was 96.67%(29/30), and the clinical total effective rate of the study group II was 80%(24/30), and the total clinical effective rate of the control group was 70%(21/30), and the differences between the groups were statistically significant(P<0.05). ②The difference of FBG, 2 hPBG and HbA1 c after treatment in the three groups was statistically significant, and the FBG, 2 hPBG and HbA1 c of II in the study group were lower than those of the control group(P<0.05). ③The differences of HAMD and GQOLI-74 scores between the three groups were statistically significant(P>0.05), and the scores of study group I in the study group were lower than those in the study group II and lower than those in the control group. There was no significant difference in TESS score between the three groups. Conclusion: The clinical efficacy of esmolalopram combined with psychological intervention in the treatment of type 2 diabetes with anxiety and depression is significant. It can improve the symptoms and blood glucose level of the patients with depression and anxiety, with less adverse reactions and good safety. It is worthy of clinical application.
引文
[1]江斌,沈仲夏,蔡敏.抗焦虑治疗对广泛性焦虑障碍共病2型糖尿病患者血糖水平的影响[J].中华临床医师杂志:电子版,2016,23(7):21-22
[2]王煦,翁卫群,王雪琴,等.我国2型糖尿病伴高血压患者抑郁症状meta分析[J].中国心理卫生杂志,2017,31(7):511-517
[3]陶领钢,黄峰,周云,等.西酞普兰与阿米替林对2型糖尿病伴抑郁患者血糖影响的对照研究[J].中国民康医学,2015,22(18):2306-2307
[4]Zheng Y,Zhou Y,Lai Q.Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes[J].Psychiatria Danubina,2015,27(2):174-182
[5]陈少元.艾司西酞普兰治疗老年急性缺血性脑卒中后抑郁的疗效观察[J].卒中与神经疾病,2014,34(5):310-311
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[7]欧建君,赵靖平,夏昆.孤独症谱系障碍早期症状研究进展[J].国际精神病学杂志,2011,38(4):250
[8] 安婷,潘昱,王丹,等.心理干预联合草酸艾司西酞普兰对老年Ⅱ型糖尿病伴广泛性焦虑患者血糖控制效果的影响[J].河南中医,2014,23(11):505-508
[9] 王立娜.艾司西酞普兰对慢性阻塞性肺疾病合并抑郁焦虑患者的疗效及生存质量的影响[J].中国健康心理学杂志,2012,20(7):961-963
[10] Ramkisson S,Pillay B J,Sartorius B.Anxiety,depression and psychological well-being in a cohort of South African adults with Type 2 diabetes mellitus[J].South African Journal of Psychiatry,2016,22(1):1-9
[11] 陆仲女,童建冲,汤文杰,等.艾司西酞普兰联合团体心理治疗对焦虑障碍伴发2型糖尿病效果分析[J].中国医院统计,2017,24(4):260-262
[12] 张涛,张文涛,白莹,等.胰岛素联合艾司西酞普兰治疗糖尿病合并焦虑抑郁症状患者的临床效果影响[J].国际精神病学杂志,2016,33(5):860-862
[13] 高婉霞,王俊.艾司西酞普兰联合心理干预对糖尿病患者抑郁焦虑症状及血糖达标的影响[J].中国现代医生,2013,51(27):145-147
[14]张浚哲,陈冲,刘铁桥.自杀意念危险因素研究进展[J].国际精神病学杂志,2011,38(3):160-164
[15] 张川江,郑兰兵,景兰,等.艾司西酞普兰联合心理干预对2型糖尿病合并焦虑抑郁患者抑郁焦虑症状及血糖水平的影响[J].海南医学,2017,28(15):2522-2524
[2]王煦,翁卫群,王雪琴,等.我国2型糖尿病伴高血压患者抑郁症状meta分析[J].中国心理卫生杂志,2017,31(7):511-517
[3]陶领钢,黄峰,周云,等.西酞普兰与阿米替林对2型糖尿病伴抑郁患者血糖影响的对照研究[J].中国民康医学,2015,22(18):2306-2307
[4]Zheng Y,Zhou Y,Lai Q.Effects of Twenty-four Move Shadow Boxing Combined with psychosomatic relaxation on Depression and Anxiety in Patients with Type-2 Diabetes[J].Psychiatria Danubina,2015,27(2):174-182
[5]陈少元.艾司西酞普兰治疗老年急性缺血性脑卒中后抑郁的疗效观察[J].卒中与神经疾病,2014,34(5):310-311
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南[M].北京:北京大学医学出版社,2011
[7]欧建君,赵靖平,夏昆.孤独症谱系障碍早期症状研究进展[J].国际精神病学杂志,2011,38(4):250
[8] 安婷,潘昱,王丹,等.心理干预联合草酸艾司西酞普兰对老年Ⅱ型糖尿病伴广泛性焦虑患者血糖控制效果的影响[J].河南中医,2014,23(11):505-508
[9] 王立娜.艾司西酞普兰对慢性阻塞性肺疾病合并抑郁焦虑患者的疗效及生存质量的影响[J].中国健康心理学杂志,2012,20(7):961-963
[10] Ramkisson S,Pillay B J,Sartorius B.Anxiety,depression and psychological well-being in a cohort of South African adults with Type 2 diabetes mellitus[J].South African Journal of Psychiatry,2016,22(1):1-9
[11] 陆仲女,童建冲,汤文杰,等.艾司西酞普兰联合团体心理治疗对焦虑障碍伴发2型糖尿病效果分析[J].中国医院统计,2017,24(4):260-262
[12] 张涛,张文涛,白莹,等.胰岛素联合艾司西酞普兰治疗糖尿病合并焦虑抑郁症状患者的临床效果影响[J].国际精神病学杂志,2016,33(5):860-862
[13] 高婉霞,王俊.艾司西酞普兰联合心理干预对糖尿病患者抑郁焦虑症状及血糖达标的影响[J].中国现代医生,2013,51(27):145-147
[14]张浚哲,陈冲,刘铁桥.自杀意念危险因素研究进展[J].国际精神病学杂志,2011,38(3):160-164
[15] 张川江,郑兰兵,景兰,等.艾司西酞普兰联合心理干预对2型糖尿病合并焦虑抑郁患者抑郁焦虑症状及血糖水平的影响[J].海南医学,2017,28(15):2522-2524