解郁安神汤治疗急性心肌梗死冠脉介入术后轻中度抑郁的临床观察
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摘要
目的:观察解郁安神汤治疗急性心肌梗死冠脉介入术后轻中度抑郁患者的临床疗效,为治疗该病提供安全、有效的治疗方法。方法:将42例符合纳入标准的患者随机分为对照组(n=20)和观察组(n=22),对照组在常规治疗基础上予口服氟哌噻吨美利曲辛(黛力新),每次1片,早上及中午各一次;观察组患者在对照组基础上予解郁安神汤口服,每次200ml,早晚各一次。记录两组患者行冠脉介入术后1天、2周、1个月及3个月SDS评分,分别检测两组患者冠脉PCI术前、术后24h、48h及3个月血清hs-CRP、TNF-α,随访3个月内两组患者心血管不良事件的发生情况及药物的副作用。结果:总体上两组患者治疗后SDS评分均较治疗前改善,差异有统计学意义(P<0.05),观察组患者较对照组改善明显(P<0.05);观察组患者术后各检测时段血清hs-CRP、TNF-α均较对照组明显降低,差异有统计学意义(P<0.05);随访发现观察组患者发生心力衰竭例数明显少于对照组(P<0.05);两组患者服药期间均未发生明显药物副作用。结论:解郁安神汤可明显改善急性心肌梗死冠脉介入术后轻中度抑郁患者的临床症状,且无明显药物副作用,为治疗急性心肌梗死冠脉介入术后轻中度抑郁患者有效、安全的药物。
Objective: To observe the effect of the Jieyu Anshen decoction( 解郁安神汤) on mild to moderate depression of acute myocardial infarction after PCI. Methods: 42 patients were divided into the control group(n=20) and the observation group(n=22). Two group were given conventional treatment. The control group was given Deanxin; the observation group was treated with the Jieyu Anshen decoction more. The SDS score was recorded of 1 day, 2 weeks, 1 month and 3 months after PCI. The levels of serum hs-CRP and TNF-αwere measured before and after PCI of 24 hours, 48 hours and 3 months. The incidence of cardiovascular adverse events and the side effects in groups were observed. Results: The SDS scores in groups were better than before; and that in the observation group was significantly improved more than the control group, with statistically significant differences(P<0.05). The levels of serum hs-CRP and TNF-α in the observation group were significantly lower than the control group(P<0.05). The number of heart failure patients in the observation group was significantly fewer than the control group(P<0.05). There was no significant side effect of medication in groups. Conclusion: The Jieyu Anshen decoction can significantly improve clinical symptoms of mild to moderate depression, with no obvious side effect, is an effective and safe medicine for treating mild to moderate depression.
Objective: To observe the effect of the Jieyu Anshen decoction( 解郁安神汤) on mild to moderate depression of acute myocardial infarction after PCI. Methods: 42 patients were divided into the control group(n=20) and the observation group(n=22). Two group were given conventional treatment. The control group was given Deanxin; the observation group was treated with the Jieyu Anshen decoction more. The SDS score was recorded of 1 day, 2 weeks, 1 month and 3 months after PCI. The levels of serum hs-CRP and TNF-αwere measured before and after PCI of 24 hours, 48 hours and 3 months. The incidence of cardiovascular adverse events and the side effects in groups were observed. Results: The SDS scores in groups were better than before; and that in the observation group was significantly improved more than the control group, with statistically significant differences(P<0.05). The levels of serum hs-CRP and TNF-α in the observation group were significantly lower than the control group(P<0.05). The number of heart failure patients in the observation group was significantly fewer than the control group(P<0.05). There was no significant side effect of medication in groups. Conclusion: The Jieyu Anshen decoction can significantly improve clinical symptoms of mild to moderate depression, with no obvious side effect, is an effective and safe medicine for treating mild to moderate depression.
引文
[1]许海燕,姚康宝,项志敏.首次急性ST段抬高与非ST段抬高心肌梗死患者临床及冠状动脉病变特点比较[J].中华老年心脑血管病杂志,2012,14(4):361-363.
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[9]刘雯,卢惠娟,胡雁,等.急性心肌梗死患者焦虑抑郁状况及预测因素分析[J].护理学杂志,2011,1(26):70-73.
[10]Carney RM,Freedland KE,Steinmeyer B,et al.History of depression and survival after acute myocardial infarction[J].Psychosom Med,2009,71(3):253-259.
[11]郭敏,史冬梅,周玉杰,等.冠状动脉介入术后患者情绪障碍调查研究[J].中国预防医学杂志,2010,11(8):770-772.
[12]刘梅颜,胡大一.抑郁症与缺血性心脏病[J].中国医药导刊,2005,7(4):271.
[13]陈宏,李秀英.抑郁症和缺血性心脏病[J].国外医学:精神病学分册,2005,32(1):10-11.
[14]王艳,谢道俊,等.黄蒲通窍胶囊对血管性痴呆大鼠行为学表现及海马CA1区病理变化的影响[J].安徽中医药大学学报,2014,33(4):69-72.
[15]Mulvihill NT,Foley JB.Inflammation in acute coronary syndromes[J].Heart,2002(87):201-204.
[2]周进才,程明静.中西医综合疗法预防经皮冠状动脉介入治疗术后再狭窄的临床疗效分析[J].中医临床研究,2016,8(11):29-31.
[3]金功文.帕罗西汀治疗急性心肌梗塞后抑郁患者的疗效观察[J].河北医学,2011,17(11):1533-1534.
[4]刘梅颜,姜荣环,胡大一,等.心脏急症与稳定性冠心病患者合并心理问题现状分析[J].中华心血管病杂志,2009,37(10):904-907.
[5]Thygesen K,Alpert J S,White H D,et al.Universal definition of myocardial infarction[J].Circulation,2007,116(22):2634-2653.
[6]张明园.精神科评定量表手册[M].长沙:湖南科学技术出版社,1998:34-38.
[7]中华医学会心血管学分会,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南(2012)[J].中华心血管病杂志,2012,40(4):4-20.
[8]黄桂传,陈容.AMI患者在急诊经皮冠状动脉介入治疗中发生心室颤动的救治配合及护理[J].现代临床护理,2009,8(9):56.
[9]刘雯,卢惠娟,胡雁,等.急性心肌梗死患者焦虑抑郁状况及预测因素分析[J].护理学杂志,2011,1(26):70-73.
[10]Carney RM,Freedland KE,Steinmeyer B,et al.History of depression and survival after acute myocardial infarction[J].Psychosom Med,2009,71(3):253-259.
[11]郭敏,史冬梅,周玉杰,等.冠状动脉介入术后患者情绪障碍调查研究[J].中国预防医学杂志,2010,11(8):770-772.
[12]刘梅颜,胡大一.抑郁症与缺血性心脏病[J].中国医药导刊,2005,7(4):271.
[13]陈宏,李秀英.抑郁症和缺血性心脏病[J].国外医学:精神病学分册,2005,32(1):10-11.
[14]王艳,谢道俊,等.黄蒲通窍胶囊对血管性痴呆大鼠行为学表现及海马CA1区病理变化的影响[J].安徽中医药大学学报,2014,33(4):69-72.
[15]Mulvihill NT,Foley JB.Inflammation in acute coronary syndromes[J].Heart,2002(87):201-204.