心理行为干预对冠心病患者生活质量的影响
|
摘要
目的：了解心脏介入诊断、治疗前后冠心病患者的情绪障碍和心理干预的效果。
方法：以冠脉造影诊断及经皮冠状动脉介入治疗(PCI)治疗成功的冠心病患者52例和同期接受单纯药物治疗的冠心病患者52例为对象,随机分成对照组和治疗组,对照组仅进行常规药物治疗和冠心病常规护理；研究组在此基础上加抗焦虑、抑郁治疗,服用圣约翰草提取物(路优泰)300mg,早晚各1次,应用普适性量表——医学结局研究简短量表(SF-36)和冠心病专用量表——西雅图心绞痛调查问卷(SAQ)、综合性医院焦虑抑郁量表(HAD)调查患者在入院前1天,出院后3个月及出院后6个月的情绪障碍和生活质量。并测试血脂、空腹血糖、血压体重指数。
结果：1、心理干预后治疗组的情绪障碍较对照组明显改善(p<0.05)。生活质量量表得分治疗组明显高于对照组(p<0.05)。
2、PCI治疗组患者生活质量为出院后6个月>出院后3个月>入院前(P<0.05)；药物治疗组患者的生活质量为出院后6个月>出院后3个月>入院前(P<0.05)；PCI治疗组患者生活质量变化幅度高于药物治疗组患者的生活质量变化幅度。
3、血脂、血糖、血压、体重指数等指标,治疗组均低于对照组(p<0.05)
结论：1、抗焦虑、抑郁治疗能明显缓解冠心病患者的负性情绪,提高临床治疗效果,改善患者的生活质量及预后。
2、PCI手术可以显著提高冠心病患者的住院期间和出院后近期的生活质量。
Objective:To study disorder in patients with coronary heart disease (CHD) before and after the interventional therapy and to investigate the effect of mental intervention.
Methods:Fifty-two patients diagnosed by coronary angiography or cured by PCI were kept in PCI guoup while the drug therapy group contained Fifty-two patients cured by drug simply.All the patients were randomly allocated to treatment or control group.The control group was given routine medication and nursing,while the research group received anti-anxiety and depression treatment which use St John's wort (300mg Bid po)based on the routine medication and nursing。The quality of life and psychologic condition one day before hospitalization,the three month after discharge and six months after dischartge in both two groups were assessed by Medical Outcome Study Short Form-36(SF-36) and the Settle Angina Survey Form (SAQ)The Hospital Anxiety and Depression Scale (HAD),and tested the blood-fat, blood-fasting sugar,blood pressure,BMI.
Results:1.After the mental intervention,,compared with control group,the rate of anxiety and depression occurred and the quality of life have marked difference with the treatment group.
2.The quality of life in 6 mnths after discharge in PCI group was best while the quality of life before hospitalization was least(P<0.05).The drug therapy group show the same results (P<0.05).
3、the blood-fat,blood-fasting sugar,blood pressure,BMI lower than treatment group(p<0.05).
Conclusion:1.Anti-anxiety and depression treatment indeed can relieve the negative emotion of patients.improve the patients'quality of life.better the clinical effect and prognosis.
2、PCI can significantly improve the quality of life during hospitalization and in a short time after discharge in patients with CHD.
方法：以冠脉造影诊断及经皮冠状动脉介入治疗(PCI)治疗成功的冠心病患者52例和同期接受单纯药物治疗的冠心病患者52例为对象,随机分成对照组和治疗组,对照组仅进行常规药物治疗和冠心病常规护理；研究组在此基础上加抗焦虑、抑郁治疗,服用圣约翰草提取物(路优泰)300mg,早晚各1次,应用普适性量表——医学结局研究简短量表(SF-36)和冠心病专用量表——西雅图心绞痛调查问卷(SAQ)、综合性医院焦虑抑郁量表(HAD)调查患者在入院前1天,出院后3个月及出院后6个月的情绪障碍和生活质量。并测试血脂、空腹血糖、血压体重指数。
结果：1、心理干预后治疗组的情绪障碍较对照组明显改善(p<0.05)。生活质量量表得分治疗组明显高于对照组(p<0.05)。
2、PCI治疗组患者生活质量为出院后6个月>出院后3个月>入院前(P<0.05)；药物治疗组患者的生活质量为出院后6个月>出院后3个月>入院前(P<0.05)；PCI治疗组患者生活质量变化幅度高于药物治疗组患者的生活质量变化幅度。
3、血脂、血糖、血压、体重指数等指标,治疗组均低于对照组(p<0.05)
结论：1、抗焦虑、抑郁治疗能明显缓解冠心病患者的负性情绪,提高临床治疗效果,改善患者的生活质量及预后。
2、PCI手术可以显著提高冠心病患者的住院期间和出院后近期的生活质量。
Objective:To study disorder in patients with coronary heart disease (CHD) before and after the interventional therapy and to investigate the effect of mental intervention.
Methods:Fifty-two patients diagnosed by coronary angiography or cured by PCI were kept in PCI guoup while the drug therapy group contained Fifty-two patients cured by drug simply.All the patients were randomly allocated to treatment or control group.The control group was given routine medication and nursing,while the research group received anti-anxiety and depression treatment which use St John's wort (300mg Bid po)based on the routine medication and nursing。The quality of life and psychologic condition one day before hospitalization,the three month after discharge and six months after dischartge in both two groups were assessed by Medical Outcome Study Short Form-36(SF-36) and the Settle Angina Survey Form (SAQ)The Hospital Anxiety and Depression Scale (HAD),and tested the blood-fat, blood-fasting sugar,blood pressure,BMI.
Results:1.After the mental intervention,,compared with control group,the rate of anxiety and depression occurred and the quality of life have marked difference with the treatment group.
2.The quality of life in 6 mnths after discharge in PCI group was best while the quality of life before hospitalization was least(P<0.05).The drug therapy group show the same results (P<0.05).
3、the blood-fat,blood-fasting sugar,blood pressure,BMI lower than treatment group(p<0.05).
Conclusion:1.Anti-anxiety and depression treatment indeed can relieve the negative emotion of patients.improve the patients'quality of life.better the clinical effect and prognosis.
2、PCI can significantly improve the quality of life during hospitalization and in a short time after discharge in patients with CHD.
引文
1. Word Health Report 2002:Reducing risks,promoting healthy life.Geneva,World Health Organization 2002.
2. Murray CJL,Lopez AD:The Global Burden of Disease Cambridge,MA,Harvard School of Public Health,1996
3.于欣 心脏心理学-潜伏在你身边的学科双心医学杂志20085(1)：4-11
4. Lett HS,Blumenthal JA,Babyak MA,er al.Depression as a risk factor for coronary artery disease:evidence,mechanisms,and treatment.Psychosom Med,2004;66:305-315
5. Musselman DL.Nemeroff CB.Depression really does hurt your heart:stress, depression,and cardiovascular disease.Prog Brain Res,2000;122:43-59
6.刘梅颜 王锦霞 抑郁症与心血管疾病双心医学杂志20085(1)：85-93
7. Glassman AH,Shapiro PA.Depression and the course of coronary artery disease. AM J Psychiatry 1998; 155(1):4-11
8. Abraham AA,Mary H.Catherine MT,et al.Depressive Symptoms and Risks of Coronary Heart Disease and Mortality in Elderly Americans.Circulation 2000; 102:1773-9
9. Lesperance F,Frasure-Smith N,Talajic M:Major depression before and after myocardial infarction:Its nature and consequences.Psychosom Med 58:99-110, 1996
10. Frasuer-smith N,Lesperance F.Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease.Arch Gen Psychiatry,2008,65:62-71
11. Pedersen SS,Lemos PA,van Vooren PR,et al.Type D personality predicts death or myocardial infarction after bare metal stent or sirolimus-eluting stent imp-lant-ation.J Am Coll Cardiol,2004,44:997-1001
12. Carney RM,Sannders RD,Freedland KE,er al.Association of depression with reduced heart rate variability in coronary artery disease.AM J Cardiol 1995; 76:562-4
13.王青 经皮腔内冠状动脉成形术和射频消融术与心理障碍双心医学杂志20085(1)101-106
14.刘梅颜 王锦霞 抑郁症与心血管疾病 双心医学杂志2008 5(1)85-93
15. Le Grandea MR,Murphya BM.Higginsa RO.et al.Physical activity and negative emotional response after percutaneous coronary intervention.Eur J Cardiovasc Prev Rehabil,2006,13:254-260
16. SullivanMD, Lacroix AZ,Spertus JA,et al.Depression predicts revascularization procedures for 5 years after coronary angiography.Psychosom Med,2003,65:229-236
17.吴文源 李清伟 心血管疾病伴发心理反应双心医学杂志 20085(1)25-32
18.Musselman DL,Evans DL,Wemeroff CB:The relationship of depression to cardiovascular disease:Epidemiology,biology,and treatment.Arch Gen Psychiatry 55:580-592,1998
19. Broadley AJM,Korszun A,jones CJH,et al:Arterial endothelial function is impaired in treated depression.Heart 88:521-524,2002
20. Anfossi G.Trovati M.Role of catecholamines in platelet fuction:pathophysilogical and clinical significance[J].Eur J Clin Invest,1996,26:353-370
21. Musselman DL,Evans DL,Wemeroff CB:The relationship of depression to cardiovascular disease:Epidemiology,biology,and treatment.Arch Gen Psychiatry 55:580-592,1998
22. Musselman DL,Marzec UM.Manatunga A:Platelet reactivity in depressed patients treated with paroxetine:Preliminary findings.Arch Gen Psychiatry 57:875-882, 2000
23. Covey LS,Glassman AH,Stetner F,et al.A randomized trial of sertraline as a cessation aid for smokers with a history of major depression.Am J Psy chiatry, 2002:159:1731-1755
24. Ziegelstein RC.Fauerbach JA,Stevens SS.et al.Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction.Arch Intern Med,2000; 160:1354-1360
25. Camey RM.Freedland KE,Eisen SA et al.Major depression and medication adherence in elderly pationts with coronary artery disease.Health Psychol,1995; 14:88-90
26. Vizza J,Neatrour DM,Felton PM,et al.improvement in psychosocial functioning during an intensive cardiovascular lifestyle modification program.J Cardiopulm Rehabil Prev,2007,27(6):376-383
27. Salovey P.Rothman A,Detweiler J B.Emotional states and physical health{J}.Am Psychol,2000,55(1):110
28.刘淑芳 贾树华 冠心病伴焦虑抑郁的临床研究医学与哲学(临床决策论坛版) 20075；28(5)
29.杨菊贤心血管疾病患者伴有焦虑抑郁的处理{J}.上海预防医学杂志,2002,14(3) ：145-146
30.袁浩龙内科疾病中的焦虑和抑郁{J}.四川精神卫生,1999,12(1)：69-70
31.石晓燕,杨倩,宋连香,等117例内科疾病患者兵法焦虑和抑郁症状的研究{J}.华西医学,1997,12(1)：60-62
32.陈颖敏,王家亮,王彬尧,等.心血管患者伴焦虑抑郁症状的临床特征与治疗{J},上海第二医科大学学报,2001,21(1)：79
33.马文林胡大一机型冠状动脉综合征伴发焦虑和抑郁的早期识别及干预应双心医学杂志20085(1)94-100
1. Katon W,Lin EH,Russo J,et al.Cardiac risk factors in patients with diabetes mellitus and major depression.J Gen Intern Med 2004;19(12):1192-9
2. EL-Gatit AS,Haw M.Relationship between depression and non-adherence to anticoagulant therapy after valve replacem-ent.East Mediterr Health J 2003;9 (1-2):12-9
3. 徐桂娟 心血管疾病与抑郁障碍：共病概念引出的新问题.ISSN 1671-5926CN21-1470／R
4. 杨菊贤,许左鞠.机型冠脉综合征的发生发展与心理行为因素[J].心血管并学进展,2004,25(4)：261-263
5. Ariyo AA.Haan M,Tangen CM,et al.Depression symptoms and Risk of Coronary Heart Kisease and Mortality in Elderly Americans.Cardiovascular health study collaborative research group.Circulation 2000;102(15):1773-1779
6. Denninx BW,Guralnik JM, Mendes de leon CF,et al. Cardio-vascular events and mortality in newly and chronically depressed persons>70 years of age.Am J Cardiol 1998;81(8):988-994
7. Chisholm D,Sanderson K,Ayuso-Mateos JL,et al /Br J Psych-iatry,2004, 184:393-403
8. 陈灏珠 心脏病学-心血管内科学教科书：经皮冠状动脉和心脏瓣膜介入治疗,2006，1278-1315
9. Freiberg MS,Cabral HJ,Heeren TC,et al.Alcohol consump-tion and the prevalence of the metabolic syndrome in the US:A cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey. Diab-etes Care,2004,27(12):2954-2959
10. Denollet J,Pedersen SS,Vrints CJ,et al.Usefulness of type Dpersonality in predicting five-year cardiac events above and beyond concurrentsymptoms of stress in patients with coronary heart disease.Am J Cardiol,2006,97(7):970-973
11. Musselman DL,Evans DL,Wemeroff CB:The relationship of depression to cardiovascular disease:Epidemio!ogy,biology,and treatment.Arch Gen Psychiatry 55:580-592,1998
12. Broadley AJM.Korszun A,jones CJH.et al:Arterial endothelial function is impaired in treated depression.Heart 88:521-524,2002
13. Anfossi G,Trovati M.Role of catecholamines in platelet fuction:pathophysi- logical and clinical significance[J].Eur J Clin Invest,1996,26:353-370
14. Musselman DL,Evans DL,Wemeroff CB:The relationship of depression to cardiovascular disease:Epidemiology,biology,and treatment.Arch Gen Psychiatry 55:580-592,1998
15. Musselman DL,Marzec UM.Manatunga A:Platelet reactivity in depressed patients treated with paroxetine:Preliminary findings.Arch Gen Psychiatry 57:875-882,2000
16. Covey LS,Glassman AH.Stetner F,et al.A randomized trial of sertraline as a cessation aid for smokers with a history of major depression.Am J Psy chiatry,2002; 159:1731-1755
17. Ziegelstein RC,Fauerbach JA,Stevens SS.et al.Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction.Arch Intern Med,2000;160:1354-1360
18. Camey RM.Freedland KE,Eisen SA et al.Major depression and medication adherence in elderly pationts with coronary artery disease.Health Psychol,1995; 14:88-90
19.马文林 胡大一 急性冠状动脉综合征伴发焦虑和抑郁的早期识别及干预双心医学杂志20085(1) 94-100
20.朱金富 冠心病的心理干预现状[J].国外医学精神病学分册,2003,30(4)：226-228
21. Salovey P,Rothman A,Detweiler J B.Emotional states and physical health{J}.Am Psychol,2000,55(1):110
22.刘淑芳贾树华冠心病伴焦虑抑郁的临床研究医学与哲学(临床决策论坛版)20075；28(5)
23.杨菊贤心血管疾病患者伴有焦虑抑郁的处理{J}.上海预防医学杂志,2002,14(3) ：145-146
24.袁浩龙.内科疾病中的焦虑和抑郁{J}.四川精神卫生,1999,12(1)：69-70
25.石晓燕,杨倩,宋连香,等117例内科疾病患者兵法焦虑和抑郁症状的研究{J}.华西医学,1997,12(1)：60-62
26.陈颖敏,王家亮,王彬尧,等.心血管患者伴焦虑抑郁症状的临床特征与治疗{J},上海第二医科大学学报,2001,21(1)：79
2. Murray CJL,Lopez AD:The Global Burden of Disease Cambridge,MA,Harvard School of Public Health,1996
3.于欣 心脏心理学-潜伏在你身边的学科双心医学杂志20085(1)：4-11
4. Lett HS,Blumenthal JA,Babyak MA,er al.Depression as a risk factor for coronary artery disease:evidence,mechanisms,and treatment.Psychosom Med,2004;66:305-315
5. Musselman DL.Nemeroff CB.Depression really does hurt your heart:stress, depression,and cardiovascular disease.Prog Brain Res,2000;122:43-59
6.刘梅颜 王锦霞 抑郁症与心血管疾病双心医学杂志20085(1)：85-93
7. Glassman AH,Shapiro PA.Depression and the course of coronary artery disease. AM J Psychiatry 1998; 155(1):4-11
8. Abraham AA,Mary H.Catherine MT,et al.Depressive Symptoms and Risks of Coronary Heart Disease and Mortality in Elderly Americans.Circulation 2000; 102:1773-9
9. Lesperance F,Frasure-Smith N,Talajic M:Major depression before and after myocardial infarction:Its nature and consequences.Psychosom Med 58:99-110, 1996
10. Frasuer-smith N,Lesperance F.Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease.Arch Gen Psychiatry,2008,65:62-71
11. Pedersen SS,Lemos PA,van Vooren PR,et al.Type D personality predicts death or myocardial infarction after bare metal stent or sirolimus-eluting stent imp-lant-ation.J Am Coll Cardiol,2004,44:997-1001
12. Carney RM,Sannders RD,Freedland KE,er al.Association of depression with reduced heart rate variability in coronary artery disease.AM J Cardiol 1995; 76:562-4
13.王青 经皮腔内冠状动脉成形术和射频消融术与心理障碍双心医学杂志20085(1)101-106
14.刘梅颜 王锦霞 抑郁症与心血管疾病 双心医学杂志2008 5(1)85-93
15. Le Grandea MR,Murphya BM.Higginsa RO.et al.Physical activity and negative emotional response after percutaneous coronary intervention.Eur J Cardiovasc Prev Rehabil,2006,13:254-260
16. SullivanMD, Lacroix AZ,Spertus JA,et al.Depression predicts revascularization procedures for 5 years after coronary angiography.Psychosom Med,2003,65:229-236
17.吴文源 李清伟 心血管疾病伴发心理反应双心医学杂志 20085(1)25-32
18.Musselman DL,Evans DL,Wemeroff CB:The relationship of depression to cardiovascular disease:Epidemiology,biology,and treatment.Arch Gen Psychiatry 55:580-592,1998
19. Broadley AJM,Korszun A,jones CJH,et al:Arterial endothelial function is impaired in treated depression.Heart 88:521-524,2002
20. Anfossi G.Trovati M.Role of catecholamines in platelet fuction:pathophysilogical and clinical significance[J].Eur J Clin Invest,1996,26:353-370
21. Musselman DL,Evans DL,Wemeroff CB:The relationship of depression to cardiovascular disease:Epidemiology,biology,and treatment.Arch Gen Psychiatry 55:580-592,1998
22. Musselman DL,Marzec UM.Manatunga A:Platelet reactivity in depressed patients treated with paroxetine:Preliminary findings.Arch Gen Psychiatry 57:875-882, 2000
23. Covey LS,Glassman AH,Stetner F,et al.A randomized trial of sertraline as a cessation aid for smokers with a history of major depression.Am J Psy chiatry, 2002:159:1731-1755
24. Ziegelstein RC.Fauerbach JA,Stevens SS.et al.Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction.Arch Intern Med,2000; 160:1354-1360
25. Camey RM.Freedland KE,Eisen SA et al.Major depression and medication adherence in elderly pationts with coronary artery disease.Health Psychol,1995; 14:88-90
26. Vizza J,Neatrour DM,Felton PM,et al.improvement in psychosocial functioning during an intensive cardiovascular lifestyle modification program.J Cardiopulm Rehabil Prev,2007,27(6):376-383
27. Salovey P.Rothman A,Detweiler J B.Emotional states and physical health{J}.Am Psychol,2000,55(1):110
28.刘淑芳 贾树华 冠心病伴焦虑抑郁的临床研究医学与哲学(临床决策论坛版) 20075；28(5)
29.杨菊贤心血管疾病患者伴有焦虑抑郁的处理{J}.上海预防医学杂志,2002,14(3) ：145-146
30.袁浩龙内科疾病中的焦虑和抑郁{J}.四川精神卫生,1999,12(1)：69-70
31.石晓燕,杨倩,宋连香,等117例内科疾病患者兵法焦虑和抑郁症状的研究{J}.华西医学,1997,12(1)：60-62
32.陈颖敏,王家亮,王彬尧,等.心血管患者伴焦虑抑郁症状的临床特征与治疗{J},上海第二医科大学学报,2001,21(1)：79
33.马文林胡大一机型冠状动脉综合征伴发焦虑和抑郁的早期识别及干预应双心医学杂志20085(1)94-100
1. Katon W,Lin EH,Russo J,et al.Cardiac risk factors in patients with diabetes mellitus and major depression.J Gen Intern Med 2004;19(12):1192-9
2. EL-Gatit AS,Haw M.Relationship between depression and non-adherence to anticoagulant therapy after valve replacem-ent.East Mediterr Health J 2003;9 (1-2):12-9
3. 徐桂娟 心血管疾病与抑郁障碍：共病概念引出的新问题.ISSN 1671-5926CN21-1470／R
4. 杨菊贤,许左鞠.机型冠脉综合征的发生发展与心理行为因素[J].心血管并学进展,2004,25(4)：261-263
5. Ariyo AA.Haan M,Tangen CM,et al.Depression symptoms and Risk of Coronary Heart Kisease and Mortality in Elderly Americans.Cardiovascular health study collaborative research group.Circulation 2000;102(15):1773-1779
6. Denninx BW,Guralnik JM, Mendes de leon CF,et al. Cardio-vascular events and mortality in newly and chronically depressed persons>70 years of age.Am J Cardiol 1998;81(8):988-994
7. Chisholm D,Sanderson K,Ayuso-Mateos JL,et al /Br J Psych-iatry,2004, 184:393-403
8. 陈灏珠 心脏病学-心血管内科学教科书：经皮冠状动脉和心脏瓣膜介入治疗,2006，1278-1315
9. Freiberg MS,Cabral HJ,Heeren TC,et al.Alcohol consump-tion and the prevalence of the metabolic syndrome in the US:A cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey. Diab-etes Care,2004,27(12):2954-2959
10. Denollet J,Pedersen SS,Vrints CJ,et al.Usefulness of type Dpersonality in predicting five-year cardiac events above and beyond concurrentsymptoms of stress in patients with coronary heart disease.Am J Cardiol,2006,97(7):970-973
11. Musselman DL,Evans DL,Wemeroff CB:The relationship of depression to cardiovascular disease:Epidemio!ogy,biology,and treatment.Arch Gen Psychiatry 55:580-592,1998
12. Broadley AJM.Korszun A,jones CJH.et al:Arterial endothelial function is impaired in treated depression.Heart 88:521-524,2002
13. Anfossi G,Trovati M.Role of catecholamines in platelet fuction:pathophysi- logical and clinical significance[J].Eur J Clin Invest,1996,26:353-370
14. Musselman DL,Evans DL,Wemeroff CB:The relationship of depression to cardiovascular disease:Epidemiology,biology,and treatment.Arch Gen Psychiatry 55:580-592,1998
15. Musselman DL,Marzec UM.Manatunga A:Platelet reactivity in depressed patients treated with paroxetine:Preliminary findings.Arch Gen Psychiatry 57:875-882,2000
16. Covey LS,Glassman AH.Stetner F,et al.A randomized trial of sertraline as a cessation aid for smokers with a history of major depression.Am J Psy chiatry,2002; 159:1731-1755
17. Ziegelstein RC,Fauerbach JA,Stevens SS.et al.Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction.Arch Intern Med,2000;160:1354-1360
18. Camey RM.Freedland KE,Eisen SA et al.Major depression and medication adherence in elderly pationts with coronary artery disease.Health Psychol,1995; 14:88-90
19.马文林 胡大一 急性冠状动脉综合征伴发焦虑和抑郁的早期识别及干预双心医学杂志20085(1) 94-100
20.朱金富 冠心病的心理干预现状[J].国外医学精神病学分册,2003,30(4)：226-228
21. Salovey P,Rothman A,Detweiler J B.Emotional states and physical health{J}.Am Psychol,2000,55(1):110
22.刘淑芳贾树华冠心病伴焦虑抑郁的临床研究医学与哲学(临床决策论坛版)20075；28(5)
23.杨菊贤心血管疾病患者伴有焦虑抑郁的处理{J}.上海预防医学杂志,2002,14(3) ：145-146
24.袁浩龙.内科疾病中的焦虑和抑郁{J}.四川精神卫生,1999,12(1)：69-70
25.石晓燕,杨倩,宋连香,等117例内科疾病患者兵法焦虑和抑郁症状的研究{J}.华西医学,1997,12(1)：60-62
26.陈颖敏,王家亮,王彬尧,等.心血管患者伴焦虑抑郁症状的临床特征与治疗{J},上海第二医科大学学报,2001,21(1)：79