抗抑郁治疗对老年糖尿病合并抑郁患者的疗效分析
|
摘要
目的探讨老年糖尿病合并抑郁症患者抗抑郁药物治疗的疗效。方法选取2016年4月-2017年9月在应急总医院就诊的老年糖尿病合并抑郁症患者100例,将其按随机数表法分为观察组和对照组,每组各50例,两组均给予糖尿病饮食、短期强化糖尿病患者教育、按需给予小剂量氯丙嗪。观察组给予盐酸舍曲林抗抑郁药物治疗,对照组给予针对糖尿病治疗的相关心理辅导。结果治疗后与治疗前相比,两组患者抑郁自评量表(SDS)及汉密尔顿抑郁量表(HAMD)评分均有明显改善(P <0.05);治疗后观察组与对照组患者相比,其SDS及HAMD评分仍有明显差异(P <0.05)。与治疗前相比,观察组患者除总胆固醇(TC)外,空腹血糖(FBG)、餐后2小时血糖(2hPBG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、高密度脂蛋白(HDL-c)、低密度脂蛋白(LDL-c)、尿微量白蛋白/尿肌酐(mALB/NCR)、脂蛋白a(LPa)等生化指标均有明显好转(P <0.01);而对照组患者除FBG及2hPBG比治疗前有改善外,其余指标均变化不明显。对观察组患者进行6个月的治疗情况随访发现,随着治疗时间的增加,其疗效愈加明显。结论抗抑郁药物治疗能明显改善老年糖尿病合并抑郁症患者的抑郁状态及生化指标。
Objective To investigate the efficacy of antidepressant treatment in elderly patients with diabetes and depression in a general hospital. Methods 100 elderly patients with diabetes mellitus complicated with depression were randomly divided into observation group and control group,50 cases in each group. Both groups were given diabetic diet,short-term intensive education for diabetic patients,and small doses of chlorpromazine as needed. The observation group was given sertraline hydrochloride antidepressant treatment,the control group was given diabetes treatment-related psychological counseling. Results The SDS and HAMD scores of the two groups were significantly improved after treatment than before treatment(P < 0.01). However,the SDS and HAMD scores of the observation group after treatment were still significantly different from those of the control group(P < 0.05). In addition,compared with before treatment,except for TC,the indicators of FBG,2 hPBG,HbA1 C,TG,HDL-c,LDL-c and other biochemical indicators in the observation group were significantly improved(P < 0.05);However,besides the FBG and 2 hPBG was improved,there was no significant change in other indicators in control group. At the same time,the patients in the observation group were followed up for 6 months. It was found that the curative effect became more significant with the prolongation of treatment time.Conclusion Antidepressant medication can significantly improve the depression status and biochemical parameters of elderly diabetic patients with depression.
Objective To investigate the efficacy of antidepressant treatment in elderly patients with diabetes and depression in a general hospital. Methods 100 elderly patients with diabetes mellitus complicated with depression were randomly divided into observation group and control group,50 cases in each group. Both groups were given diabetic diet,short-term intensive education for diabetic patients,and small doses of chlorpromazine as needed. The observation group was given sertraline hydrochloride antidepressant treatment,the control group was given diabetes treatment-related psychological counseling. Results The SDS and HAMD scores of the two groups were significantly improved after treatment than before treatment(P < 0.01). However,the SDS and HAMD scores of the observation group after treatment were still significantly different from those of the control group(P < 0.05). In addition,compared with before treatment,except for TC,the indicators of FBG,2 hPBG,HbA1 C,TG,HDL-c,LDL-c and other biochemical indicators in the observation group were significantly improved(P < 0.05);However,besides the FBG and 2 hPBG was improved,there was no significant change in other indicators in control group. At the same time,the patients in the observation group were followed up for 6 months. It was found that the curative effect became more significant with the prolongation of treatment time.Conclusion Antidepressant medication can significantly improve the depression status and biochemical parameters of elderly diabetic patients with depression.
引文
[1]谢坤,张晓庆.住院2型糖尿病合并抑郁症患者生命质量的相关性研究[J].中华疾病控制杂志,2014,18(6):515-517.
[2]张娟,毕艳,沈山梅,等. 2型糖尿病患者抑郁的患病率及相关危险因素分析[J].中华内分泌代谢杂志,2011,2(10):796-799.
[3] American DA. Standards of medical care in diabetesd 2013[J].Diabet Care 2013,36(1):11-66.
[4]姚摇静.糖尿病患者中的抑郁问题[J].国外医学:精神病学分册,2001,28(4):199-203.
[5] Cuijpers P,Karyotaki E,Weitz E,et al. The effects of psychotherapies for major depression in adults on remission,recovery and improvement:a meta-analysis[J]. J Affect Disord,2014,159(20):118-126.
[6] Ebert DD,Nobis S,Lehr D,et al. The 6-month effectiveness of internet-based guided self-help for depression in adults with type1 and 2 diabetes mellitus[J]. Diabet Med,2016,34(1):99.
[7] Safren SA,Gonzalez JS,Wexler DJ,et al. A randomized controlled trial of cognitive behavioral therapy for adherence and depression(CBT-AD)in patients with uncontrolled type 2 diabetes[J].Diabet Care,2014,37(9):625-633.
[8] Echeverry,D,Duran,P,Bonds,C,et al. Effect of pharmacological treatment of depression on A1c and quality of life in low-income Hispanics and African-Americans with diabetes[J]. Diabet Care,2009,32(12):2156-2160.
[2]张娟,毕艳,沈山梅,等. 2型糖尿病患者抑郁的患病率及相关危险因素分析[J].中华内分泌代谢杂志,2011,2(10):796-799.
[3] American DA. Standards of medical care in diabetesd 2013[J].Diabet Care 2013,36(1):11-66.
[4]姚摇静.糖尿病患者中的抑郁问题[J].国外医学:精神病学分册,2001,28(4):199-203.
[5] Cuijpers P,Karyotaki E,Weitz E,et al. The effects of psychotherapies for major depression in adults on remission,recovery and improvement:a meta-analysis[J]. J Affect Disord,2014,159(20):118-126.
[6] Ebert DD,Nobis S,Lehr D,et al. The 6-month effectiveness of internet-based guided self-help for depression in adults with type1 and 2 diabetes mellitus[J]. Diabet Med,2016,34(1):99.
[7] Safren SA,Gonzalez JS,Wexler DJ,et al. A randomized controlled trial of cognitive behavioral therapy for adherence and depression(CBT-AD)in patients with uncontrolled type 2 diabetes[J].Diabet Care,2014,37(9):625-633.
[8] Echeverry,D,Duran,P,Bonds,C,et al. Effect of pharmacological treatment of depression on A1c and quality of life in low-income Hispanics and African-Americans with diabetes[J]. Diabet Care,2009,32(12):2156-2160.