双心医学诊疗模式对慢性心力衰竭合并焦虑抑郁患者的疗效观察.pdf

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1、山西医药杂志2015年5月第44卷第9期ShanxiMedJ，May2015，Vo1．44，No．9·985·双心医学诊疗模式对慢性心力衰竭合并焦虑抑郁患者的疗效观察曹锐红【摘要】目的观察双心医学诊疗模式在慢性心力衰竭(CHF)合并焦虑抑郁患者中的疗效。方法采用《躯体化症状自评量表》筛查CHF患者，得分在38～42存在轻中度焦虑抑郁的7O例患者入选，按随机数字表法分为治疗组(35例)和对照组(35例)，2组均采用正规的抗心力衰竭治疗方案，治疗组再加用氟哌噻吨美利曲辛片1粒(O．5mg／lOmg)，早、中各1次，疗程3个月。2组治疗前后均进行躯体化症状自评量表评分、美国纽约心脏

2、病学会(NYHA)心功能分级评定、心脏超声检查、6min步行试验(6MWT)及检测血浆B型脑钠肽(BNP)值。结果与治疗前相比，治疗组总有效率为86，对照组为6O，2组比较差异有统计学意义(P

3、并焦虑抑郁的患者可明显改善心脏功能，提高患者的生活质量。【关键词】双心治疗；心力衰竭，慢性；心脏功能Theclinicalobservationofpsycho-cardiologytreatmentmodeinthepatientswithchronicheartfailurecomplicatedwithanxiety-depressionCaoRuihong．VasculocardiologyDepartment，TraditionalChineseMedicalHospitalofZhangJiagang，Jiangsu215600，China[Abstract]0b

4、jectiveTheaimofthisstudywastoevaluatetheeffectivenessofpsycho-cardiologytreatmentmodeinthepatientswithchronicheartfailure(CHF)complicatedwithanxiety-depression．MethodsSeventyCHFpatientswithmildtomoderateanxiety-depression(scoresbetween38—。42)wereselectedandrandomlydivid—edintotreatmentgroup

5、(，l—a5)andthecontrolgroup(n一35)basedoncriteriaoftheSomaticSelf-ratingScale(SSS)classification．Theregularantiheartfailuretreatmentschemewasusedintwogroups，butthetreatmentgroupwascombinedwithFlupentixolandmelitracentablets(0．5mg／10mg)onetableteachtime，twotimes(morningandafternoon)aday，thecour

6、seoftreatmentwas3months．ThescoreofSSS，theexaminationofcar—diaccolorDopplerultrasound，6-minwalktest(6MWT)，D-typenatriureticpeptide(BNP)inplasmawerecarriedoutandcardiacfunctionclassificationwascalculatedaccordingtoNYHAbeforeandaftertreatmentintwogroups．ResultsComparedwithbeforetreatment，theto

7、taleffectiverateoftreatmentgroupwas86，whilethatinthecontrolgroupwas60。Thereweresignificantdifferences(P<0．05)．Echo—cardiographicindexes(LVEDD，LVEF)，6MWT，BNP，SSSscoreswereimprovedaftertreatmentcomparedwithbeforetreatment(P<0．05)inthetwogroups．Comparedwith