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目的探讨舍曲林联合心理疗法治疗冠心病(CHD)合并抑郁症患者的临床疗效,评估其抑郁程度,为临床治疗提供科学理论依据。方法本文选择湖州市第三人民医院2014年7月—2016年4月收治的91例冠心病合并抑郁症患者随机分为观察组(n=46)和对照组(n=45)。对照组给予CHD常规治疗及心理干预,观察组在对照组的基础上联合盐酸舍曲林治疗。观察比较2组临床疗效,汉密尔顿抑郁量表(HAMD)、抑郁自评量表(SDS)及症状自评量表(SCL-90)评分,应用SPSS 17.0进行统计学处理分析。结果观察组治疗总有效45例(97.83%),显著高于对照组的39例(86.67%)(Z=2.496,P=0.013)。治疗后2周、12周,2组HAMD、SDS评分均显著下降(P<0.05),且观察组显著低于对照组(P<0.05)。SCL-90评分比较,观察组治疗后2周躯体化、抑郁、焦虑、敌对、恐怖及偏执得分均显著下降(P<0.05),治疗后12周8项指标得分均下降(P<0.05);对照组治疗后12周躯体化、抑郁、焦虑及恐怖差异存在统计学意义(P<0.05)。观察组躯体化、抑郁、焦虑及恐怖得分均显著低于对照组(P<0.05)。结论舍曲林联合心理疗法治疗CHD合并抑郁症临床疗效显著,可有效降低HAMD、SDS、SCL-90评分,改善抑郁症状,值得推广应用。
Objective To investigate the clinical efficacy of sertraline combined with psychotherapy in the treatment of patients with coronary heart disease (CHD) complicated with depression and to evaluate the degree of depression and provide a scientific basis for clinical treatment. Methods 91 patients with CHD complicated by depression admitted to the Third People’s Hospital of Huzhou from July 2014 to April 2016 were randomly divided into observation group (n = 46) and control group (n = 45). The control group was given routine treatment and psychological intervention of CHD. The observation group was treated with sertraline hydrochloride on the basis of the control group. The clinical efficacy, Hamilton Depression Rating Scale (HAMD), Self-rating Depression Scale (SDS) and Symptom Checklist 90 (SCL-90) were compared between the two groups. The data were analyzed by SPSS 17.0. Results The total effective rate of observation group was 45 cases (97.83%), which was significantly higher than that of control group (39 cases, 86.67%) (Z = 2.496, P = 0.013). At 2 weeks and 12 weeks after treatment, the scores of HAMD and SDS decreased significantly in both groups (P <0.05), and the observation group was significantly lower than the control group (P <0.05). Scores of somatization, depression, anxiety, hostility, terror and paranoid significantly decreased in observation group 2 weeks after treatment (P <0.05), and scores of 8 indicators decreased 12 weeks after treatment (P <0.05). There was significant difference in somatization, depression, anxiety and horror in control group after 12 weeks of treatment (P <0.05). The somatization, depression, anxiety and terror scores in the observation group were significantly lower than those in the control group (P <0.05). Conclusion The combination of sertraline and psychotherapy is effective in treating CHD complicated with depression. It can effectively reduce the score of HAMD, SDS and SCL-90, and improve depression symptoms. It is worth popularizing and applying.