目的:探讨氟西汀联合心理干预治疗心血管疾病患者伴焦虑抑郁症状的临床疗效。方法:选择伴有抑郁、焦虑情绪障碍的85例冠心病患者(心功能Ⅱ、Ⅲ级),并将其随机分成研究组和对照组。观察6w,对照组患者仅给予常规的治疗,研究组患者在常规治疗基础上给予氟西汀联合心理干预治疗。观察治疗前后两组患者采用汉密顿焦虑量表( Hamilton Anxiety Scale,HAMA) 评定焦虑症状,汉密顿抑郁量表( Hamilton Depression Scale,HAMD) 评定抑郁症状;并对治疗后心功能分级(NYHA)恢复到Ⅰ级的例数及左室射血分数进行分析评价。结果:治疗6 周 后,研究组均较对照组的汉密顿焦虑量表及汉密顿抑郁量表评分下降显著( P lt;0.01),研究组抗焦虑显效率为87.16%、抗抑郁显效率为82.26%,对照组分别为43.75%、45.36%,研究组均显著高于对照组( P lt;0.01);研究组患者的左室射血分数显著高于对照组 ( P lt;0.05),心功能分级(NYHA)恢复到Ⅰ级的例数显著高于对照组 ( P lt;0.05)。结论:氟西汀联合心理干预治疗不仅能改善心血管疾病伴焦虑抑郁患者的焦虑、抑郁情绪障碍,还能改善患者的心功能,疗效显著优于单用心血管药物治疗。
Objective To study the effects of anxious condition on asthma symptom burden and asthma control in elderly asthma patients in primary care settings. Methods Totally 128 elderly asthma patients were recruited in this study. The patients were required to fill in the questionnaire，then the score of asthma control test （ACT） and Hamilton anxious meter（HAMA） were calculated. Risk factors of anxious condition were analyzed by logistic analysis. Results The ACT scores in the anxious patients were significantly lower than those of the non-anxious patients [17.45±3.14 vs. 21.45±2.37，Plt;0.05）. The patients with lower incoming and more complications had more severe anxious condition，lower asthma control level，and more asthmatic medications. Meanwhile the latter conditions also increased the incidence of anxiety in the elderly asthma patients significantly （Plt;0.05）. Conclusions The elderly asthma patients in primary care settings are also complicated with anxiety，and the anxious condition can significantly increase asthma symptom burden and decrease asthma control level.
ObjectiveTo investigate the effect of Metformin (MET) on the anxiety behavior of mice with Pentylenetetrazol (PTZ)-induced epilepsy and the mechanisms. MethodsSixty male 8-week-old C57BL/6 mice were randomly divided into normal control group (Normal), Temporal lobe epilepsy (TLE) model control group (TLE-con), TLE + MET treatment group (TLE-MET), and normal mice + MET intervention group (MET-con) (n=15/group). In the TLE-con group and the TLE-MET group, mice were injected intraperitoneally with PTZ every other day to establish the TLE model, while mice in the Normal group and the MET group were given the same dose of normal saline. During PTZ administration, mice in the TLE-MET treatment group and the MET-con group were intraperitoneally injected with MET at 200 mg/(kg·d) every other day, for 14 times in a total of 28 days. The mice in the Normal group and the TLE-con group were intraperitoneally injected with the same amount of normal saline. Open field test (OFT) and elevated cross maze (EPM) were used to evaluate the anxiety behavior of mice in each group, and the Western blotting analysis was performed to detect expression of Toll like receptor 4 (TLR4), Nuclear factor-kappa B (NF-κB) p65 in brain tissues. ResultsCompared with the Normal group, the TLE-con group showed decreased times in the open arm in the EPM test (P<0.01) and in the center of open field in the OFT test (P<0.01), while MET intervention could increase the times of epileptic mice in the central area and the open arm (P<0.05). Compared with the Normal group, the expression of TLR4 and NF-κB in the cerebral cortex in the TLE-con group was increased significantly (P<0.05), while MET intervention could partially decrease the expression of TLR4 and NF-κB in the cerebral cortex of epileptic mice (P<0.05). ConclusionMET may improve the anxiety behavior of epileptic mice by reducing the inflammatory TLR4–NF-κB pathway.
Anxiety is a strong behavioral and psychological reaction with fear components, while depression is a mental disorder dominated by high or low mood, both of which are accompanied by cognitive and behavioral changes, and are common comorbidities in patients with heart disease. Cardiac surgery is one of the important factors which trigger specific emotional and physiological reactions of patients. Persistent or initial depression and anxiety after surgery will not only increase surgical complications, short- or long-term mortality and medical costs, but also seriously affect patients' social function and quality of life. With the transformation of bio-psycho-social medical model, it is necessary to evaluate the perioperative psychological state and biological risk of patients undergoing cardiac surgery. This article reviews the characteristics, related mechanisms and therapeutic interventions of anxiety and depression in patients undergoing cardiac surgery.
目的 探讨糖耐量异常患者的焦虑抑郁状况及其与生活质量的相关性，为糖尿病相关心理问题的早期识别与干预提供参考。 方法 以2010年1月－2012年6月糖耐量异常患者145例为试验组，健康人群147例作为对照组，两组分别填写焦虑自评量表（SAS）和抑郁自评量表（SDS），试验组还需填写世界卫生组织生活质量测定量表简表（WHOQOL-BREF）并对其焦虑、抑郁得分与WHOQOL-BREF的各因子的相关性进行分析。 结果 145例患者中有51例（35.2%）存在抑郁情绪，47例（32.4%）存在焦虑情绪，焦虑合并抑郁情绪者29例（20%）。糖耐量异常患者焦虑、抑郁评分明显高于对照组（P＜0.01），其生活质量多个领域评分低于对照组（P＜0.01），且生活质量与焦虑、抑郁情绪存在负相关（P＜0.05）。 结论 糖耐量异常患者焦虑、抑郁情绪明显高于正常人群，其生活质量偏低，提示了对在该人群进行早期心理干预的必要性。
ObjectiveTo compare the anxiety, depressive and personality characteristics between diabetes mellitus patients with or without diabetic retinopathy (DR), and look for psychological treatment and corresponding prevention measures. Methods435 diabetic patients were enrolled in this study from April to November 2014 in our hospital, including 178 DR cases (group A) and 257 cases without retinopathy (group B). All the patients completed a questionnaire, the Self-Rating Anxiety (SAS), the Self-Rating Depression Scale (SDS) and the big five personality scale (NEO-FFI), and were scored by eye doctors. According to the score, SAS can be divided into mild anxiety, moderate anxiety, and severe anxiety. SDS is divided into depression, mild depression, moderate depression and major depression. NEO-FFI was scored from emotional stability, outgoing, openness, easy-going and sense of responsibility. Multiple linear regression analysis was used to analyze the DR risk factors in those scores and education level, high blood pressure, age, alcohol consumption, occupation and other factors. ResultsThere were 110 cases of mild anxiety, 57 cases of moderate anxiety, 11 cases of severe anxiety; 74 cases without depression, 53 cases of mild depression, 31 cases of moderate depression, 20 cases with major depression in group A. There were 181 cases of mild anxiety, 53 cases of moderate anxiety, 23 cases of severe anxiety; 177 cases without depression, 44 cases of mild depression, 25 cases of moderate depression, 11 cases with major depression in group B. Group A patients had higher SAS, SDS scores than group B, the difference was statistically significant (P=0.035). Group B patients had higher NEO-FFI score in outgoing, easygoing, responsibility (P=0.022), lower NEO-FFI score in emotional stability (P=0.014) and same NEO-FFI score in openness(P=0.210)compare to Group A patients. Multiple linear regression analysis results showed that education level, high blood pressure, age, weight, drinking, occupation can affect the degree of changes in the retina (P=0.019). ConclusionsCompared with those without retinopathy, DR patients were more prone to anxiety and depression. They also had low score in personality characteristics of outgoing, easygoing, responsibility.
Objective To evaluate the therapeutic efficacy and safety of trazodone versus alprazolam for generalized anxiety disorder (GAD). Methods After the third day of a three-day screening period, 60 patients with generalized anxiety disorder were randomly assigned to the trazodone group (30 patients, 50-150 mg/d), and alprazolam group (30 patients 1.2-4 mg/d) for 4 weeks. Patients and their doctors were blind. Data were analyzed by SPSS 10.0 and intention-to-treat analysis. Results The total effective rate of trazodone was 77% (23/30), while alprazolam was 70% (21/30) (Pgt;0.05) .No difference was seen for adverse events. None was lost to follow in the two groups. Conclusions Trazodone appears to be as effective as alprazolam in treating generalized anxiety disorder. Adverse events may include confusion and loss of appetite, but patients are able to tolerate these.
Objective To evaluate the clinical effectiveness and safety of Jiu Wei Lv Ping particle in the treatment of generalized anxiety disorder (GAD). Methods The multi-center, randomized double-blind method was used to observe 227 GAD patients who were divided into the treatment group (n=114, treated with Jiu Wei Lv Ping particle 6 g, three times a day) and the control group (n=113, treated with buspirone 10 mg, three times a day). HAMD score, and CGI-GI score were used to evaluate the clinical efficacy. TESS score and the list of symptom-recording were used to observe the safety. All the outcomes for evaluation before and after treatment at week 1, week 2, week 3 and week 4. Results According to intention-to-treat analysis (ITT), the level of decrease of HAMA score from baseline at each observational point of the treatment group was similar to that of the control group (t test, Pgt;0.05). At the end point, the effective rate of treatment group was 87.72％, and the effective rate of the control group was 87.61%. There was no significant difference between the two groups (CMH test, Pgt;0.05). According to the score of CGI-GI at each observational point, there was no difference of the effective rate between the treatment group and the control group (student test, Pgt;0.05). The side effect rate of the treatment group was 16.67%, The frequent symptoms were thirst (8.77%), dizziness (7.02%), nausea (2.63%), constipation (2.63%) and diarrhea (1.75%). The side effect rate of the control group was 30.97%, The frequent symptoms were thirst (15.04%), constipation (6.19%), nausea (4.42%), diarrhea (4.42%), dizziness (3.45%) and tachycardia (1.77%). The side effect of the treatment group was lower than that of the control group. But there was no significant difference between the two groups according to the score of TESS (F test, Pgt;0.05). Conclusions The therapeutic action of Jiu Wei Lv Ping particle in the treatment of GAD is affirmed with less side effects. It is valuable to use clinically.
Objective To evaluate the effect of music therapy for childbirth. Methods Such databases as The Cochrane Library, PubMed, EMbase, EBSCO host, SpringerLINK Online Journals, CBM and WanFang Data were searched from January of 2000 to December of 2010 to collect randomized controlled trials (RCTs) of music therapy for childbirth. The quality of RCTs was appraised and the data were extracted. Meta-analyses were conducted with RevMan5.02 software for the standarded RCTs. Results A total of nine RCTs were included. Five RCTs indicated the music therapy could alleviate the labor pain; five RCTs indicated the music therapy could reduce the event risk of cesarean section due to the failure of transvaginal trial labor; three RCTs indicated the music therapy could shorten the first stage of labor; two RCTs indicated the music therapy could stabilize the systolic pressure and heart rate when complete cervical dilation was done, and three RCTs indicated the music therapy could relieve anxiety. In addition, music therapy had no influence on neonate Apgar’s score; and the result of meta-analyses on postpartum hemorrhage was not reliable through sensitivity analyses. Conclusion The music therapy applied during childbirth can relieve the labor pain and anxiety, stabilize the heart rate and systolic pressure when complete cervical dilation is done, reduce the event risk of cesarean section due to the failure of transvaginal trial labor, shorten the first stage of labor, and is beneficial to the mind and body of parturient.