【摘要】 目的 探讨降高血压药物联合抗焦虑抑郁药物万拉法新治疗老年性原发高血压伴焦虑抑郁障碍的疗效及安全性。 方法 纳入2006年10月-2008年10月我院门诊和住院诊治的老年性原发高血压伴焦虑抑郁障碍患者100例,随机分为干预组和对照组。所有患者给予常规降压药物治疗,干预组另外给予万拉法新治疗,治疗12周后评价临床疗效。结果 干预组临床降压疗效总有效率940%,显著高于对照组总有效率800%(Plt;005)。两组患者的收缩压、舒张压与治疗前比较均显著改善(Plt;005),干预组患者与对照组比较血压明显改善(Plt;005)。干预组临床抗焦虑抑郁疗效总有效率960%,显著高于对照组总有效率580%(Plt;005)。两组均无明显的不良反应。结论 降高血压药物联合抗焦虑抑郁药物万拉法新治疗老年性原发高血压伴焦虑抑郁障碍疗效肯定,且安全可靠,值得临床推广应用。【Abstract】 Objective To investigate the efficacy and safety of antihypertensive drugs combined with antianxiety depression drug venlafaxine for treatment of patients with senile primary hypertension (SPH) and anxietydepression disorder (AD). Methods One hundred SPH patients with AD with were randomly divided into an intervention group and a control group. All cases were given antihypertensive drugs medication,while the intervention group was given venlafaxine. After 12 weeks of treatment,the clinical efficacy was evaluated. Results The antihypertensive efficacy rate in the intervention group was 940%,significantly higher than that of the control group 800% (Plt;005). The systolic blood pressure(SBP)and diastolic blood pressure (DBP) of the two groups significantly improved compared with those before treatment (Plt;005), and the intervention group’ SBP and DBP improved significantly than those of the control group (Plt;005). The total effective rate of antianxiety depression efficacy of the intervention group was 960%, significantly higher than that of the control group 580% (Plt;005). The two groups had no significant adverse reactions. Conclusion For patients with senile primary hypertension and anxietydepression disorder,the combination medication with antihypertensive drugs and venlafaxine was safe,reliable and worthy of clinical application.
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。
ObjectiveTo explore the prevalence of depression and anxiety of chronic obstructive pulmonary disease complicated coronary artery disease before and after percutaneous intracoronary arterial stenting. MethodsA total of 114 chronic obstructive pulmonary disease complicated coronary artery disease patients were enrolled in this study and were measured with the Hospital Anxiety and Depression Scale before and after percutaneous intracoronary arterial stenting. ResultsA total of 71 patients (62.3%) had depression symptom and 68 patients (59.6%) had anxiety symptom before percutaneous intracoronary arterial stenting. There were 46 patients (40.4%) had significant depression symptom and 40 patients (35.1%) had significant anxiety symptom before percutaneous intracoronary arterial stenting. A total of 85 patients (74.6%) had depression symptom and 83 patients (72.8%) had anxiety symptom after percutaneous intracoronary arterial stenting. There were 60 patients (52.6%) had significant depression symptom and 48 patients (42.1%) had significant anxiety symptom after percutaneous intracoronary arterial stenting. There was significant difference in prevalence rate of depression and anxiety before and after percutaneous intracoronary arterial stenting (P < 0.05). ConclusionsThe patients with chronic obstructive pulmonary disease complicated coronary artery disease show higher prevalence of depression and anxiety. The prevalence of depression and anxiety increases significantly after percutaneous intracoronary arterial stenting.
ObjectiveTo explore the relationship between the impairment of empathy and anxiety and depression in patients with epilepsy. MethodsAll the patients were collected in the Neurology Department of the First Affiliated Hospital of DaLian Medical University from March 2015 to January 2016, included 93 cases of adult patients with epilepsy and 100 cases of normal control group, all of them were given the test of HAMA, HAMD, MoCA and IRI-C.To analyze the relationship between the ability of empathy and anxiety and depression in patients with epilepsy, in the difference seizure type, frequency and duration of onset. Results1.Compared with the control group, the patients with epilepsy showed impaired ability of dissociative empathy, which was impaired cognitive empathy and emotional empathy, anxiety and depression were also significantly higher than those in the control group, the difference was significant.2.Different types:2.1 GTCS:cognitive empathy:no GTCS, pure GTCS group, SGS group, there were no significant differences between the three groups of empathy scores, emotional empathy, the SGS group had decrease in cognitive empathy with no GTCS, anxiety and depression more serious.There was no difference in cognitive empathy between the SGS group and the pure GTCS group, but the anxiety and depression of the SGS group were significantly serious than those of the pure GTCS group.There was no significant difference between no GTCG group and GTCS group in cognitive empathy, anxiety and depression.There was a significant negative correlation between emotional empathy and anxiety and depression in group SGS.There was no correlation between GTCS and pure GTCS group scores and anxiety depression.2.2CPS:CPS group were worse than those of the non CPS group, and the anxiety and depression were higher than those of the non CPS group.The total score of empathy, emotional empathy and anxiety and depression were significantly negatively correlated.There was no correlation in non CPS group.3.Different seizure frequency:high frequency group empathy scores, cognitive empathy lower in low frequency, anxiety and depression is more serious; empathy and anxiety and depression emotion has showed a significant negative correlation, no correlation between empathy scores, cognitive empathy and anxiety and depression.There was no correlation between empathy scores, cognitive empathy, emotional empathy and anxiety and depression.4.Different onset period:>5 years, empathy scores, cognitive empathy were lower than ≤5 years group and anxiety depression was more serious; emotional empathy and anxiety and depression was negatively related, no correlation between empathy score and cognitive empathy and anxiety and depression. ConclusionsEmpathy ability, cognitive empathy injury, emotional empathy retention declined in adult patients with epilepsy.Anxiety and depression were more severe in adult patients with epilepsy.There is negatively correlated in emotional empathy and anxiety and depression in patients with epilepsy, the scores of cognitive empathy and anxiety and depression have no correlation.The types of epilepsy, seizure frequency, age of onset is associated with cognitive empathy and anxiety and depression in epilepsy, and affect the correlation between empathy and anxiety and depression.
Objective To explore the effect of motivational interviewing (MI) on anxiety and depression in patients with lung cancer undergoing initial chemotherapy. Methods From May 2015 to April 2016, patients with lung cancer who underwent initial chemotherapy after operation were collected and randomly divided into the control group and the MI group. The patients in the control group received traditional health education, psychological care, and post-discharge follow up; while the patients in the MI group were given routine nursing cares and three motivational interviews and one telephone follow up. At the admission and one month after chemotherapy, all patients were evaluated by the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Distress Thermometer (DT). Results At the admission, the SAS, SDS, and DT scores of patients in the two groups had no significant differences (P>0.05). After one month of chemotherapy, the SAS, SDS, and DT scores in the MI group were much better compared to the admission (P<0.05). The differences in the SAS, SDS, and DT scores between the two groups were significant (P<0.05). Conclusion MI can significantly alleviate anxiety and depression of patients with lung cancer undergoing initial chemotherapy.
ObjectiveTo systematically evaluate the effect of repeated transcranial magnetic stimulation (rTMS) in treating epilepsy.MethodsThe randomized controlled trials (RCTs) of rTMS for epilepsy and related diseases were collected from PubMed, EMbase, Cochrane Library, CBM, CNKI, VIP, and Wanfang databases by computer. The retrieval time was from establishment to June 2019. Two researchers independently screened the literature, extracted the data and evaluated the deviation risks of the included studies. RevMan5.3 software was used for Meta analysis.ResultsA total of 21 RCTs were included, including 1 587 patients. The results showed that rTMS assisted antiepileptics drugs (AEDs) could improve the effective rate of epilepsy treatment [RR=1.28, 95% CI (1.19, 1.37)], significantly reduced HAMA, HAMD and NFDS scores in the treatment of patients with epilepsy combined with anxiety and depression [MD=−3.94, 95% CI (−4.25, −3.63)], and improve DQ and GMFM-88 scores in children with cerebral palsy combined with epilepsy [MD=7.95, 95% CI (7.00, 8.90)]. In addition, using rTMS will not cause additional adverse reaction [peto OR=0.52, 95% CI (0.31, 0.84)].ConclusionsThe current evidence showed that rTMS combined AEDs can improve the efficient of AEDs therapy. When treat anxiety depression comorbidity, it can significantly reduce the anxiety depression score. In addition in children with cerebral palsy merger, it can improve muscle strength and development. And rTMS will not cause additional adverse reactions. Limited by the quantity and quality of the selected studies, the conclusions need to be verified by more high-quality studies.
ObjectivesTo compare the clinical features and the effects on cognition, emotion, and prognosis of antiepileptic drugs (AEDs) between occipital lobe epilepsy (OLE) and temporal lobe epilepsy (TLE).MethodsWe collected the clinical data of the patients with OLE and TLE from the Department of Neurology, the First Hospital of Jilin University from January 2016 to May 2018. We measured the patients with Mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), digital span, Auditory verbal memory test (AVMT), Generalized anxiety disorder (GAD-7), Patient health questionnaire-9 (PHQ-9) and Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (c-NDDI-E) and followed up for 1 year.Results① After 1 year’s follow-up, the frequency of the two groups decreased compared with the first visit (Z=3.734, P=0.000) and the extent was similar (Z=−0.290, P=0.772). In group OLE, occipital aura was 45.9% (17 cases) and temporal aura was 37.8% (14 cases). In TLE group, temporal aura was 49.3% (33 cases) and occipital aura 7.5% (5 cases). In OLE group, post-seizure headache was found in 17 cases (45.9%), which was more than the 15 cases (22.4%) in TLE group (χ2=6.210, P=0.013). ② 30 cases (81.1%) in OLE group interictal discharge involved lobes outside occipitotemporal lobe, 4 of which had a wide-lead-involved discharge, and 19 cases (28.4%) in TLE group involved lobes outside temporal lobe, and there was a significant difference between the two groups (χ2=26.592, P=0.000). ③ There was no significant difference in the score of MOCA and AVMT in the group of OLE-A and OLE-B, either the group of TLE-A and TLE-B. The score of AVMT in group OLE-A was higher than that in group TLE-A (t=3.193, P=0.002), and that in group OLE-B was higher than that in group TLE-B (t=2.264, P=0.029). There was no significant difference in GAD-7, PHQ-9, and c-NDDI-E (P>0.05). After follow-up for 1 year, the scores were compared with its initial scales. The score of GAD-7 (Z=−2.561, P=0.010), PHQ-9 (Z=−2.053, P=0.040) and c-NDDI-E (Z=−2.493, P=0.013) all decreased. The score of GAD-7 (r=0.281, P=0.021) and c-NDDI-E (r=0.456, P=0.000) have a positive correlation with the frequency of seizure. Therapeutic effect: In OLE group, the efficiency of carbamazepine or oxcarbazepine group was 58.82% and of levetiracetam group was 83.33%. in TLE group, the efficiency of carbamazepine or oxcarbazepine was 72.50% and of levetiracetam group was 70.00%. There was no significant difference between group OLE and group TLE in the curative effect of carbamazepine or oxcarbazepine group (χ2=1.033, P=0.310) or levetiracetam group (χ2=0.356, P=0.551). After 1 year’s follow-up, the frequency of OLE group was 0.00 (0.000, 2.750) times per month, and the TLE group was 0.00 (0.000, 1.500) times per month. There was no significant difference between the two groups (Z=−0.226, P=0.822). At the follow-up, the frequency of seizure in the two groups was lower than that at the first visit (P=0.000). The frequency of seizure in TLE group was similar to that in OLE group (=−0.648, P=0.517). After 1 year, 5 patients (13.51%) in OLE group were newly diagnosed as refractory epilepsy and 6 patients (9.00%) in TLE group There was no significant difference in the rate of the newly diagnosed refractory epilepsy between the two groups (2=0.524, P=0.469).ConclusionOccipital aura and post-seizure headache are specific to OLE, which can be used as one of the basis for diagnosis of OLE. Epileptiform discharge in OLE is more likely to spread out in multiple cerebral lobes, while epileptiform discharge in TLE is confined to temporal lobe and the area near it. The cognitive impairment in OLE or TLE is not related to the duration of the disease. The degree of depression is positively correlated with the frequency of seizure. The responses to AEDs of OLE and TLE are similar.
ObjectiveTo investigate prevalence of anxiety and depression in chronic obstructive pulmonary disease (COPD) in order to increase the awareness of physicians on this comorbidity.MethodsPatients were from a multicenter prospective cohort study and 13 institutions or hospitals participated in the study. Four hundred and ten patients with a prior diagnosis of COPD were prospectively recruited from January 2017 to January 2019, and baseline date were analyzed. Hospital Anxiety and Depression Scale was used to identify anxiety and depression.ResultsThe cohort had a mean age of (60.7±10.0) years with 76.8% males and 74.3% smokers. Seventy-nine patients (19.3%) had anxiety or depression. Among them, 36 subjects (8.8%) had anxiety, and 64 patients (15.6%) were with depression, and 21 patients (5.1%) with anxiety and depression. The prevalence of severe anxiety (2.7%) and severe depression (2.4%) was low. Compared to patients without anxiety or depression, patients with anxiety or depression had significantly higher CAT scores (17.8±9.3 with anxiety, 17.4±8.4 with depression, 12.5±7.3 without anxiety or depression, P 0.002 and 0.000 respectively). The risk of acute exacerbations was higher in patients with depression (37.5% vs. 22.7%, P=0.016). Proportion of patients categorized into GOLD group D was higher in patients with depression (P=0.001).ConclusionsAbout 20% COPD patients has anxiety or depression. Prevalence of depression is two times that of anxiety. The prevalence of severe anxiety or severe depression is low. Patients with depression have lower quality of life, higher risk of acute exacerbations, and higher proportion of patients categorized into GOLD group D.