胰岛素联合心理治疗对初诊2型糖尿病伴抑郁症状患者疗效观察  

The Effect of Mental Intervention Combined with Insulin Injection on Newly-diagnosed Type 2 Diabetic Patients with Depression Symptoms

作　　者：王少真[1] 史亚男[2] 徐延光[1] 张金钟[3] 

机构地区：[1]卫生部及天津市激素与发育重点实验室,天津医科大学代谢病医院,中国300070 [2]天津医科大学 [3]天津中医药大学

出　　处：《中国健康心理学杂志》2009年第4期471-473,共3页China Journal of Health Psychology

摘　　要：目的观察胰岛素联合心理治疗对初诊2型糖尿病伴抑郁症状患者的疗效。方法将120例初诊的2型糖尿病合并抑郁症状患者随机分为两组,分别采用胰岛素联合心理治疗与单纯胰岛素治疗14天,观察患者空腹血糖、血糖波动、胰岛素用量以及低血糖发生率,并采用HAM D抑郁量表、HAMA焦虑量表和Zung抑郁自评量表评定抑郁症状的改善。结果胰岛素联合心理治疗比较单纯胰岛素治疗患者的日内血糖波动小(P<0.01)、胰岛素用量少(P<0.01)、低血糖发生率低(P<0.05),并能显著缓解患者的焦虑抑郁症状(HAM D测评:P<0.01,HAMA测评:P<0.05,Zung自评:P<0.05)。结论糖尿病的早期治疗不仅胰岛素应用越早越好,且心理支持越早越好,胰岛素与心理支持的有机结合应成为糖尿病治疗的基本原则。Objective To observe the effect of mental intervention combined with insulin injection on newly-diagnosed type 2 diabetic patients with depression symptoms. Methods 120 newly-diagnosed diabetic patients with depression symptoms were recruited and randomly divided into two groups. Then they were treated by mental intervention combined with insulin injection and insulin injection alone respectively. After 14 days, all patients were observed the fasting glucose, blood glucose fluctuation, doses of insulin injection and the incidence of hypoglycemia. The therapeutic effects were evaluated by Hamilton Rating Scale for Depres- sion and Anxiety and Zung Self-Rating Depression Scale. Results Patients received mental intervention combined with insulin injection showed smaller range of daily blood glucose fluctuation （P〈0.01）, decreasing doses of insulin injection （P〈0.01） and lower incidence of hypoglycemia （P〈0. 05） than those received insulin therapy alone. Moreover mental intervention combined with insulin injection therapy could significantly improve patients＇ depression and anxiety symptoms （HAMD： P〈0.01, HAMA： P〈0.05, Zung： P〈0. 05）. Conclusion Not only insulin injection should be used as early as possible, but also the earlier mental intervention is involved into therapy, the better effects will be brought for type 2 diabetic patients with depression symptoms. Therefore, mental intervention combined with insulin injection should be implemented as a basic principle to treat type 2 diabetic patients with depression symptoms.

关 键 词：胰岛素联合心理治疗 2型糖尿病 血糖 抑郁症状 

分 类 号：R587.1[医药卫生—内分泌] R749.3[医药卫生—内科学]