归脾汤加减中药治疗老年高血压病合并抑郁症及对患者血压和生活质量的影响  

Effects of modified Guipi Decection on blood pressure and life quality of patients with hypertension complicated with depression

作　　者：李海聪[1] 杨毅玲[2] 李求兵[1] 王燕[1] 杨学青[1] 田心[1] 陈晓光[1] 王博元 

机构地区：[1]中日友好医院,北京100029 [2]北京中医药大学,北京100029 [3]北京护国寺中医院,北京100035

出　　处：《中华中医药杂志》2016年第8期3076-3081,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：中日友好医院院级科研基金资助项目(No.2010-MS-37)~~

摘　　要：目的:研究归脾汤加减中药治疗老年高血压病合并抑郁症的临床疗效及其改善抑郁作用对患者血压和生活质量的影响。方法:332例患者随机分为治疗组(168例)和对照组(164例),分别采用归脾汤加减中药与西药舍曲林治疗,同时观察两组患者治疗前后不同时期的血压变化、17项汉密尔顿抑郁量表(HAMD17)、汉密尔顿焦虑量表(HAMA)、健康状况问卷(SF-36)、治疗药物副作用量表(TESS)等评分变化,以判断两者的临床疗效。结果:治疗组能显著降低患者HAMD17评分,改善其抑郁症状,总有效率达80.5%,优于对照组(68.2%,P<0.05);随着HAMD17评分下降和抑郁症状的改善,患者的血压也出现明显改善,目标血压达标率较治疗前明显提高,治疗组目标血压达标率达66.9%,显著高于对照组(45.3%,P<0.01)。同时治疗组患者HAMA评分显著降低(P<0.01),患者焦虑症状改善;两组SF-36总分及各因子评分在治疗后均显著高于治疗前(P<0.05,P<0.01),且治疗组对改善生理机能、生命活力、情感职能、精神健康和健康变化等因子都优于对照组(P<0.05,P<0.01)。结论:归脾汤加减中药治疗老年高血压病合并抑郁症有良好的临床疗效,改善患者的抑郁症状,有利于提高降压疗效及改善患者的生活质量。Objective: To study the effect of modified Guipi Decection on blood pressure and life quality of patients with hypertension complicated with depression. Methods: Three hundred and thirty-two patients with hypertension complicated with depression were randomly divided into treatment with Chinese medicine(168 cases) and treatment with western medicine(164 cases). The Chinese medicine group orally accepted modified Guipi Decection, while western medicine group accepted Sertraline. To determine the clinical effects, the indexes including blood pressure, Hamilton Depression Scale-17(HAMD17) score, Hamilton anxiety rating scale(HAMA) score, health survey questionnaire(SF-36) score and treatment emergent symptom scale(TESS) score were made comparison before and after treatment. Results: Modified Guipi Decection could significantly decrease HAMD17 score, indicating a good effect on the improvement of depression. It showed that the total effective rate of the treatment with modified Guipi Decection reached 80.5%, which was superior to the treatment with Sertraline(68.2%, P<0.05). Consequently, patients' blood pressure level was obviously improved. Indeed, it showed that success rate of target blood pressure after the treatment was higher than before the treatment. Moreover, the success rate of target blood pressure in modified Guipi Decection reached 66.9% that was significantly higher than the control group(45.3%, P<0.01). Meanwhile, modified Guipi Decection could significantly decrease HAMA score(P<0.01), indicating a good effect on the improvement of anxiety. Moreover, SF-36 score and treatment emergent symptom scale(TESS) score in the two treatment group were increased when compared to before the treatment(P<0.05, P<0.01). Additionally, the improvement of some factors including physiological function, vitality of life, emotion, mental health and health change in Chinese medicine group when compared to the treatment with western medicine(P<0.05, P<0.01). Conclusion: Due to a good antidepressant and antihypertensive eff

关 键 词：归脾汤 老年患者 高血压 抑郁症 生活质量 辨证论治 

分 类 号：R259[医药卫生—中西医结合] R277.7[医药卫生—中医内科学]