认知行为治疗对冠心病心衰患者情绪及心功能的影响  

Effect of cognitive behavior therapy on the emotion and cardiac function in the patients with coronary heart disease

作　　者：王磊[1] 寿晓玲[2] 王志轩[1] 邱越锋 任爱华[2] 

机构地区：[1]浙江医院精神卫生科,浙江杭州310013 [2]浙江医院心脏康复科,浙江杭州310013

出　　处：《中国现代医生》2016年第36期109-113,共5页China Modern Doctor

基　　金：浙江省科技厅公益基金技术应用研究计划项目(2016C33123);浙江省中医药科技计划项目(2013ZB015);浙江省医药卫生科技计划项目(2012KYA010)

摘　　要：目的探讨认知行为治疗对冠心病心衰患者情绪及心功能的影响。方法收集浙江医院心脏康复科住院的冠心病心衰患者112例,随机分为试验组和对照组,所有冠心病心衰患者均在心脏康复医师的指导下规范服用心血管药物和完成康复运动训练,试验组同时接受正规的认知行为治疗。分别于干预前、干预1个月后及干预6个月后予以血压、心率、左室射血分数(LVEF)及6 min步行试验等心功能相关指标评定以及综合医院焦虑抑郁量表(HADS)测评。结果 (1)所有患者中抑郁检出33例(29.5%),焦虑检出58例(51.8%);(2)试验组患者的依从性明显优于对照组(P<0.05);(3)治疗6个月后,试验组HADS评分均低于对照组(P<0.05);6个月后,两组患者的6 min步行试验距离、心率、收缩压以及LVEF较干预前均显著改善(P<0.05);6个月后,试验组6 min步行试验距离、心率以及LVEF等指标与对照组比较有所改善,有统计学差异(P<0.05)。结论认知行为治疗可以改善冠心病心衰患者康复中的情绪问题,提高依从性,进一步改善心功能。Objective To investigate the effect of cognitive behavior therapy on the emotion and cardiac function in the patients with coronary heart disease. Methods 112 patients with coronary heart disease complicated with heart failure who were hospitalized in the Department of Cardiac Rehabilitation in Zhejiang Hospital were collected and were randomly divided into the experimental group and the control group. All patients with coronary heart disease complicated with heart failure were given cardiovascular drugs and completed rehabilitation exercise training under the guidance of cardiac rehabilitation physicians. The intervention group was also given formal cognitive behavioral therapy. Relevant indicators of cardiac functions such as blood pressure, heart rate, left veutricular ejection fraetion（LVEF） and 6-rain walk test were evaluated before the intervention and 1 month and 6 months after the intervention, and the hospital anxiety and depression scale（HADS） were also evaluated. Results （1） The cases of depression was 33（29.5%） in all patients and the cases of anxiety was 58 （51.8%）; （2） The compliance of patients in the experimental group was significantly bet- ter than that in the control group （P〈0.05）; （3） The HADS score in the experimental group was lower than that in the control group（P〈0.05） after 6 months of the treatment; after 6 months, the distane in 6-min walk test, heart rate, systolic blood pressure and LVEF of the two groups were significantly improved compared with those before the inter vention（P〈0.05）; after 6 months, the distance of 6-min walk test, heart rate and LVEF in the experimental group were improved compared with those in the control group, and the differences were statistically significant （P〈0.05）. Conclusion Cognitive behavior therapy can improve the emotional problems of the patients with coronary heart disease complicated with heart failure, enhance the compliance, and further improve cardiac function.

关 键 词：认知行为治疗 冠心病 心力衰竭 心脏康复 依从性 

分 类 号：R541.4[医药卫生—心血管疾病]