中青年高血压伴失眠症患者的心因性分析及心理和运动干预研究  

Psychogenic analysis and psychological and exercise interventions for young and middle-aged patients with hypertension and insomnia

作　　者：黄慧卿[1] 许文萍 叶敏宏[1] 李卫华[3] 黄峥嵘[3] 何德化[3] 程琳[1] Huang Huiqing;Xu Wenping;Ye Minhong;Li Weihua;Huang Zhengrong;He Dehua;Cheng Lin(Department of First Cadre Health,First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China;不详)

机构地区：[1]厦门大学附属第一医院干部保健一科,福建厦门361003 [2]厦门大学附属第一医院重症医学科,福建厦门361003 [3]厦门大学附属第一医院心血管内科,福建厦门361003

出　　处：《中国循证心血管医学杂志》2020年第12期1458-1461,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：福建省医学创新课题(2017-CXB-14)。

摘　　要：目的调查中青年高血压伴失眠症患者的抑郁和焦虑状态,并探讨相应的心理和运动干预策略。方法对2019年3月至2019年9月于厦门大学附属第一医院就诊并初次诊断为高血压的中青年患者1191例行失眠症的常规筛查,明确高血压合并失眠症患者474例(39.8%),其中,符合入组研究的患者364例。患者完善Zung自评抑郁量表(SDS)和Zung自评焦虑量表(SAS)分析后采用随机数字表法分为对照组(n=182)及观察组(n=182)。对照组常规予药物治疗及饮食指导,观察组在对照组基础上进一步给予相应的心理辅导及运动指导。两组均随访2个月,观察两组患者的SDS及SAS得分、睡眠质量、血压水平、血压达标率和降压药物强度积分的差别。结果中青年高血压伴失眠症发病率高达39.8%,该群体患者存在抑郁和焦虑。随访2个月后,较干预前两组患者的抑郁和焦虑情况均有改善(P<0.05),且与对照组相比,观察组患者抑郁和焦虑情况症状改善更为显著(P<0.05)。较治疗前,随访2月后,两组患者的睡眠均有改善(P<0.05),且与对照组比较,观察组的睡眠时间和匹兹堡睡眠质量指数(PSQI)评分改善更显著(P<0.05);随访2月后,两组患者的血压较干预前均明显降低(P<0.05),且与对照组比较,观察组的收缩压、舒张压及血压达标率改善更显著(P<0.05),降压药物强度积分也更低(P<0.05)。结论中青年高血压伴失眠症发病率高,抑郁和焦虑是主要心因性因素。药物及饮食指导外,心理调节及运动干预对改善睡眠及血压达标获益明显。Objective To investigate the depression and anxiety of young and middle-aged patients with hypertension and insomnia,and to explore the corresponding psychological and exercise interventions strategies.Method Regular screening of 1191 young and middle-aged patients with hypertension for the first time diagnosed with hypertension at the First Affiliated Hospital of Xiamen University from March 2019 to September 2019,and 474 patients with hypertension and insomnia were identified.The 364 patients in the study were randomly divided into the control group and the observation group(182 patients each)after analysis of the Zung Self-rating Depression Scale(SDS)and the Zung Self-rating Anxiety Scale(SAS).The control group was routinely treated with medication and dietary guidance,while the observation group was given further psychological counseling and exercise guidance based on this.After 2 months of follow-up,the differences in SDS and SAS scores,sleep quality,blood pressure levels,blood pressure compliance rate,and antihypertensive drug intensity scores were observed between the two groups.Results The prevalence of hypertension and insomnia in young and middle-aged people is as high as 39.8%,and this group of patients has depression and anxiety.After 2 months of follow-up,depression and anxiety of both groups of patients improved(P<0.05),especially in the observation group(P<0.05).Sleep in both groups of patients improved(P<0.05),However,compared with the control group,the sleep time and Pittsburgh Sleep Quality Index(PSQI)scores in the observation group improved more significantly(P<0.05).Blood pressure in both groups was significantly reduced(P<0.05),and compared with the control group,the systolic blood pressure,diastolic blood pressure,and blood pressure compliance rate of the observation group improved more significantly(P<0.05),and the antihypertensive drug intensity score was also lower(P<0.05).Conclusion Young and middle-aged people have a high incidence of hypertension and insomnia.Depression and anxiety are

关 键 词：高血压 失眠症 心理 运动 

分 类 号：R544.1[医药卫生—心血管疾病]