帕罗西汀联合认知行为疗法对冠心病伴抑郁症患者行为管理及自我效能的影响  

Effects of paroxetine combined with cognitive behavioral therapy on behavior management and self-efficacy of patients with coronary heart disease and depression

作　　者：常宁[1] 赵刘乐[2] 胡佳 赵宣 张亚坤 CHANG Ning;ZHAO Liu-le;HU Jia;ZHAO Xuan;ZHANG Ya-kun(a.Department of Internal Medicine,the Eighth Hospital of Shijiazhuang City,Shijiazhuang 050081,China;Department of Traditional Chinese Medicine,the Eighth Hospital of Shijiazhuang City,Shijiazhuang 050081,China;Department of Laboratory Medicine,the Eighth Hospital of Shijiazhuang City,Shijiazhuang 050081,China;Department of Sleep Medicine,the Eighth Hospital of Shijiazhuang City,Shijiazhuang 050081,China)

机构地区：[1]石家庄市第八医院内科,河北石家庄050081 [2]石家庄市第八医院中医科,河北石家庄050081 [3]石家庄市第八医院检验科,河北石家庄050081 [4]石家庄市第八医院睡眠医学科,河北石家庄050081

出　　处：《实用药物与临床》2021年第10期929-932,共4页Practical Pharmacy and Clinical Remedies

基　　金：河北省中医药管理局科研计划项目(2018267)。

摘　　要：目的研究帕罗西汀联合认知行为疗法(CBT)对冠心病(CHD)伴抑郁症患者行为管理及自我效能的影响。方法选取2019年1月至2020年7月本院收治的150例CHD伴抑郁症患者,随机分为对照组(常规冠心病药物加帕罗西汀治疗)与治疗组(对照组基础上进行CBT干预)各75例,治疗4周后比较两组患者的抑郁症疗效、心功能指标、贝克抑郁量表(BDI-Ⅱ)、汉密尔顿抑郁量表(HAMD)、自我效能感量表(GSES)评分、自我行为管理评分以及不良反应发生率。结果治疗组的抑郁症有效率88.00%,高于对照组的74.67%(P<0.05);治疗后两组患者心功能指标比较,差异无统计学意义(P>0.05);治疗后治疗组BDI-Ⅱ、HAMD评分均低于对照组,GSES评分高于对照组(P<0.05);治疗后治疗组的不良嗜好、症状、情绪认知、日常生活、依从性的行为管理评分高于对照组(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论帕罗西汀联合CBT治疗CHD伴抑郁症疗效良好,能改善患者认知功能,提高患者行为管理及自我效能。Objective To study the effects of paroxetine combined with cognitive behavioral therapy(CBT)on behavior management and self-efficacy of patients with coronary heart disease(CHD)and depression.Methods A total of 150 patients with CHD and depression who admitted to the hospital from January 2019 to July 2020 were enrolled and randomly divided into control group(routine CHD drugs combined with paroxetine)and treatment group(CBT intervention in addition to the treatment for control group),75 cases in each group.The curative effect on depression,cardiac function indexes,scores of Beck Depression Inventory(BDI-II),Hamilton Depression Scale(HAMD),General Self-Efficacy Scale(GSES)and self-behavior management,and the incidence of adverse reactions were compared between the two groups.Results The response rate of depression treatment in treatment group was higher than that in control group(88.00%vs 74.67%)(P<0.05).There were no significant differences in cardiac function indexes between the two groups after treatment(P>0.05).After treatment,scores in BDI-II and HAMD in treatment group were lower than those in control group,while GSES scores were higher than those in control group(P<0.05).After treatment,scores in behavior management such as bad habits,symptoms,emotional cognition,daily life and compliance in treatment group were higher than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The curative effect of paroxetine combined with CBT is good on patients with CHD and depression,which can improve their cognitive function,behavior management and self-efficacy.

关 键 词：帕罗西汀 认知行为疗法 冠心病 抑郁症 行为管理 自我效能 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R541.4[医药卫生—临床医学]