认知行为治疗辅助舍曲林对2型糖尿病伴抑郁患者的影响  

Effect of cognitive behavioral therapy assisted Sertraline on type 2 diabetes mellitus patients combined with depression

作　　者：张洪艳[1] 张玉平[2] 张燕娇 郑静静 卞睿 王琪娜[3] 李文慧[4] 任卫东[5] ZHANG Hongyan;ZHANG Yuping;ZHANG Yanjiao;ZHENG Jingjing;BIAN Rui;WANG Qina;LI Wenhui;REN Weidong(The Third Department of Neurology,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou075000,China;Department of Pathophysiology,College of Basic Medicine,Hebei North University,Hebei Province,Zhangjiakou075000,China;United Front Department of Publicity,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou075000,China;Department of Cardiovascular Medicine,the Second Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou075100,China;Department of Endocrinology,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou075000,China)

机构地区：[1]河北北方学院附属第一医院神经内三科,河北张家口075000 [2]河北北方学院基础医学院病理生理教研室,河北张家口075000 [3]河北北方学院附属第一医院宣传统战处,河北张家口075000 [4]河北北方学院附属第二医院心血管内科,河北张家口075100 [5]河北北方学院附属第一医院内分泌科,河北张家口075000

出　　处：《中国医药导报》2023年第3期67-70,83,共5页China Medical Herald

基　　金：河北省医学科学研究课题计划项目(20200529);河北省张家口市重点研发计划项目(1921058D)。

摘　　要：目的 探讨认知行为治疗辅助舍曲林对2型糖尿病伴抑郁患者的影响。方法 选取2019年1月至2020年12月河北北方学院附属第一医院收治的2型糖尿病伴抑郁患者60例,根据随机数学表法将其分为对照组(30例)和试验组(30例)。对照组口服盐酸舍曲林片,试验组在对照组的基础上辅助认知行为治疗,疗程为8周。比较两组临床疗效;比较两组治疗前后心率变异性(HRV)、空腹胰岛素(FINS)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、稳态模型胰岛素抵抗指数(HOMA-IR)、C反应蛋白(CRP)、汉密尔顿抑郁量表(HAMD)总分。结果 对照组脱落4例,试验组脱落2例。试验组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,两组HRV变化的间期总体标准差(SDNN)、副交感神经活动的连续窦性R-R间期差值均方根(rMSSD)、副交感神经调节能力的相邻间期的差值标准差(SDSD)、副交感神经调节能力的高频段功率(HF)高于治疗前,交感神经活性为主的低频段功率(LF)、LF/HF低于治疗前,差异有统计学意义(P<0.05);试验组SDNN、r MSSD、SDSD、HF高于对照组,LF、LF/HF低于对照组,差异有统计学意义(P<0.05)。治疗后,两组FINS、FBG、HOMA-IR、HAMD总分、CRP低于治疗前,且试验组低于对照组,差异有统计学意义(P<0.05)。两组治疗前后Hb A1c比较,差异无统计学意义(P>0.05)。结论 认知行为治疗辅助舍曲林对2型糖尿病伴抑郁患者临床效果更佳,同时对HRV、血糖、胰岛素功能、CRP改善更理想。Objective To investigate the effect of cognitive behavioral therapy assisted Sertraline on type 2 diabetes mellitus patients combined with depression. Methods Sixty patients with type 2 diabetes mellitus patients combined with depression admitted to the First Affiliated Hospital of Hebei North University from January 2019 to December 2020 were selected, and they were divided into control group(30 cases) and experimental group(30 cases) according to the random number table method. The control group took Sertraline Hydrochloride Tablets orally, experimental group was given cognitive behavioral therapy on the basis of control group, and the course of treatment was eight weeks. The clinical efficacy was compared between two groups;the heart rate variability(HRV), fasting insulin(FINS), fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), homeostasis model assessment of insulin resistance(HOMA-IR), C-reactive protein(CRP), and total score of Hamilton depression scale(HAMD) were compared between two groups before and after treatment.Results There were four cases dropped out of control group and two cases dropped out of experimental group. The clinical efficacy of experimental group was better than that of control group, and the difference was statistically significant(P<0.05).Intertemporal population standard deviation of HPV change(SDNN), the mean square root mean square difference of successive sinus R-R intervals of parasympathetic activity(r MSSD), the standard deviation of successive interval difference of parasympathetic accommodation(SDSD), and the high frequency power for parasympathetic modulatory capacity(HF)were higher than those before treatment, low-frequency power for sympathetic activity predominant(LF) and LF/HF were lower than those before treatment, and the differences were statistically significant(P<0.05);the SDNN, r MSSD, SDSD, and HF of experimental group were higher than those of control group, and LF and LF/HF were lower than those of control group,and the differences were statistically s

关 键 词：心率变异性 认知行为治疗 舍曲林 2型糖尿病 抑郁障碍 C-反应蛋白 

分 类 号：R587[医药卫生—内分泌]