氟西汀及心理治疗对原发性高血压伴抑郁症患者的作用  

Influence of fluoxetine combined with psychotherapy in treatment of hypertensive patients with depression

作　　者：汪顺银 李勇 温国华 洪佳伟 邓卫国 黄德嘉[2] 方元[2] 张耿新[3] 熊华锋[3] 

机构地区：[1]佛山市张槎医院心内科,广东省佛山市528000 [2]四川大学华西医院心内科,四川省成都市610041 [3]佛山市第二人民医院心内科,广东省佛山市528000

出　　处：《中国临床康复》2003年第21期2938-2940,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察氟西汀及心理治疗对原发性高血压伴抑郁症患者血压和生活质量的影响。方法:将127例原发性高血压伴抑郁的患者采用随机数字表法分为治疗组和对照组,治疗组62例在口服硝苯地平控释片30mg/d基础上给予心理治疗及氟西汀20mg/d口服,共12周;对照组65例仅给以硝苯地平控释片30mg/d口服。观察两组患者血压控制及生活质量改善情况。结果:①12周后治疗组降压总有效率79%(49/62),而对照组总有效率57%(37/65),两组之间有差异(χ2=14.2,P<0.005)。②治疗组55例平均收缩压(SBP)及舒张压(DBP)分别下降(19.2±2.1)mmHg及(10.6±1.2)mmHg而对照组58例分别下降(10.2±1.6)mmHg及(5.2±0.7)mmHg,治疗组下降幅度优于对照组(t=26.0,P<0.01;t=29.8,P<0.01)。③生活质量定量观察:治疗前后体力健康、精神健康、总体功能评分及生活质量总分的改变,治疗组高于对照组(分别为3.5±4.1比2.1±4.1,t=1.98,P<0.05;4.0±5.0比1.6±4.7,t=3.77,P<0.01;2.3±3.4比0.9±3.4,t=2.29,P<0.05;9.6±8.7比5.5±9.1,t=2.66,P<0.01)。④生活质量定性观察:治疗组在体力健康、精神健康、总体功能方面改善的百分比高于对照组(分别为53.4%比23.7%,χ2=24.5,P<0.005;60.3%比27.8%,χ2=26.4,P<0.005;44.7%比25.2%,χ2=10.2,P<0.005)。结论:氟西?AIM: To observe the effect of fluoxetine combined with psychotherapy on blood pressure and the quality of life( QOL) in hypertensive patients with depression. METHODS:One hundred and twenty seven hypertensive patients with depression were randomly divided into treatment group(n=62) and control group(n=65).Patients in the control group were only treated with oral nifedipine GITS(Adalat Bayer, Gem) 30 mg/d.Patients in the treatment group were treated with psychotherapy and administration of anti depressant Fluoxetine (Prozac Eli Lilly,USA)20 mg/d on the basis of nifedipine GITS for 12 weeks.RESULTS:① The total effective rate of the treatment group was 79% 12 weeks after treatment, significantly higher than that of the control group(57% ) (χ 2=14.2,P< 0.005).② The mean SBP and DBP were decreased by ( 19.2± 2.1) and( 10.6 ± 1.2) mmHg respectively in 55 cases of the treatment group, significantly higher than those of 58 cases of the control group[(10.2± 1.6) and ( 5.2± 0.7) mmHg respectively](t=26.0, P< 0.01;t=29.8, P< 0.01).③ Quantitative observation of QOL showed that the scores of physical health, mental health, general function and total QOL in the treatment group (3.5± 4.1,4.0± 5.0,2.3± 3.4,9.6± 8.7 respectively) were increased significantly higher than those in the control group(2.1± 4.1, t=1.98,P< 0.05;1.6 ± 4.7,t=3.77,P< 0.01;0.9± 3.5, t=2.29,P< 0.05;5.5± 9.1,t=2.66,P< 0.01 respectively).④ Qualitative observation of QOL showed that the improved percentages of physical health, mental health and general function were significantly higher in the treatment group (53.4% , 60.3% and 44.3% ) than the control group Significantly more patients with qualitatively improved QOL were found in the therapy group (23.7 % ,χ 2=24.5,P< 0.005; 27.8 % ,χ 2=26.4, P< 0.005 ;25.2 % ,χ 2=10.2,P< 0.005).

关 键 词：氟西汀 心理治疗 原发性高血压 抑郁症 并发症 血压 生活质量 

分 类 号：R544.1[医药卫生—心血管疾病] R749.4[医药卫生—内科学]