CAJ | 학술논문

目的：探讨抗焦虑抑郁治疗对合并焦虑抑郁的慢性心力衰竭患者的临床疗效、生活质量的影响。方法将入选的82例伴有焦虑抑郁状态的慢性心力衰竭患者随机分为两组，干预组42例，对照组40例。干预组在常规抗心力衰竭治疗的基础上+舍曲林+心理干预；对照组予常规抗心力衰竭治疗。比较两组治疗前后心功能分级、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评分、6min步行试验、Ang-Ⅱ及NT-proBNP结果。结果干预组患者心功能的改善，HAMA、HAMD评分改善均明显优于对照组，两组治疗后6min步行试验行走距离、Ang-Ⅱ均较治疗前改善，干预组较对照组疗效更明显（P＜0.05）；NT-proBNP均较治疗前下降，但两组间差异无统计学意义。结论对有慢性心力衰竭合并焦虑抑郁障碍的患者，在常规纠正心力衰竭治疗基础上联合抗焦虑抑郁治疗，能有效缓解患者的临床症状，改善焦虑抑郁状态、抑制交感过度激活，改善患者的生活质量。
목적：탐토항초필억욱치료대합병초필억욱적만성심력쇠갈환자적림상료효、생활질량적영향。방법장입선적82례반유초필억욱상태적만성심력쇠갈환자수궤분위량조，간예조42례，대조조40례。간예조재상규항심력쇠갈치료적기출상+사곡림+심리간예；대조조여상규항심력쇠갈치료。비교량조치료전후심공능분급、한밀이돈초필량표（HAMA）、한밀이돈억욱량표（HAMD）평분、6min보행시험、Ang-Ⅱ급NT-proBNP결과。결과간예조환자심공능적개선，HAMA、HAMD평분개선균명현우우대조조，량조치료후6min보행시험행주거리、Ang-Ⅱ균교치료전개선，간예조교대조조료효경명현（P＜0.05）；NT-proBNP균교치료전하강，단량조간차이무통계학의의。결론대유만성심력쇠갈합병초필억욱장애적환자，재상규규정심력쇠갈치료기출상연합항초필억욱치료，능유효완해환자적림상증상，개선초필억욱상태、억제교감과도격활，개선환자적생활질량。
Objective To investigate the effect of anti-anxiety and depression treatment on life quality and emotional disorder in the chronic heart failure patients with anxiety and depression. Method 82 patients with chronic heart failure accompanied by anxiety and depression were randomly divided into intervention group(42 cases)and control group(40 cases).They were given conventional treatment of chronic heart failure, and at the same time the intervention group was given psychological treatment and orally administered with senraline hydrochloride. The patients were followed up for 4 weeks. Results There were improvement of NYHA cardiac function grading and 6-minute walking distance in both intervention group and control group, but the efifcacy of the former showed signiifcantly greater than the latter’s(P<0.05). Four weeks after treatment the scores of HAMA and HAMD signiifcantly decreased(P<0.05), and were less than those of control group(P<0.05), those of control group no signiifcant change between before and after treatment. Conclusion Anti-anxiety-depression therapy can improve the clinical symptoms and cardiac function, alleviate the anxiety-depressive mood in chronic heart failure patients with anxiety and depression.