CAJ | 학술논문

目的：观察度洛西汀合并菩提树放松技术治疗广泛性焦虑障碍（ GAD）的疗效及对心率变异性的影响。方法2013年3月～2014年3月间，根据ICD?10中GAD诊断标准选择124例GAD患者作为研究对象，利用随机数字表分为干预组（n＝62）和对照组（n＝62）。干预组固定接受度洛西汀（20 mg／d）合并菩提树放松治疗，2次／周，连续8周；对照组仅接受度洛西汀（20 mg／d）治疗。分别于干预前和干预后第2、4、6、8周末用SAS、HAMA评定疗效，用治疗中需处理的不良反应症状量表（ TESS）评定药物的不良反应，对心率变异性（heart rate variability，HRV）的低频（low frequency，LF）与高频（high frequency，HF ）比值（LF／HF）进行观察。结果1．两组干预后SAS和HAMA评分较干预前显著降低[干预前：对照组（63．52±14．25）分，（30．26±11．25）分，干预组（64．35±14．33）分，（29．83±10．85）分，干预8周后：对照组（30．23±6．68）分，（9．28±3．20）分，干预组（25．14±5．59）分，（7．70±2．87）分]（均P＜0．05）。组间疗效差异有统计学意义（χ2＝4．09， P＜0．05），两组不良反应差异无统计学意义（P＞0．05）。2．干预组LF／HF较对照组减低，特别是第13，14，15，16次干预后，两组间差异有统计学意义（ t 13?16＝－2．806，－2．725，－3．572，－2．272；P 13?16＝0．006，0．007，0．001，0．025），焦虑严重指数值与LF／HF值呈显著正相关（ r＝0．342， P＜0．05）。结论度洛西汀合并菩提树放松技术能有效提高GAD患者的心率变异性，疗效更好。
목적：관찰도락서정합병보제수방송기술치료엄범성초필장애（ GAD）적료효급대심솔변이성적영향。방법2013년3월～2014년3월간，근거ICD?10중GAD진단표준선택124례GAD환자작위연구대상，이용수궤수자표분위간예조（n＝62）화대조조（n＝62）。간예조고정접수도락서정（20 mg／d）합병보제수방송치료，2차／주，련속8주；대조조부접수도락서정（20 mg／d）치료。분별우간예전화간예후제2、4、6、8주말용SAS、HAMA평정료효，용치료중수처리적불량반응증상량표（ TESS）평정약물적불량반응，대심솔변이성（heart rate variability，HRV）적저빈（low frequency，LF）여고빈（high frequency，HF ）비치（LF／HF）진행관찰。결과1．량조간예후SAS화HAMA평분교간예전현저강저[간예전：대조조（63．52±14．25）분，（30．26±11．25）분，간예조（64．35±14．33）분，（29．83±10．85）분，간예8주후：대조조（30．23±6．68）분，（9．28±3．20）분，간예조（25．14±5．59）분，（7．70±2．87）분]（균P＜0．05）。조간료효차이유통계학의의（χ2＝4．09， P＜0．05），량조불량반응차이무통계학의의（P＞0．05）。2．간예조LF／HF교대조조감저，특별시제13，14，15，16차간예후，량조간차이유통계학의의（ t 13?16＝－2．806，－2．725，－3．572，－2．272；P 13?16＝0．006，0．007，0．001，0．025），초필엄중지수치여LF／HF치정현저정상관（ r＝0．342， P＜0．05）。결론도락서정합병보제수방송기술능유효제고GAD환자적심솔변이성，료효경호。
Objective To observe the efficacy of duloxetine combined with Bodhi Tree relaxation tech?nique in the treatment of generalized anxiety disorder ( GAD ) and the influence of heart rate variability ( HRV ) . Methods According to the standard of ICD?10,124 GADs were selected as study objects from March 2013 to March 2014. They were randomly divided into intervention group and control group. The intervention group fixedly received duloxetine ( 20 mg/day) and Bodhi Tree relaxation therapy,2 times / week,for 8 weeks;and the control group received only Duloxetine (20 mg/day) treatment. All patients were assessed with SAS,HAMA and Treat?ment Emergent Symptom Scale( TESS) at the baseline and at the end of the 2nd ,4th ,6th ,8th week of the treatment to evaluate the efficacy and side effects. The LF/HF of HRV were observed. Results 1.In both groups,SAS score and HAMA score remarkably decreased after intervention than before treatment( before intervention:control group (63.52±14.25,30.26±11.25) intervention group (64.35±14.33,29.83±10.85);after 8 weeks:control group (30.23±6.68,9.28±3.20) intervention group (25.14±5.59,7.70±2.87), P<0.05). There was statistical signifi?cant between the two groups in the therapeutic effects (χ2=4.09, P<0.05) ,and no significant difference between the two groups on the TESS (P>0.05). 2. The ratio of LF/HF showed significantly decrease in the intervention group than those in the control groupt 13?16=-2.806,-2.725,-3.572,-2.272;P13?16=0.006,0.007,0.001,0.025).The value of anxiety se?verity index and LF/HF was positively correlated ( r=0.342, P<0.05).Conclusion Duloxetine combined with Bodhi Tree relaxation technique can effectively improve the heart rate variability in patients,curative effect is better.