CAJ | 학술논문

目的观察抗抑郁、抗焦虑治疗对海洋石油员工偏头痛与抑郁、焦虑障碍共病的效果.方法符合偏头痛、抑郁、焦虑障碍诊断标准的海洋石油员工偏头痛患者142例,采用完全随机数字表法分为治疗组和对照组,每组71例.2组均给予发作期止痛、缓解期预防头痛再发药物治疗,其中治疗组给予5-羟色胺及去甲肾上腺素再摄取抑制剂(SNRI类)盐酸文拉法辛添加治疗.于治疗前及治疗后第6周、第12周记录头痛发作频率、视觉模拟评分(VAS)、SF-36健康调查量表评估结果,评价汉密尔顿抑郁量表(HAMD)与焦虑量表(HAMA).观察期为12周.结果第6周时,治疗组与对照组比较头痛发作频率、VAS明显减少(前者分别为2.4±3.1,5.6±2.7;后者为3.8±4.0,6.4±2.0),差异有统计学意义(P＜0.05),抑郁情绪明显改善(HAMD分值比较P＜0.05),但焦虑情绪无变化(HAMA分值比较P＞0.05);治疗组SF-36量表在生理职能(RP)、身体疼痛(BP)、总体健康(GH)、活力(VT)4个维度上得分高于对照组(P＜0.01或P＜0.05);第12周时,治疗组较对照组头痛发作频率、VAS明显减少(P＜0.01),抑郁、焦虑情绪明显改善(HAMD分值比较P＜0.01、HAMA分值比较P＜0.05),治疗组SF-36量表在RP、BP、GH、VT、社会功能(SF)、情感职能(RE)、精神健康(MH)7个维度上得分高于对照组(P＜0.01).结论对伴有抑郁、焦虑障碍的偏头痛海洋石油员工患者以抗抑郁、抗焦虑治疗后可以明显减少偏头痛发作频率、减轻头痛程度、改善精神障碍、提高生活质量.
목적 관찰항억욱、항초필치료대해양석유원공편두통여억욱、초필장애공병적효과.방법 부합편두통、억욱、초필장애진단표준적해양석유원공편두통환자142례,채용완전수궤수자표법분위치료조화대조조,매조71례.2조균급여발작기지통、완해기예방두통재발약물치료,기중치료조급여5-간색알급거갑신상선소재섭취억제제(SNRI류)염산문랍법신첨가치료.우치료전급치료후제6주、제12주기록두통발작빈솔、시각모의평분(VAS)、SF-36건강조사량표평고결과,평개한밀이돈억욱량표(HAMD)여초필량표(HAMA).관찰기위12주.결과 제6주시,치료조여대조조비교두통발작빈솔、VAS명현감소(전자분별위2.4±3.1,5.6±2.7;후자위3.8±4.0,6.4±2.0),차이유통계학의의(P＜0.05),억욱정서명현개선(HAMD분치비교P＜0.05),단초필정서무변화(HAMA분치비교P＞0.05);치료조SF-36량표재생리직능(RP)、신체동통(BP)、총체건강(GH)、활력(VT)4개유도상득분고우대조조(P＜0.01혹P＜0.05);제12주시,치료조교대조조두통발작빈솔、VAS명현감소(P＜0.01),억욱、초필정서명현개선(HAMD분치비교P＜0.01、HAMA분치비교P＜0.05),치료조SF-36량표재RP、BP、GH、VT、사회공능(SF)、정감직능(RE)、정신건강(MH)7개유도상득분고우대조조(P＜0.01).결론 대반유억욱、초필장애적편두통해양석유원공환자이항억욱、항초필치료후가이명현감소편두통발작빈솔、감경두통정도、개선정신장애、제고생활질량.
Objective To analyze the effects of intervention on the migraine patients with comorbidity of depression and anxiety among offshore marine personnel.Methods One hundred and forty-two migraine patients that met the migraine,depression and anxiety diagnostic standards were chosen from the offshore marine personnel,and were randomly divided into 2 groups,each consisting of 71 patients.At the onset of the disease,the patients of both groups were given painkillers,and during remission they were administered with preventive drugs (SNRI) for the recurrence of the disease.One of the groups was provided with additional treatment of 5-hydroxytryptamine and noradrenergic inhibitor.Migraine attack frequency,Visual Analogue Score (VAS),SF-36 Health Survey Scale,Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) evaluation results were recorded both before treatment and at week 6 and 12 after treatment.The whole observation period lasted for 12 weeks.Results At week 6,migraine attack frequency and visual analogue scores for the venlafaxinc treatment group were obviously reduced,as compared with those of the nonvenlafaxine treatment group(P ＜ 0.05),while the mode of depression was obviously improved (HAMD value,P ＜0.05).However,no changes could be seen in the mode of anxiety (HAMA value,P ＜ 0.05).For the venlafaxine treatment group,the scores of physiological function (PF),body pain (BP),general hcalth (GH) status,vitality (VT) of SF-36 were higher than those of the non-venlafaxine treatment group (P ＜ 0.01 and P ＜0.05).At week 12,attack frequency and visual analogue scores were significantly reduced,as compared with the non-venlafaxine treatment group (P ＜ 0.01),while the depression and anxiety scores obviously improved (HAMD value,P ＜ 0.01 ; HAMA value,P ＜ 0.05).For the venlafaxine treatment group,the scores of RP,BP,GH,VT,social function (SF),RE,mental health (MH) of SF-36 were higher than those of the non-venlafaxine treatment group(P ＜ 0.01).Conclusions Treatment of migraine patients with comorbidity of depression and anxiety by using anti-depression and anti-anxiety drugs could obviously reduce migraine attack frequency,seriousness of pain and in the mean time improve the status of mental disorder and the life quality of the patients as well.