CAJ | 학술논문

目的：观察冠心病伴焦虑抑郁患者的社区规范化管理效果。方法选取2009年1月~2012年12月于新丰县中医院就诊的6个社区（街镇）的冠心病伴焦虑抑郁患者96例为研究对象，其中男性54例，女性42例，年龄36~72岁，平均年龄（53.2±9.3）岁。按照就诊顺序，使用随机数字表，将入组患者分为对照组和观察组（各48例）。对照组仅给药物治疗，观察组给予药物治疗联合社区规范化管理干预。比较两组患者临床指标控制率、抑郁自评量表（SDS）及焦虑自评量表（SAS）评分、随访情况。结果观察组体质指数（BMI）、血压（BP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）等指标达标率显著高于对照组，差异具有统计学意义（P均＜0.05）。两组患者SDS及SAS评分治疗后较治疗前均降低，差异有统计学意义（P均＜0.05）；治疗后，观察组SDS及SAS评分较对照组均显著降低，为[（41.3±4.7）分vs.（50.8±4.5）分]和[（38.9±3.8）分vs.（48.3±4.5）分]，差异有统计学意义（P均＜0.05）。与对照组比较，观察组随访管理率、按时服药率及控制率明显增高，失访率明显降低，差异有统计学意义（P均＜0.05）。结论采用规范化社区管理可明显提高冠心病伴焦虑抑郁患者临床指标达标率，改善焦虑抑郁症状，值得临床推广使用。
목적：관찰관심병반초필억욱환자적사구규범화관리효과。방법선취2009년1월~2012년12월우신봉현중의원취진적6개사구（가진）적관심병반초필억욱환자96례위연구대상，기중남성54례，녀성42례，년령36~72세，평균년령（53.2±9.3）세。안조취진순서，사용수궤수자표，장입조환자분위대조조화관찰조（각48례）。대조조부급약물치료，관찰조급여약물치료연합사구규범화관리간예。비교량조환자림상지표공제솔、억욱자평량표（SDS）급초필자평량표（SAS）평분、수방정황。결과관찰조체질지수（BMI）、혈압（BP）、총담고순（TC）、저밀도지단백담고순（LDL-C）、고밀도지단백담고순（HDL-C）등지표체표솔현저고우대조조，차이구유통계학의의（P균＜0.05）。량조환자SDS급SAS평분치료후교치료전균강저，차이유통계학의의（P균＜0.05）；치료후，관찰조SDS급SAS평분교대조조균현저강저，위[（41.3±4.7）분vs.（50.8±4.5）분]화[（38.9±3.8）분vs.（48.3±4.5）분]，차이유통계학의의（P균＜0.05）。여대조조비교，관찰조수방관리솔、안시복약솔급공제솔명현증고，실방솔명현강저，차이유통계학의의（P균＜0.05）。결론채용규범화사구관리가명현제고관심병반초필억욱환자림상지표체표솔，개선초필억욱증상，치득림상추엄사용。
Objective To observe the effect of community-based standardized management in patients with coronary heart disease (CHD) accompanied by anxiety and depression. Methods The patients with CHD accompanied by anxiety and depression (n=96, male 54, female 42, aged from 36 to 72 and average age=53.2 ±9.3) were chosen from 6 communities from Jan. 2009 to Dec. 2012. The patients were divided, according to registration order, into control group and observation group (each n=48) by using random digital table. The control group was only given drug therapy and observation group, drug therapy combining community-based standardized management. The control rate of clinical indexes, scores of self-rating depressive scale (SDS) and self-rating anxiety scale (SAS), and follow-up situation were compared between 2 groups. Results The control rates of body mass index (BMI), blood pressure (BP), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) were significantly higher in observation group than those in control group (P<0.05). The scores of SDS and SAS decreased in 2 groups after treatment (all P<0.05). After treatment, the scores of SDS and SAS decreased significantly in observation group compared with control group [(41.3± 4.7) vs. (50.8±4.5)] and [(38.9±3.8) vs. (48.3±4.5), all P<0.05]. In observation group, follow-up management rate, rate of taking drugs regularly and control rate increased significantly, and missing rate decreased significantly compared with control group (all P<0.05). Conclusion Community-based standardized management can improve the control rate of clinical indexes, and relieve symptoms of anxiety and depression in patients with CHD accompanied by anxiety and depression, which is worth to be popularized in clinic.