摘要
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。
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.
出处
《中国循证心血管医学杂志》
2015年第4期465-467,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
广东省韶关市新技术推广项目
关键词
冠心病
焦虑
抑郁
社区管理
Coronary heart disease
Anxiety
Depression
Community-based management
