The Clinical Observation Of St.Johns’ Wort Extract On The Treatment Of Coronary Heart Disease With Anxiety And Depression

With the rapid development of China’s social economy, the changes oflifestyle, the incidence of coronary heart disease showed a trend of increasingyear by year. World Health Organization predicts that more than100millionpeople die of coronary heart disease in china each year, which is serious threatto human health and life. Coronary heart disease is the interactions due tomultiple factors, including hypertension, diabetes, dyslipidemia, hyperuricemia,smoking, unhealthy lifestyles, the inflammatory response. Coronary heartdiseases as a physical and mental illnesses, their occurrence, development areclosely related with biological factors and psychological factors. The studyconfirmed that anxiety and depression are the dangerous factors which havenon-ignorable impact of coronary heart disease. Mental disorders have a higherincidence among the coronary heart disease population, especially in patientswith coronary heart disease combined with anxiety and depression, because ofits high mortality and poor prognosis, it should attract enough attention ofclinicians. With the refinement of the division of clinical departments, duringthe treatment of patients with coronary heart disease, clinicians oftenoverlooked some patients with concomitant anxiety, depression, makes this partof the patients received regular cardiovascular medical therapy, but clinicalsymptoms are often not well improved. The results show that, after anti-anxiety,antidepressant treatment, the treatment effect of coronary heart disease can besignificantly improved, for the patients with coronary heart disease combinedwith anxiety and depression. Therefore, anti-anxiety, antidepressant treatmentshould be advocated as part of a comprehensive rehabilitation of patients with coronary heart disease. On the basis of conventional cardiology drugintervention treatment, St John’s Wort Extract is chosen as the treatment for thepatients of coronary heart disease combined with anxiety and depression. Thispaper aims to observe the improvement of the clinical symptoms, and thereference indication, before and after anti-anxiety, antidepressant drugsintervention treatment of the patients of coronary heart disease combined withanxiety and depression, to study the possible mechanism.Objective: To evaluate the clinical efficacy of St. John’s wort extract onthe treatment of coronary heart disease combined with anxiety and depression.Methods: All of the participants were selected from diagnosis of coronaryheart disease, who were the patients hospitalized at the Department ofCardiology of Chinese-Japanese Union Hospital, from January2011toDecember2011.Thereinto,47cases were male and38females, who arebetween the age of42-74years old, on average,(59.6±6.1) years old.85patients were evaluated by Zung Self-rateing Anxiety Scale (SAS), who havethe total score greater than41points receive a diagnosis of anxiety. ZungSelf-rateing Depression Scale (SDS), who have the total score greater than40points, a diagnosis of depression. The patients were randomly divided intoobservation group (40cases) and control group (45cases). Which anginaseverity grading is according to the standards set by the Canadian Institute ofCardiovascular Disease. The treatments were both given to these two groups:dilating coronary artery, improving circulation, anti-platelet aggregation andlipid treatment. At the same time, The observation group combine with St.John’s Wort Extract follow-up treatment for six weeks. The following changedindication were compared: the improvement of Angina symptoms,Electrocardiogram ST segment changes;24-hour ambulatory electrocardiogramSDANN, rMSSD and the number of atrium premature beats and ventricularpremature beats; cardiac color Doppler ultrasound ejection fraction, left ventricular shortening fraction, diastolic function, anxiety self-assessment Scale(SAS) and Self-Rating Depression Scale (SDS) scores.Results:①Observation group in the treatment of5days,10days,15days, patients with angina pectoris ease number higher than the control group(P<0.05); attack frequency was significantly less than the control group (P<0.05); the two groups in angina pectoris duration was no significant difference(P>0.05);②With the improvement of anxiety and depression, theimprovement of the ECG in patients with myocardial ischemia in theobservation group is better than the control group (P <0.05);③after six weeks’treatment of observation group, SDANN, rMSSD were higher than controlgroup (P<0.05);④observation group compared with the control group, aftersix weeks, the number of atrium premature beats and ventricular prematurebeats less than the control group (P <0.05);⑤after six weeks, comparedbetween the two groups of patients with ejection fraction, left ventricularshortening fraction, improvement in diastolic function, the difference was notstatistically significant (P>0.05);⑥observation group compared with thecontrol group, the score of SAS and SDS significantly lower than the controlgroup, there is significant differences (P <0.05).Conclusion:①The Saint John’s wort extract, can not only alleviate theanxiety and the severity of depression of patients with coronary artery disease,but also assist to improve the treatment of coronary heart disease;②patientswith coronary heart disease combined with psychological disorders should begiven sufficient attention, physically, and mentally.