The Investgation Of Coronary Heart Disease With Anxiety-Depression And The Clinical Observation Of Intervention Therapy Of Yixin Decoction

Objective1.To investigate the incidence of coronary heart disease(CHD); 2. To observe the efficacy of Yixin decoction on CHD patients with anxiety depression.based on diagnosis and treating with TCM.Methods This study includes two parts: 1. in part one, 245 patients with confirmed CHD were tested with Hamilton Anxiety Scale(HAMA) and Hamilton depression scales(HAMD),all the data were recorded and statistically analyzed. 2. in part two, 60 CHD patients with stable angina pectoris and anxiety-depression(syndrome of liver-depression and spleen-deficiency in TCM) were randomly divided into treatment group and control group with 30 cases in each group; the patients in control group received regular treatment of secondary prevention of CHD, the patients in treatment group received Yixin decoction additionally, one dose taking two times a day, besides the regular treatment. Both groups were treated for 4 weeks,in order to observe the changes of the accumulating points of TCM symptom, anxiety depression scale scores, ECG efficacy, curative effect of angina pectoris before and after treatment in two groups.Results1. Among 245 CHD patients under investigation, 64 cases with anxiety disorder(26.1%), 71 cases with depressive disorder(28.98%), 25 cases with anxiety-depression disorder(10.2%). The CHD patients with anxiety-depression were tested with HAMA and HAMD, to analyze the influence of various factors on CHD with anxiety-depression. The results showed that in anxiety and depression scale, the score is higher in female than in male, higher in singles than in married person, higher in cases with hypertension than in patients without hypertension, higher in cases with diabetes than in cases without diabetes, the difference has statistical significance(P<0.01 or P < 0.05). Age and smoking history have no influence on anxiety and depressionscore(P>0.05), educaiton level has an impact on anxiety score(P<0.05),the types of CHD have an effect on depression score(P < 0.05). 2. For the CHD patients with stable angina pectoris and anxiety-depression treated by Yixin decoction,the total effective rate in treatment group is higher than that in control group, the difference has statistical significance(P<0.05), though the accumulating points of TCM symptom were improved after therapy, the treatment group improved more significantly(P < 0.01). the total effective rate of stable angina pectoris is higher in treatment group, and the difference has statistical significance(P < 0.05).Anxiety-depression scores were better improved in treatment group than in control group, the difference has statistical significance(P < 0.01). The unstable angina pectoris(ACS) in patients with coronary heart disease is higher than that of stable angina pectoris(P>0.05).Conclusion1.CHD is often accompanied by anxiety and depression disorder, and anxiety-depression can aggravate angina pectoris and influence the curative effect. In this survy,it is found that gender,education level,marital status,hypertension history,history of diabetes and CHD as the influencing factors,the female, low education level,single, hypertension history, history of diabetes and severity of coronary artery disease patients more easily associated with anxiety and depressive disorders. 2. The therapy of Yixin decoction with secondary prevention of CHD can improve the clinical efficacy of CHD patients with anxiety-depression, effectively relieve anxiety and depression,decrease anginal attacks resulted from anxiety-depression.