| Objective:1.To investigate the incidence of anxiety and depression in hypertensive patients;2.To observe the clinical effect of Yi Xintang in the treatment of hypertension complicated with anxiety,and to explore its possible mechanism.Method:This study is divided into two parts:1.The first part of the incidence of investigation: The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were scored in 300 hypertensive patients who were diagnosed.The relationship between hypertension and anxiety and depression was analyzed and the influencing factors were analyzed.2.The second part of clinical observation: 42 patients with hypertension and anxiety and TCM dialectical liver depression and spleen deficiency and blood stasis patients were randomly divided into treatment group 22 cases,the control group of 20 cases,The control group received regular western medicine antihypertensive therapy,the treatment group in the control group based on the treatment of Yixin Tang,day one,two times a warm morning and evening.Two groups of treatment are around,The changes of blood pressure,TCM syndrome score,anxiety self-rating scale and cardiac autonomic function were analyzed before and after treatment.Result:Clinical investigation:1.There were 180 patients(60%)who had diagnosed anxiety and or depressive status in 300 outpatients or hospitalized hypertensive patients,including 109 patients(36.3%)with simple state of anxiety;45 patients with simple depression(15%);Anxiety patients with depression in 26 patients(8.7%).2.300 cases of hypertensive patients survey data show that:Whether it is anxiety or depression score,female,age is less than or equal to 60 years old,secondary and above educational level,unmarried patients with higher points,prone to anxiety and depression.Anxiety score:According to the level of blood pressure elevation,grade 3 hypertensive patients were higher than those of grade 1 and 2 hypertensive patients(P<0.01),however,there was no significant difference in anxiety scores between grade 1 and 2 hypertensive patients(P>0.05);According to the classification of hypertension risk stratification,high risk patients with anxiety scores>high risk patients>low and moderate risk patients(P<0.01);Patients with other cardiovascular complications were higher than those without patients(P <0.01);The length of the course had no effect on the anxiety score of the patients(P>0.05).Depression score: According to the level of blood pressure elevation,grade 3 hypertensive patients were higher than those of grade 1 and 2patients(P<0.01),however,there was no significant difference in depression scores between grade 1 and 2 hypertensive patients(P>0.05);According to the classification of hypertension risk stratification,high-risk patients with depression score> low,moderate risk,high risk patients(P <0.05),however,there was no significant difference in depression scores among patients with low,moderate risk and high risk(P>0.05);There was no effect of other cardiovascular complications and duration(P>0.05).Clinical Observation:1.The efficacy of the two groups of patients with hypertension: the treatment group markedly 6,effective 13,ineffective 2;control group markedly effective5,effective 9,invalid 6.The total effective rate was 86.36% in the treatment group and70.00% in the control group,the treatment group was same with the control group(P<0.05).3.The systolic blood pressure,diastolic blood pressure,systolic blood pressure and diastolic blood pressure were significantly improved(P<0.01),and the treatment group was better than the control group(P<0.05).4.In the two groups,the treatment group recovered 4 people,markedly effective 10 people,effective 6,ineffective 2;the control group recovered 1,marked 5,effective 7,ineffective 7;treatment group total effective rate 90.09%,The control group was 65.00%,the treatment group was better than the control group(P<0.05);The scores of TCM syndromes were significantly improved(P<0.01),and the treatment group was significantly better than the control group(P<0.05).5.The scores of SAS scores in both groups were significantly improved(P<0.01),and the treatment group was significantly better than the control group(P<0.01).6.SDNN,SDANN and HF were higher than those before treatment,LF decreased before treatment(P<0.01),the level of SDNN,SDANN and HF in the treatment group was better than that in the control group(P<0.01 or P<0.05).The level of LF in the treatment group was better than that in the control group(P <0.05).Conclusion:Clinical investigation:1.The incidence of anxiety and depression in hypertensive patients is higher.2.Female,age less than or equal to 60 years old,high level of education,unmarried,high blood pressure 3,very high risk,combined with other cardiovascular and cerebrovascular disease patients with higher anxiety scores,prone to anxiety;Age less than or equal to 60 years old,high level of education,unmarried,high blood pressure 3,very high risk of depression in patients with high scores,prone to depression.Clinical Observation:1.Hypertension with anxiety in patients with conventional Western medicine on the basis of antihypertensive therapy with Yixin Tang treatment,showing good clinical results,can improve the efficacy of antihypertensive,reduce blood pressure load,regulate blood pressure rhythm,improve TCM syndrome,improve heart autonomic nerve function,Yixin Tang treatment group indicators are better than the control group,the side no obvious adverse reactions,safe and reliable.2.Yixin Tang can improve the clinical efficacy of hypertension combined with anxiety disorder,and its mechanism may be through the two-way regulation of autonomic nervous function,anti anxiety,and achieve the effect of stable hypotension. |
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