| BackgroundIn clinical work,it is found that many patients worry about the adverse prognosis of the disease after ECG examination shows myocardial ischemia,thus causing anxiety or depression.The School of Public Health of Fudan University conducted a study entitled "Prevalence Study of Depression,Anxiety,and Depression Combined Anxiety Symptoms in Non-psychiatric Patients in Chinese Cities" from 2004 to 2005.The study showed that cardiovascular patients had depression or anxiety rates of 22.8 % and 70.9 %,However,the diagnosis rate of patients with depression or anxiety by cardiovascular doctors was low,3.7 % and 2.4 %,respectively,and the treatment rate for patients with depression or anxiety was even lower,which was 2.4 %.ObjectiveIn recent years,the incidence of cardiovascular diseases has shown an increasing trend,among which myocardial ischemia and myocardial infarction are common types.The occurrence of disease is often accompanied by anxiety and depression,which seriously affects patients' mental health and therapeutic effect.Based on this,we hope to explore the clinical effect of sertraline hydrochloride combined with psychological intervention in the treatment of anxiety and depression in patients with myocardial ischemia through a comparative study.Methods156 patients with myocardial ischemia accompanied by anxiety and depression were selected from December 2017 to December 2018 in my hospital.They were randomly divided into four groups,39 cases in each group.Basic drug therapy,basic drug + sertraline therapy,basic drug + psychotherapy,basic drug + sertraline + psychotherapy were given respectively.The HAMD score and HAMA score of the four groups were compared;the curative effect,adverse reaction rate,incidence of cardiovascular adverse events and satisfaction of the four groups were observed and compared;the changes of ST-T,HAMD score reduction rate,HAMA score reduction rate and quality of life score of the four groups before and after treatment were compared.Results(1)There was no significant difference in HAMD score and HAMA score between the four groups before treatment(P> 0.05);after treatment,the HAMD score and HAMA score of the four groups decreased significantly,which was lower than that before treatment,and the scores before and after treatment had significant difference(P< 0.05);after treatment,the HAMD score of the four groups was significantly lower than that of the other groups,and the difference existed.The difference was statistically significant(P< 0.05).After treatment,HAMD score reduction and HAMA score reduction in the basic drug + sertraline + psychological treatment group were significantly highest,while HAMD score reduction rate and HAMA score reduction rate were the highest,with statistical significance(P< 0.05).(2)The total effective rate was 38.46% in the basic drug treatment group,48.72% in the basic drug + sertraline treatment group,43.59% in the basic drug + psychotherapy group and 94.87% in the basic drug + sertraline + psychotherapy group.Compared with the four groups,the total effective rate in the basic drug + sertraline + psychotherapy group was significantly higher than that in other groups,with statistical significance(P < 0.05).(3)Compared with the incidence of cardiovascular adverse events after treatment in the four groups,the incidence of adverse events in the basic drug treatment group was 33.33%,the incidence of adverse events in the basic drug + sertraline treatment group was 10.26%,the incidence of adverse events in the basic drug + sertraline + psychological treatment group was 5.13%,and the incidence of adverse events in the basic drug + psychological treatment group was 28.21%.Compared with the four groups,the incidence of cardiovascular adverse events in the basic drug + sertraline + psychotherapy group was significantly lower,the difference was statistically significant(P< 0.05).(4)There were no adverse reactions in the basic drug group and the basic drug + psychological treatment group.There was one case of gastrointestinal reactions in the basic drug + sertraline treatment group.The incidence of adverse reactions was 2.56%.There were 2 cases of gastrointestinal reactions and 2 cases of dry mouth in the basic drug + sertraline + psychotherapy group.The incidence of adverse reactions was 10.26%.However,the adverse reactions in the two groups were mild and no special treatment was taken.The adverse reactions gradually eased and disappeared in the course of continued treatment.There were no abnormal blood routine and liver function indicators in the course of treatment.(5)There was no significant difference in quality of life scores between the four groups before treatment(P > 0.05);The quality of life score of the four groups after treatment was significantly higher than that before treatment,and the difference was significant(P < 0.05);The basic drug + sertraline + psychotherapy group was significantly higher than other groups,and the difference was statistically significant(P < 0.05).(6)The satisfaction of the basic drug treatment group was 69.23%,that of the basic drug + sertraline treatment group was 82.05%,that of the basic drug + psychotherapy group was 79.49%,and that of the basic drug + sertraline + psychotherapy group was 97.44%.Comparing the satisfaction of the four groups,the basic drug + sertraline + psychotherapy group was higher than the other groups,and the difference was statistically significant(P < 0.05).ConclusionSertraline combined with psychological intervention has a significant effect on anxiety and depression in patients with myocardial ischemia.It can effectively improve the symptoms of anxiety and depression,improve the total effective rate,improve the quality of life of patients,and reduce the risk of adverse cardiovascular events and adverse reactions. |
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