| Objective: Coronary heart disease(CHD)is the leading cause of death worldwide.Percutaneous coronary intervention(PCI)is one of the most effective treatments for CHD.Data show that the patients after PCI have a high incidence of psychological disorders.This not only affects the quality of life,but also is unfavorable to the prognosis of heart disease.Therefore,identifying the psychological problems is crucial while treating the heart diseases.Timely and effective intervention can enable the patients to achieve the physical and mental well-being gradually.This paper aims to compare the effects of simple psychological counseling and psychological counseling plus antidepressant drug therapy on the psychological disorders and angina pectoris after PCI,respectively,so as to provide the reference for the treatment of patients with psychological disorders after PCI.Methods: The patients with psychological disorders after PCI for CHD were admitted to the Department of Cardiovascular Internal Medicine,260 th Hospital of Chinese People's Liberation Army from January 2014 to March 2018.The patients were randomly divided into simple psychological counseling group(n=44)and psychological counseling + antidepressant drug group(n=43).There were no significant differences in the age,gender,diabetes,hypertension,major changes in work and life between the two groups.The patients in the simple psychological counseling group received the psychological counseling and routine treatment of cardiology.The psychological counseling + antidepressant drug group was treated with flupentixol-melitracen plus Qiye Shen'an tablets on the basis of the therapy for the simple psychological counseling group.At the 15 and 30 days after the treatment,the patients' psychological disorders were assessed by self-rating scale of somatization symptoms(the higher the score,the more serious the condition of psychological disorder).Clinical symptoms of angina pectoris were assessed by angina attack time(the higher the score,the more serious the condition of angina pectoris).The therapeutic effects of the two methods on the psychological disorder and angina pectoris after PCI were judged.Results: 1 Therapeutic effect on psychological disorder 1.1 Simple psychological counseling groupThe self-rating scale of somatization symptoms showed that the mean score was 54.23±10.22 before the treatment.The mean score was 36.52±9.06 at the 15 days after the treatment,which was significantly lower than that before the treatment(P<0.001).The mean score was 31.11±7.40 at the 30 days after the treatment,which was significantly lower than that before the treatment(P<0.001)and the 15 days after the treatment(P<0.05).These results indicated that the psychological counseling treatment could lower the psychological disorder scores of the patients after PCI,and the therapeutic effects could be significantly improved with the prolongation of treatment time.1.2 Psychological counseling plus antidepressant drug intervention groupThe self-rating scale of somatization symptoms showed that the mean score was 53.84±10.12 before the treatment.The mean score was 29.28±12.87 at the 15 days after the treatment,which was significantly lower than that before the treatment(P<0.001).The mean score was 25.65±10.86 at the 30 days after the treatment,which was significantly lower than that before the treatment(P<0.001).There was no significant difference between the 30 and 15 days after the treatment(P>0.05).These results suggested that the psychological counseling plus antidepressant drug treatment achieved the optimal effect at the 15 days after treatment,and the therapeutic effect was stable.1.3 Comparison of therapeutic effects between the two groupsThe statistical analyses showed that the scores of psychological disorders in the intervention group of psychological counseling plus antidepressants drug were significantly lower than those in the simple psychological counseling group at the 15 and 30 days after the treatment,respectively(P<0.05).These results indicated that the improvement of psychological disorders was more significant after intervention with flupentixol-melitracen plus Qiye Shen'an tablets.2 Therapeutic effect on angina pectoris 2.1 Simple psychological counseling groupThe angina score showed that the mean pre-treatment score was 73.09±28.04.The mean score was 24.23±17.35 at the 15 days after the treatment,which was significantly lower than that before the treatment(P<0.001).The mean score was 17.20±15.24 at the 30 days after the treatment,which was significantly lower than that before the treatment(P<0.001)and the 15 days after the treatment(P<0.05).These results indicated that routine cardiology plus psychological counseling treatment could significantly reduce the angina pectoris score,and the therapeutic effects could be significantly improved with the prolongation of treatment time.2.2 Psychological counseling plus antidepressant drug intervention groupAngina pectoris score showed that the mean pre-treatment score was 73.95±28.16.The mean score was 21.02±16.49 at the 15 days after the treatment,which was significantly lower than that before the treatment(P<0.001).The mean score was 13.51±10.72 after the 30 days of the treatment,which was significantly lower than that before the treatment(P<0.001)and the 15 days after the treatment(P<0.05).These results suggested that the routine cardiology treatment + psychological counseling + anti-depressant drugs intervention could significantly reduce angina pectoris score,and the therapeutic effects could be significantly improved with the prolongation of treatment time.2.3 Comparison of therapeutic effects between the two groupsThe statistical analyses showed that there was no significant difference in the angina score between the psychological counseling + antidepressant drug intervention group and the simple psychological counseling group at the 15 or 30 days after the treatment,respectively(P>0.05).These results showed that the angina pectoris score was not significantly improved after intervention with anti-depressant drugs such as flupentixol-melitracen + Qiye Shen'an tablets.Conclusions:1.The psychological disorder of CHD patients after PCI could be decreased significantly after the simple psychological counseling combined routine treatment of cardiology,or plus flupentixol-melitracen and Qiye Shen'an tablets antidepressant drug treatment.2.Addition of antidepressant drug had the better therapeutic effect on the psychological disorder.3.Both the treatments significantly improved the clinical symptoms of angina pectoris,and the therapeutic effects were basically equal. |
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