The Clinical Efficacy And Safety Of Duloxetine In Patients With Anxiety And Depression After PCI For Coronary Heart Disease

Objective:To investigate the clinical efficacy and safety of Duloxetine in patients with anxiety and depression after PCI for Coronary Heart Disease.Methods:80 cases of patients with anxiety and depression after PCI of Coronary Heart Disease admitted to the First Affiliated Hospital of Henan University of Science and Technology from August 2017 to July 2018 were selected as clinical subjects.In accordance with the principle of random,they are divided into treatment group and control group.On the basis of conventional treatment,the patients of treatment group also applied the Duloxetine,and the control group received Citalopram observing whether clinical symptoms are improved.At the same time,we had a dynamic evaluation for the patients' anxiety depression score,when they are in different stages of the treatment.In addition,we needed to evaluate the safety and reliability of the treatment,providing a guidance for clinical medication.Result:1.There was no significant difference between the two groups in the Patient Health Questionnaire(PHQ-9)score before treatment(P > 0.05).At the end of the second,fourth and eighth week of treatment,PHQ-9 scores of the two groups decreased successively,and there were statistical differences between the two groups and those before treatment(P < 0.05).At the second and fourth weekend of treatment,the PHQ-9 scores of the two groups showed significant statistical difference(P < 0.05).At the end of the 8th week of treatment,there was no significant difference in the PHQ-9 score between the two groups(P > 0.05).2.The Generalized Anxiety Disorder-7(GAD-7)score before treatment showed no significant difference between the two groups(P > 0.05).At the end of the second,fourth and eighth week of treatment,GAD-7 score of the two groups decreased successively,and there was no statistical difference between the two groups(P < 0.05).At the second and fourth weekend of treatment,the GAD-7 scores of the two groups were significantly different(P < 0.05).At the end of the 8th week,the GAD-7 score of the two groups showed no significant difference(P > 0.05).3.There was no significant difference in pretreatment health status assessmentscale score between the two groups(P > 0.05).At the end of the 8th week of treatment,sf-36 scores of patients in the treatment group were significantly higher than those in the control group in terms of mental health,physiological function,physical pain,basic health status,physiological function and emotional function,with statistically significant differences(P < 0.05).However,there was no significant difference in the scores of social function and energy between the two groups(P > 0.05).4.There was no significant difference in SI score between the two groups before treatment(P > 0.05).The SI scores of the patients in the treatment group at the second and fourth weekends were significantly lower than those in the control group,with statistically significant differences(P < 0.05).At the end of the 8th week of treatment,the SI score of the treatment group was still lower than that of the control group,but there was no statistical difference(P > 0.05).Treatment group after treatment in patients with 2 to 8 weekend the curative effect of the overall index(GI)were significantly lower than that of Citalopram group,treatment 2 weekend GI value by comparing two groups of patients had no significant statistical difference(P > 0.05),but in the treatment of 4 weeks,two groups of patients with GI value over the weekend,8 groups to compare the differences were statistically significant(P < 0.05).Treatment group of patients treated at the second weekend to cure after the curative effect of 8 weekend index(EI)were significantly higher than that of Citalopram group,EI values were compared in the treatment of 2 weekend no significant statistical difference(P > 0.05),but the two groups of patients in the treatment of 4,8 weekend EI values,by the comparison between groups has significant statistical difference(P < 0.05).5.The total effective rate of the treatment group was 90.0%,slightly higher than that of the control group(87.5%),with no statistical difference(P > 0.05).6.During the whole study,the incidence of adverse drug reactions in the treatment group was 25%,slightly higher than that in the control group(22.5%),but there was no significant difference between the two groups(P > 0.05).The incidence of adverse cardiovascular events in the treatment group was 15%,slightly higher than10% in the control group,but there was no significant difference between the two groups(P > 0.05).There was no significant difference between the two groups in the ecg QTc interval at each stage and the baseline(P > 0.05).Conclusion:1.Both Duloxetine and Citalopram can improve anxiety and depression after PCI of Coronary Heart Disease,improve the clinical treatment effect of Coronary Heart Disease,and have good clinical application value.2.Compared with Citalopram,Duloxetine has the advantages of quick onset and high short-term clinical symptom remission rate.Both of them have low incidence of adverse drug reactions and cardiovascular events,and do not prolong the QTc interval of electrocardiogram,which is reliable for the clinical safety of patients with anxiety and depression after PCI for Coronary Heart Disease.