138例双心疗法治疗急性冠脉综合征患者的临床分析
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【摘要】 目的 研究双心疗法治疗急性冠脉综合征(ACS)患者的疗效。方法 选择ACS患者138例，随机分为研究组69例和对照组69例，所有病例均给予常规心血管药物规范性治疗。治疗组在规范治疗基础上加用心理干预治疗，包括药物治疗和认知治疗、行为干预、生物反馈放松治疗，其中药物治疗用盐酸舍曲林和氯硝安定。观察两组用药3个月后，患者ACS症状的改善情况以及用药期间的不良反应。结果 ①ACS症状的改善情况：研究组总有效率为95.65%；对照组总有效率为76.81%。研究组与对照组相比，差异有统计学意义(P<0.05)。②不良反应：两组用药期间均未见药物不良反应，无意外死亡病例。结论 双心疗法治疗急性冠脉综合征患者安全、有效、可行，而且比常规规范治疗更有效，但尚需进行大样本的循证研究来更完善地进一步深入探讨。
【关键词】 双心疗法；急性冠脉综合征；心理干预
Analysis of 138 cases of double-heart therapy in acute coronary syndromepatients
CHEN You-quan,CHEN Ci-bin,CHEN Xi-ming, et al. Department of Cardiovascular Internal Medicine，The Third Affiliated Hospital ofGuangzhou Medical College, Guangzhou 510150,China
【Abstract】 Objective
To study the therapeutic effect of double-heart therapy in acute coronary syndrome(ACS)patients. Methods 138 patients with ACS patients, 69 patients were randomly divided into study group and control group 69 patients, all patients were given normative conventional treatment of cardiovascular drugs. In treatment group, patients were plus the use of psychological intervention, including medication and cognitive therapy, behavioral interventions, biofeedback relaxation treatment, drug treatment with Sertraline and Clonazepam. Improvement of symptoms in patients with ACS and the adverse reactions were observed 3 months after treatment. Results ① ACS symptom improvement: the total effective rate of Study group was 95.65%,and the one of control group 76.81%,the difference was statistically significant(P<0.05). ②Adverse reactions: the two groups were no adverse drug reactions during the period, no cases of accidental death. Conclusion Double-heart therapy in acute coronary syndrome patients is safe, effective, feasible,and more effective than conventional standard treatment, but still need to conduct some evidence-based investigations of large sample sizes to further explore.
【Key words】 Double-heart therapy; Acute coronary syndrome; Mental intervention
疾病就要从心脏、心理行为-“双心疗法”-两方面着手，在躯体药物治疗的同时，采用心理评估及各种心理行为干预措施，才能更有效地预防、治疗心血管疾病。目前，关注心血管疾病患者的心理问题，已成为当今医学界的新话题。我院采用双心疗法应用于急性冠脉综合征(acute coronary symptom, ACS)患者，作初步探索研究，取得满意疗效，现报告如下。
1 资料与方法
1.1 一般资料 选择2010年1月至2010年12月在本院接受治疗的ACS合并抑郁症患者138例，其中男56例，女82例，年龄46~86岁，平均(66±5.8)岁，本组138例患者的临床表现均常伴有：难以用器质性疾病解释的心悸、心前区不适、胸闷、呼吸困难、多汗、急躁易怒、头晕耳鸣、失眠多梦等症状 ......
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