【摘要】 目的 探討降高血壓藥物聯合抗焦慮抑郁藥物萬拉法新治療老年性原發高血壓伴焦慮抑郁障礙的療效及安全性。 方法 納入2006年10月-2008年10月我院門診和住院診治的老年性原發高血壓伴焦慮抑郁障礙患者100例,隨機分為干預組和對照組。所有患者給予常規降壓藥物治療,干預組另外給予萬拉法新治療,治療12周后評價臨床療效。結果 干預組臨床降壓療效總有效率940%,顯著高于對照組總有效率800%(Plt;005)。兩組患者的收縮壓、舒張壓與治療前比較均顯著改善(Plt;005),干預組患者與對照組比較血壓明顯改善(Plt;005)。干預組臨床抗焦慮抑郁療效總有效率960%,顯著高于對照組總有效率580%(Plt;005)。兩組均無明顯的不良反應。結論 降高血壓藥物聯合抗焦慮抑郁藥物萬拉法新治療老年性原發高血壓伴焦慮抑郁障礙療效肯定,且安全可靠,值得臨床推廣應用。【Abstract】 Objective To investigate the efficacy and safety of antihypertensive drugs combined with antianxiety depression drug venlafaxine for treatment of patients with senile primary hypertension (SPH) and anxietydepression disorder (AD). Methods One hundred SPH patients with AD with were randomly divided into an intervention group and a control group. All cases were given antihypertensive drugs medication,while the intervention group was given venlafaxine. After 12 weeks of treatment,the clinical efficacy was evaluated. Results The antihypertensive efficacy rate in the intervention group was 940%,significantly higher than that of the control group 800% (Plt;005). The systolic blood pressure(SBP)and diastolic blood pressure (DBP) of the two groups significantly improved compared with those before treatment (Plt;005), and the intervention group’ SBP and DBP improved significantly than those of the control group (Plt;005). The total effective rate of antianxiety depression efficacy of the intervention group was 960%, significantly higher than that of the control group 580% (Plt;005). The two groups had no significant adverse reactions. Conclusion For patients with senile primary hypertension and anxietydepression disorder,the combination medication with antihypertensive drugs and venlafaxine was safe,reliable and worthy of clinical application.
ObjectivesTo compare the clinical features and the effects on cognition, emotion, and prognosis of antiepileptic drugs (AEDs) between occipital lobe epilepsy (OLE) and temporal lobe epilepsy (TLE).MethodsWe collected the clinical data of the patients with OLE and TLE from the Department of Neurology, the First Hospital of Jilin University from January 2016 to May 2018. We measured the patients with Mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), digital span, Auditory verbal memory test (AVMT), Generalized anxiety disorder (GAD-7), Patient health questionnaire-9 (PHQ-9) and Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (c-NDDI-E) and followed up for 1 year.Results① After 1 year’s follow-up, the frequency of the two groups decreased compared with the first visit (Z=3.734, P=0.000) and the extent was similar (Z=?0.290, P=0.772). In group OLE, occipital aura was 45.9% (17 cases) and temporal aura was 37.8% (14 cases). In TLE group, temporal aura was 49.3% (33 cases) and occipital aura 7.5% (5 cases). In OLE group, post-seizure headache was found in 17 cases (45.9%), which was more than the 15 cases (22.4%) in TLE group (χ2=6.210, P=0.013). ② 30 cases (81.1%) in OLE group interictal discharge involved lobes outside occipitotemporal lobe, 4 of which had a wide-lead-involved discharge, and 19 cases (28.4%) in TLE group involved lobes outside temporal lobe, and there was a significant difference between the two groups (χ2=26.592, P=0.000). ③ There was no significant difference in the score of MOCA and AVMT in the group of OLE-A and OLE-B, either the group of TLE-A and TLE-B. The score of AVMT in group OLE-A was higher than that in group TLE-A (t=3.193, P=0.002), and that in group OLE-B was higher than that in group TLE-B (t=2.264, P=0.029). There was no significant difference in GAD-7, PHQ-9, and c-NDDI-E (P>0.05). After follow-up for 1 year, the scores were compared with its initial scales. The score of GAD-7 (Z=?2.561, P=0.010), PHQ-9 (Z=?2.053, P=0.040) and c-NDDI-E (Z=?2.493, P=0.013) all decreased. The score of GAD-7 (r=0.281, P=0.021) and c-NDDI-E (r=0.456, P=0.000) have a positive correlation with the frequency of seizure. Therapeutic effect: In OLE group, the efficiency of carbamazepine or oxcarbazepine group was 58.82% and of levetiracetam group was 83.33%. in TLE group, the efficiency of carbamazepine or oxcarbazepine was 72.50% and of levetiracetam group was 70.00%. There was no significant difference between group OLE and group TLE in the curative effect of carbamazepine or oxcarbazepine group (χ2=1.033, P=0.310) or levetiracetam group (χ2=0.356, P=0.551). After 1 year’s follow-up, the frequency of OLE group was 0.00 (0.000, 2.750) times per month, and the TLE group was 0.00 (0.000, 1.500) times per month. There was no significant difference between the two groups (Z=?0.226, P=0.822). At the follow-up, the frequency of seizure in the two groups was lower than that at the first visit (P=0.000). The frequency of seizure in TLE group was similar to that in OLE group (=?0.648, P=0.517). After 1 year, 5 patients (13.51%) in OLE group were newly diagnosed as refractory epilepsy and 6 patients (9.00%) in TLE group There was no significant difference in the rate of the newly diagnosed refractory epilepsy between the two groups (2=0.524, P=0.469).ConclusionOccipital aura and post-seizure headache are specific to OLE, which can be used as one of the basis for diagnosis of OLE. Epileptiform discharge in OLE is more likely to spread out in multiple cerebral lobes, while epileptiform discharge in TLE is confined to temporal lobe and the area near it. The cognitive impairment in OLE or TLE is not related to the duration of the disease. The degree of depression is positively correlated with the frequency of seizure. The responses to AEDs of OLE and TLE are similar.
Objective
To estimate the incidence of post-myocardial infarction depression among Chinese acute myocardial infarction (AMI) patients by meta-analysis and to provide references for the management of AMI patients.
Methods
We searched databases including PubMed, The Cochrane Library (Issue 6, 2016), CNKI, CBM, WanFang Data and VIP from January 2000 to July 2016, to collect literature regarding the incidence of post-myocardial infarction depression among patients with AMI. Two reviewers independently screened literature, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed by using Comprehensive Meta Analysis (CMA) 2.0 software.
Results
Totally, 22 cross-sectional studies were included, involving 2 986 AMI patients, of which1 239 were post-myocardial infarction depression patients. The overall incidence of post-myocardial infarction depression among the AMI patients was 42.7% (95%CI 36.3% to 49.4%). There was no statistical differences observed when the studies were stratified by sex, regions, scales and years (allP values>0.05).
Conclusion
In China, the incidence of post-myocardial infarction depression is high and rising year by year roughly among AMI patients. The status should be paid more attention.
ObjectiveTo systematically review the effectiveness and safety of Wuling capsule for patients with depression after stroke.
MethodsThe randomized controlled trials (RCTs) about Wuling capsule for treating the patients with post-stroke depression was searched in PubMed, The Cochrane Library (Issue 4, 2013), EMbase, CBM, CNKI, WanFang Data and VIP from the dates of their establishment to November 2013. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment of the included studies were completed by two reviewers independently. Meta-analysis was conducted using RevMan 5.2 software.
ResultsA total of eighteen RCTs involving 1 683 patients were finally enrolled. The results of meta-analysis indicated that:a) the Wuling capsule group was more effective in decreasing depression scores than the control group at 4, 8, 12 weeks (4 weeks:SMD=-0.87, 95%CI-1.25 to-0.5, P < 0.000 1; 8 weeks:SMD=-1.22, 95%CI-1.86 to-0.59, P=0.000 2; 12 weeks:SMD=-0.62, 95%CI-1.09 to-0.15, P=0.01). b) The effectiveness rate (92.7%) of the Wuling capsule group was significantly higher than that of the control group (77.2%) at the end of follow-up, with a significant difference (RR=1.20, 95%CI 1.14 to 1.27, P < 0.000 01). c) The two groups were alike in the incidence of palpitation.
ConclusionCurrent evidence suggests that, Wuling capsule improves the symptoms of stroke-stroke depression with less adverse reaction. However, due to the limited quantity and quality of the included studies, more multicenter high quality RCTs with large sample size are needed to verify the above conclusion.
【摘要】 目的 了解結直腸癌患者術后發生抑郁、焦慮狀況，分析其影響因素。 方法 2010年1-3月，采用Zung抑郁自評量表（SDS）、焦慮自評量表（SAS）和一般資料調查問卷，結合病歷資料及心理評估，對64例結直腸癌術后患者進行測評，采用SPSS 13.0軟件對數據進行統計分析。 結果 64例患者SDS（47.02±10.38）分，SAS評分（42.42±7.96）分，均高于國內常模（Plt;0.001）。抑郁和焦慮發生率分別為42.2%、20.3%。造口患者抑郁得分高于非造口患者（P=0.004），Miles術患者抑郁得分高于非造瘺根治術患者（P=0.039），姑息術患者抑郁得分高于非造瘺根治術患者（P=0.007）；家庭月收入≤1 000元者抑郁得分高于1 001~3 000元及gt;3 000元者（P=0.040，0.017）。不同情況患者焦慮得分差異無統計學意義（Pgt;0.05）。SDS與SAS呈正相關（Plt;0.001）。 結論 結直腸癌術后患者存在不同程度的抑郁和焦慮。護理人員尤其應關注造口術后、晚期患者及收入低下患者，并進行針對性健康教育和心理干預。【Abstract】 Objective To evaluate the postoperative anxiety and depression of patients with colorectal cancer and investigate its related factors. Methods From January to March 2010, 64 patients who were diagnosed to have colorectal cancer and received therapeutic operations were investigated with self-rating depressive scale (SDS), self-rating anxiety scale (SAS) and self-made related questionnaire respectively. Psychological assessment and medical records gathering were also carried out. The data collected were analyzed by SPSS 13.0. Results The total score of SDS (47.02±10.38) and SAS (42.42±7.96) of the 64 patients were both higher than those of the general population (Plt;0.001). The incidence rate of depression and anxiety was 42.2% and 20.3% respectively. Patients without stoma had lower SDS scores than those with stoma (P=0.004); patients undergoing Miles operation had higher SDS scores than those receiving non-fistula formation radical operations (P=0.039); patients receiving palliative treatment had higher SDS scores than those receiving non-fistula formation radical operations (P=0.007); patients with family monthly income less than 1 000 RMB had higher SDS scores than those with more than 3 000 RMB and between 1 001-3 000 RMB (P=0.017, 0.040). SAS scores among different patients were not significantly different (Pgt;0.05). SDS had positive correlation with SAS (Plt;0.001). Conclusions Patients with colorectal cancer have higher emotions of anxiety and depression after operation than those in the general population. It is suggested that more psychological consultation, treatment and nursing should be carried out to promote the overall physical and mental rehabilitation of the patients, especially for those having undergone stoma formation, late-stage patients and those with a low income.
Evidence has been retrieved through MEDLINE and Cochrane Libray about the treatment for patients with advanced Parkinson’s disease who suffered from on-off, dyskinesia and depression after chronic use of L-dopa. All of the evidence has been evaluated. Methods of evidence-based treatment were drawn up according to the evidence, clinciams’ experiences and patients’ preferences. All symptoms of the patient have been improved obviously.
Objective
To identify related factors of anxiety and depression in spinal cord injury (SCI) patients based on patient-environment-occupation (PEO) model, and provide evidences for clinical practice.
Methods
A total of 241 patients with SCI treated between April 2014 and April 2015 were collected as the study subjects. All the patients were confirmed with SCI through CT or MRI, and had physical dysfunction. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied in all the 241 SCI patients to measure their psychological state. Meanwhile, PEO factors such as demographic information as well as ability of activities of daily living (ADL) and relatives’ stress were assessed by self-made questionnaire, Modified Barthel Index (MBI) and Relatives’ Stress Scale (RSS). Then, multiple stepwise regression was applied to identify significant covariance with SAS/SDS as dependent variables and other 14 factors as independent variables.
Results
The regression equation showed that only SDS, MBI, living environment and disease course were significantly associated with SAS. Only SAS, MBI and RSS were significantly associated with SDS.
Conclusions
The ability of ADL and environment are significantly correlated with psychological state of SCI patients. Early intervention of ADL and decreasing environmental barriers are needed to improve patients’ psychological state.
