张石磊;王栋;权伟;
ZHANG Shilei;WANG Dong;QUAN Wei;Mental Health Education and Consultation Center,Charg'an University;Drug and Equipment Section,The 15th Hospital of PLA;Mental Health Center of Xi'an City;

• 1:长安大学心理健康教育与咨询中心
• 2:中国人民解放军第十五医院药械科
• 3:西安市精神卫生中心

摘要(Abstract)：

目的:探讨心理干预对高血压患者治疗效果的影响。方法:将不同程度抑郁状态的70例高血压患者随机分为对照组和干预组,两组均接受常规药物治疗,干预组在药物治疗的基础上进行5周综合心理干预;比较两组患者汉密尔顿抑郁量表(HAMD)评分和生活满意度量表(SWLS)评分,并测定治疗前后的血压,分析心理干预对高血压患者抑郁情绪、生活满意度以及血压的影响。结果:治疗5周后,干预组HAMD评分由(24.14±8.08)分下降至(12.91±4.27)分,与对照组比较,差异有统计学意义(P<0.01);干预组SWLS评分由(15.88±4.27)分提高到(26.15±2.95)分,与对照组比较,差异有统计学意义(P<0.01);治疗后干预组平均收缩压及舒张压分别下降(21.08±14.38)mm Hg和(12.88±8.77)mm Hg,对照组平均收缩压及舒张压分别下降(2.42±8.92)mm Hg和(2.31±8.17)mm Hg,干预组下降幅度明显大于对照组(P<0.01)。结论:药物结合心理干预治疗能有效缓解高血压患者的抑郁情绪,可有效控制血压,提高患者生活满意度。
Objective: To explore the effects of antihypertensive drugs combined with psychological intervention on the blood pressure,depressive emotion and life satisfaction in hypertension patients.Methods: Among 235 patients with essential hypertension,70 depressed patients were selected by Hamilton Depression Scale( HAMD) and The Satisfaction with Life Scale( SWLS),and randomly divided into psychological intervention group( n = 34,receivng routine treatment and comprehensive psychotherapy for five weeks) and control group( n = 36,routine treatment alone). The blood pressure,depressive emotion and life satisfaction were compared between intervention group and control group.Results: In five weeks after treatment,the depression symptoms and the level of satisfaction were significantly improved in psychological intervention group. The HAMD score dropped from 24. 14 ± 8. 08 to 12. 91 ± 4. 27 while the score in control group was 22. 55 ± 8. 51( P < 0. 01); The SWLS score rose to 26. 15 ± 2. 95 from 15. 88 ± 4. 27 while the score in control group was 17. 52 ± 3. 95( P < 0. 01).The mean systolic blood pressure( SBP) and diastolic blood pressure( DBP) decreased by( 21. 08 ±14. 38) and( 12. 88 ± 8. 77) mm Hg in psychological intervention group,while in control group the SBP and DBP were decreased by( 2. 42 ± 8. 92) and( 2. 31 ± 8. 17) mm Hg respectively. Conclusion: Comprehensive psychotherapy combined with antihypertensive drugs can effectively control the blood pressure,alleviate depressive emotion and improve life satisfaction in hypertensive patients.

关键词(KeyWords)： 心理疗法;干预性研究;高血压;抑郁;生活满意度
psychotherapy;intervention studies;hypertensive disease;depression;life satisfaction

Abstract:

Keywords:

基金项目(Foundation): 2014年长安大学辅导员工作研究课题;; 2014年中央高校基本科研业务费专项

作者(Authors): 张石磊;王栋;权伟;
ZHANG Shilei;WANG Dong;QUAN Wei;Mental Health Education and Consultation Center,Charg'an University;Drug and Equipment Section,The 15th Hospital of PLA;Mental Health Center of Xi'an City;

DOI: 10.19367/j.cnki.1000-2707.2015.03.026

参考文献(References)：

• [1]中国高血压防治指南起草委员会.中国高血压防治指南[J].高血压杂志,2000(1):94-102.
• [2]张红,赵庆华.原发性高血压患者焦虑抑郁情绪及其应对方式的相关性研究[J].重庆医科大学学报,2007(7):749-750.
• [3]Scalco AZ,Scalco MZ,Azul JB,et al.Hypertension and depression[J].Clinics,2005(3):241-250.
• [4]丁品,邴洁.心理治疗对64例老年高血压病人康复的影响[J].心血管康复医学杂志,1999(2):16-18.
• [5]段书,赵水平,朱熊兆.心理干预降低原发性高血压患者降压药物剂量的临床研究[J].中国临床心理学杂志,2005(1):100
• [6]张志锐,陈学诗,王金岩,等.原发性高血压综合心理治疗的远期疗效观察[J].中华精神科杂志,1996(3):170-173.
• [7]汤毓华,张明园.汉密顿抑郁量表(HAMD)[J].上海精神医学,1984(2):61-64.
• [8]Diener ED,Emmons RA,Larsen RJ,et al.The satisfaction with life scale[J].Journal of personality assessment,1985(1):71-75.
• [9]曾祥龙,刘翔平,于是.接纳与承诺疗法的理论背景,实证研究与未来发展[J].心理科学进展,2011(7):1020-1026.
• [10]黄薛冰,张亚林.认知疗法新进展[J].国外医学:精神病学分册,2000(2):116-118.
• [11]张婍,王淑娟,祝卓宏.接纳与承诺疗法的心理病理模型和治疗模式[J].中国心理卫生杂志,2012(5):377-381.
• [12]Routledge F,Mc Fetridge-Durdle J.Nondipping blood pressure patterns among individuals with essential hypertension:a review of the literature[J].European Journal of Cardiovascular Nursing,2007(1):9-26.
• [13]王东升,邱建国,周晋源.心理治疗和改善睡眠降低血压变异性的临床研究[J].山西医科大学学报,2012(4):279-281.
• [14]Hayes SC,Luoma JB,Bond FW,et al.Acceptance and commitment therapy:model,processes,and outcomes[J].Behaviour Research and Therapy,2006(44):1-25.
• [15]骆桂秀,马梁红,唐柳云.原发性高血压心理社会因素调查分析[J].右江民族医学院学报,2005(3):306-307.
• [16]梁婉仪,林伟春,洪建康,等.药物联合综合性心理干预治疗高血压对照研究[J].临床心身疾病杂志,2008(1):33-34.
• [17]段书,肖晶,赵水平,等.心理干预及抗抑郁药物治疗对高血压病伴抑郁情绪的患者血压和生活质量的影响[J].中南大学学报:医学版,2009(4):313-317.

文章评论(Comment)：