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《广州医药》编辑部
目的 分析舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁患者的效果。方法 选择2023年1月—2025年1月平顶山市第一人民医院收治的86例冠心病介入术后患者,随机分为对照组(43例)、舒肝解郁胶囊组(43例),均进行常规治疗及体外反搏治疗,舒肝解郁胶囊组加用舒肝解郁胶囊,测量并比较两组患者治疗前后心肺功能,评估患者焦虑和抑郁情绪、临床疗效及生活质量。结果 治疗后舒肝解郁胶囊组左心室射血分数(LVEF)和最大摄氧量(VO2max)均显著高于对照组(P<0.05);治疗后舒肝解郁胶囊组汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分均低于对照组(P<0.05);舒肝解郁胶囊组总有效率高于对照组(P<0.05);治疗后舒肝解郁胶囊组生活质量综合评定问卷(GQOLI-74)各维度评分均显著高于对照组(P<0.05)。结论 舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁效果显著,可减轻患者负面情绪,改善其心肺功能及生活质量。
Objective To analyze the effect of Shugan Jieyu Capsule combined with external counterpulsation in the treatment of anxiety and depression in patients with coronary artery disease after percutaneous coronary intervention(PCI).Methods From January 2023 to January 2025,86 patients with coronary heart disease who had undergone PCI in our hospital were enrolled and randomly divided into a control group(43 cases) and a Shugan Jieyu Capsule group(43 cases).All patients received conventional treatment and external counterpulsation.The Shugan Jieyu Capsule group was given Shugan Jieyu Capsule in addition.Cardiopulmonary function was measured and compared before and after treatment between the two groups,and anxiety and depression,clinical efficacy,and quality of life were evaluated.Results After treatment,the left ventricular ejection fraction(LVEF) and maximum oxygen uptake(VO2max) in the Shugan Jieyu Capsule group were significantly higher than those in the control group(P<0.05).The Hamilton Anxiety Rating Scale(HAMA) and Hamilton Depression Rating Scale(HAMD) scores in the Shugan Jieyu Capsule group were significantly lower than those in the control group(P<0.05).The total effective rate in the Shugan Jieyu Capsule group was significantly higher than that in the control group(P<0.05).After treatment,the scores on all dimensions of the General Quality of Life Assessment Questionnaire-74(GQOLI-74) in the Shugan Jieyu Capsule group were significantly higher than those in the control group(P<0.05).Conclusions Shugan Jieyu Capsule combined with external counterpulsation is effective in treating anxiety and depression after PCI,alleviating negative emotions and improving cardiopulmonary function and quality of life.
目的 探讨全身麻醉(全麻)髋关节置换术后苏醒期患者家属迁移应激水平及其相关影响因素。方法 选取2021年4月—2022年10月在南昌市洪都中医院行全麻髋关节置换术苏醒期的108例患者,使用ICU转出患者家属应激压力评估量表评价患者家属迁移应激水平,调查患者及家属相关资料,分析全麻髋关节置换术后苏醒期患者家属迁移应激水平的相关影响因素。结果 108例全麻髋关节置换术后苏醒期患者家属迁移应激得分为(56.35±5.86)分,家属迁移应激水平中等;经多元线性回归分析显示,患者麻醉重症监护室(AICU)住院时间≥24 h、女性、文化水平初中及以下、消极应对是全麻髋关节置换术后苏醒期患者家属迁移应激水平升高的危险因素(P<0.05)。结论 全麻髋关节置换术后苏醒期患者家属迁移应激水平中等,受患者AICU住院时间、家属性别、文化水平、应对方式因素影响。
Objective To analyze the levels of relocation anxiety and its related influencing factors in the family members of patients during the recovery period after hip arthroplasty under general anesthesia.Methods From April 2021 to October 2022,108 patients in Nanchang Hongdu Traditional Chinese Medicine Hospital undergoing total hip arthroplasty under general anesthesia were selected.The levels of relocation anxiety in their families were evaluated using the ICU transferred out patient family stress assessment scale,and the relevant data of the patients and their families were investigated.The relevant factors affecting the levels of relocation anxiety in their families during the recovery period after total hip arthroplasty under general anesthesia were analyzed.Results The relocation anxiety score of 108 patients’ family members during the recovery period after hip arthroplasty under general anesthesia was(56.35±5.86),with a moderate level.Multiple linear regression analysis showed that patients’ AICU hospitalization time≥24 hours,women,education level of junior high school or below and negative coping were the influencing factors for the level of relocation anxiety of family members of patients during the recovery period after hip replacement under general anesthesia(P<0.05).Conclusions The level of relocation anxiety in family members of patients undergoing general anesthesia and hip arthroplasty during the recovery period is moderate,which is influenced by factors such as length of patients’ stay in AICU,family members’ gender,educational level and coping styles.
目的 分析音乐治疗焦虑领域研究热点的演变与趋势。方法 利用文献计量学方法对近20年(2003——2023)发表音乐治疗焦虑方面的研究与文献进行了可视化分析:对中国知网(CNKI)及Web of Science(WOS)文献库中收录的文献进行关键词(中文关键词:音乐治疗、焦虑;英文关键词:Music therapy、Anxiety)检索,利用CiteSpace 6.3 R2软件绘制知识图谱进行可视化分析。结果 通过文献的检索与筛选最终纳入中文文献506篇及英文文献1 782篇,其中国内外主要发文者为刘月芳、刘春艳、Bradt、Cold、Silverman等研究者团队,国内外主要研究机构均为高校,但国内高校相对于国外相关研究开展较为独立且合作联系较少;发文国家主要为美国、中国以及土耳其,西方国家之间的合作联系较为密切,我国开展相关跨地域研究主要是与亚洲国家进行多中心合作。国内研究热点为“音乐疗法”“心理干预”“五行音乐”等,国外研究热点为“Pain”“Depression”“Quality of life”等。结论 本文通过CiteSpace软件进行文献计量学分析发现,音乐治疗与焦虑结合是国内外研究的热点,国内研究聚焦于焦虑,而国外研究更关注音乐治疗在广泛心理问题中的应用。尽管该研究领域发展迅速,但国内外合作交流较少,国际研究团队间合作不够紧密。未来研究需进一步探索音乐治疗的机制和最佳实践方法,加强跨学科合作,利用科技创新,结合中国文化特色,以期实现音乐治疗在焦虑治疗中的更广泛应用,并提升患者的生活质量。同时,未来相关研究方法需多样化,以全面掌握研究趋势,为音乐治疗焦虑提供更有力的证据支持。
Objective To explore the evolution and trends of research hotspots in the field of music therapy for anxiety and provide reference and basis for related research.Methods Bibliometric analysis method was used to visualize and analyze the research and literature on music therapy for anxiety in the past 20 years(2003-2023).Keyword searches were conducted in Chinese National Knowledge Infrastructure(CNKI)and Web of Science(WOS)databases,and a knowledge map was drawn using CiteSpace 6.3 R2 software for visualization analysis.Results Through the literature search and screening,506 Chinese and 1782 English literatures were included,and the main authors at home and abroad were researcher teams such as Liu Yuefang,Liu Chunyan,Bradt,Cold and Silverman.The main research institutions at home and abroad were universities,but domestic universities were more independent and had fewer collaborative relationships than foreign ones.The main publishing countries were the United States,China and Turkey,and there was closer cooperation between western countries.Multicenter cooperation with Asian countries was the main form of cross-region research in China.The research hotspots at home were “music therapy”,“psychological intervention”,“five elements music”,while the foreign research hotspots were “pain”,“depression”,and “quality of life”.Conclusions The combination of “music therapy” and “anxiety” is the main research hotspot at home and abroad in recent years.Among them,foreign scholars mainly use anxiety and other psychological problems as research topics to explore the application of music therapy to these issues,while domestic scholars focus on the research of anxiety and propose many music therapy programs for anxiety.In addition,there is relatively little cooperation and communication between domestic and foreign research sectors,and the degree of coincidence among international research teams is not high.Therefore,research teams at home and abroad should strengthen cooperation and communication.Based on the analysis of research hotspots in music therapy for anxiety in the past 20 years,this field has received considerable attention and has developed rapidly,but there are still many aspects that need to be explored and improved through continuous efforts and innovation.
目的 探讨中医妇科门诊患者的焦虑及抑郁的发生情况,优化诊治工作,更好地服务患者。方法 采用焦虑自评量表(SAS)和 抑郁自评量表(SDS)评定190名中医妇科门诊患者的心理状态。结果 中医妇科患者焦虑均分高于正常常模组(P<0.05),抑郁评分与全国常模相比则无统计学差异(P>0.05),有焦虑及抑郁症状的患者分别为6.3%及10%。结论 中医妇科门诊患者的焦虑症状较正常人群高,医生在临床诊治过程应重视对患者心理状态的评价,并进行相应的心理干预及人文关怀, 以提高患者对治疗的依从性和满意度,为其身体及心理健康打下良好基础。
Objective To explore the occurrences of anxiety and depression in female TCM gynecology outpatients, and thus to make improvements in diagnosis, treatment, and service for the patients. Methods We adopted Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) to evaluate the mental status of 190 TCM gynecology outpatients. Results Anxiety scores in TCM gynecology group were higher than those in the normal group (P<0.05), while there was no statistical difference in depression scores between these two groups (P>0.05). Among the outpatients, 6.3% had symptoms of anxiety, and 10% had symptoms of depression. Conclusion TCM gynecology outpatients show more anxiety symptoms than normal people. We should pay attention to the assessment of those patients' mental status in the process of diagnosis and treatment, and offer psychological intervention and humane care to those patients accordingly. In this way, we could enhance patients' compliance and satisfaction, and help them build a solid foundation in physical health as well as in mental health.
目的 探讨焦虑障碍与冠心病经皮冠状动脉介入治疗(PCI)患者术后发生对比剂肾病(CIN)的相关性及机制,为早期发现CIN高危人群及其预防提供理论依据。方法 入选2014年6月—2016年12月于天津市第四中心医院心内科住院确诊冠心病并接受PCI患者,进行综合医院焦虑/抑郁情绪测定表(HAD)及汉密尔顿焦虑量表(HAMA)评价,依据量表的评分标准,最终纳入研究共120例,其中焦虑障碍组60例,非焦虑障碍组60例。观察2组患者PCI术前及术后72 h肌酐(SCr)、肌酐清除率(Ccr)、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)、C反应蛋白(CRP)、白细胞介素-18(IL-18)的变化情况,并记录CIN的发生率。结果 2组患者PCI术前Scr、Ccr水平差异无统计学意义(P>0.05);2组患者PCI术后Scr水平均较术前升高,Ccr水平较术前降低(P<0.01)。PCI术后,焦虑障碍组Scr水平高于非焦虑障碍组,Ccr水平低于非焦虑障碍组(P<0.05)。2组患者PCI术前sICAM-1、CRP、IL-18、TNF-α差异无统计学意义(P>0.05);2组患者PCI术后sICAM-1、CRP、IL-18、TNF-α水平较术前均升高(P<0.01);PCI术后焦虑障碍组sICAM-1、CRP、IL-18、TNF-α水平高于非焦虑障碍组,差异有统计学意义(P<0.05)。PCI术前,焦虑障碍组HAD、HAMA评分高于非焦虑障碍组,差异有统计学意义(P<0.01);非焦虑障碍组患者PCI术后较术前HAD、HAMA评分差异无统计学意义(P>0.05);焦虑障碍组PCI术后HAD、HAMA评分高于术前,差异有统计学意义(P<0.01);PCI术后,焦虑障碍组HAD、HAMA评分高于非焦虑障碍组,差异有统计学意义(P<0.01)。结论 焦虑障碍可能是冠心病患者PCI术后发生对比剂肾病的危险因素之一。
目的 了解广州综合医院内分泌科门诊就诊者中抑郁焦虑障碍的患病率。方法 对广州市第一人民医院的内分泌科门诊就诊的患者进行横断面调查。采用医院焦虑抑郁量表(HADS)对105名入选的患者进行筛查,精神科医生对HADS≥8 分的患者进行国际神经精神科简式访谈问卷( MINI ) 的诊断性评估。结果 MINI诊断的抑郁障碍、焦虑障碍、抑郁和焦虑共病的患病率分别为3.80%、0.95%和2.86%。结论 抑郁和焦虑障碍是综合医院内分泌科门诊就诊者中的常见问题,但识别率和治疗率均不高。
Objective To investigate the prevalence rates of depressive and anxiety disorders of the endocrinology outpatients in a general hospital of Guangzhou. Methods A cross-sectional survey was conducted in the endocrinology outpatient department of Guangzhou First People's Hospital. A total of 105 outpatients were screened with hospital anxiety and depression scale(HADS). The patients with the HADS score of 8 and over were investigated and diagnosed by psychiatrists with the mini-international neuropsychiatric interview(MINI). Results The prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, and depressive-anxiety co-morbid disorders were 3.80%, 0.95% and 2.86%, respectively. Conclusion Depression and anxiety disorders are common problems in the endocrinology outpatient department of general hospitals,but few outpatients were well-diagnosed and treated.
目的 探讨脉管炎围手术期出现焦虑症状及影响因素和护理以提高在围手术期的生活质量。方法 通过对脉管炎患者进行问卷调查焦虑发生及影响因素。结果 脉管炎围手术期患者出现焦虑是十分常见的,生活质量下降直接或间接影响手术的成功率。结论 有效的护理干预能改善各方面的焦虑因素,使患者在围手术期保持心情舒畅,从而适应截肢形象的改变,提高生活质量。
目的 对兰索拉唑肠溶片联合氟哌噻吨美利曲辛治疗焦虑糜烂性胃炎患者的治疗效果进行研究。方法 选取2013年1月—2015年1月在我院收治的伴有焦虑情绪的糜烂性胃炎患者106例。随机分为对照组,给予兰索拉唑肠溶片治疗,观察组,给予兰索拉唑肠溶片联合氟哌噻吨美利曲辛治疗,并且对疗效进行比较。结果 治疗前,两组患者在腹痛、腹胀、反酸、嗳气以及黏膜糜烂各指标评分比较,差异无统计学意义(P>0.05);治疗后,2组患者以上指标均有所改善,并且观察组患者同期指标改善均优于对照组(P<0.05);治疗前,两组患者胃黏膜中PGE2和MDA含量无差异(P>0.05);治疗后,两组患者的PGE2均上升,而MDA则下降,并且观察组患者PGE2含量比对照组高,MDA则比对照组低,差异均有统计学意义(P<0.05);治疗前,两组患者HAMA、HAMD评分差异不明显,无统计学意义(P>0.05);治疗后,两组患者焦虑情况均有所改善,并且观察组患者情绪改善程度优于对照组患者,差异均有统计学意义(P<0.05);观察组不良反应发生率为5.6%,对照组不良反应发生率5.6%,差异无统计学意义,P>0.05。结论 兰索拉唑与氟哌噻吨美利曲辛联合应用有助于改善糜烂性胃炎患者的病情,并且可以缓解患者的焦虑情绪,安全性高,值得临床推广。
Objective To observe the clinical efficacy of lansoprazole enteric-coated tablets combined with flupentixol-melitracen in treating anxiety patients with erosive gastritis. Methods 106 patients with erosive gastritis and anxiety in our hospital from January 2013 to January 2015 were divided into an observation group and a control group, with 53 patients in each group. The control group was given lansoprazole enteric-coated tablets alone, and the observation group was treated with lansoprazole enteric-coated tablets and flupentixol-melitracen. Clinical symptoms and mucosal erosion were compared between the two groups of patients before and after treatment. Gastric mucosa malondialdehyde (MDA) and prostration E2 (PGE2) contents, anxiety and depression status were also assessed. Results After treatment, the scores of abdominal pain, bloating, acid reflux, belching, and mucosal erosions were significantly lower in the observation group than in the control group (P< 0.05). PGE2and MDA contents in the gastric mucosa in the observation group were different from those in the control group(P< 0.05). HAMA and HAMD scores were lower in the observation group than in the control group (P< 0.05). There was no difference of adverse reaction rate between the control group and the observation group (P>0.05). Conclusion Lansoprazole enteric-coated tablets combined with flupentixol-melitracen has better clinical efficacy than lansoprazole enteric-coated tablets only in patients with erosive gastritis and anxiety in terms of the improvement of clinical symptoms and mucosal erosion and the relief of negative emotions.
焦虑症是最常见的精神障碍,区别于生理性焦虑,患者常表现出持续的焦虑状态。越来越多证据表明,抑制性神经元参与生理性焦虑的产生和消退,而这类神经元功能异常与焦虑症的发生密切相关。小清蛋白(PV)神经元是一类主要的抑制性中间神经元,广泛分布于大脑皮质和其他脑区,并且具有独特形态和功能。PV神经元可通过快速放电活动精确控制局部微环路和大脑网络活动,进而调控焦虑发生。文章综述PV神经元如何介导生理性焦虑及其功能异常及如何导致焦虑症的产生,重点介绍了PV神经元的解剖和功能特性,这些特性使它们拥有快速和强力的抑制作用,能够快速调控神经网络活动,和PV神经元以及相关的神经环路调控焦虑发生的环路机制,以及PV神经元调控焦虑发生的分子机制,并展望未来的研究方向,以期为开发新的焦虑症干预策略提供科学依据。
Anxiety disorders,distinct from physiological anxiety,are characterized by a chronic and pervasive state of heightened anxiety and represent the most common mental diseases.Emerging evidence implicates inhibitory neurons in both the generation and extinction of physiological anxiety,with dysfunction in these neurons strongly associated with the pathogenesis of anxiety disorders.Among inhibitory neurons,parvalbumin(PV)-positive interneuron,a key subset with unique morphological and functional characteristics,are widely distributed across the cerebral cortex and various brain regions.These neurons exert rapid,potent inhibitory control over local microcircuits and broader neural networks through their fast-spiking activity,making them integral to the regulation of anxiety-related behaviors.This review highlights three key aspects:the anatomical and functional properties of PV neurons;their role in circuit mechanisms;the molecular pathways by which PV neurons regulate anxiety.By elucidating the role of PV neurons in modulating physiological anxiety and highlighting their dysfunction in anxiety disorders,this review aims to inform future research and foster the development of novel therapeutic interventions for anxiety disorders.