多塞平對2型糖尿病合并抑郁癥作用的臨床觀察
發(fā)布時間：2018-10-17 13:46
【摘要】：目的探究2型糖尿病和抑郁癥之間的相互關(guān)系以及應(yīng)用抗抑郁癥藥物對其的療效。糖尿病的病人也和許多的其他內(nèi)科疾病一樣,因為各種的原因容易患有抑郁癥,三環(huán)類抗抑郁癥藥物多賽平在改善抑郁癥狀外,也可同時改良糖尿病患者的空腹血糖、餐后2小時血糖、糖化血紅蛋白、血壓和血脂。方法選擇山東省千佛山醫(yī)院自2010年06月至2013年06月符合1999WHO糖尿病診斷標(biāo)準(zhǔn)的2型糖尿病和同時也符合抑郁癥診斷標(biāo)準(zhǔn)的住院患者30例。對其進行隨機分為兩組,其中觀察組16人,男6例,女10例,對照組14人,男6人,女8人,清晨抽取空腹靜脈血,取血漿行空腹血糖(FPG)、甘油三酯(TG)、膽固醇(CH)、糖化血紅蛋白(Hb A1c)檢查,早餐后2 h抽靜脈血行餐后2 h血糖(2h PG)檢查。并由專業(yè)醫(yī)護人員根據(jù)漢密爾頓抑郁量表(24項版本Hamilton Depression Scale HAMD)對其進行問卷調(diào)查,對30例患者進行評定抑郁癥的分度。兩組患者均常規(guī)給予控制糖尿病飲食、糖尿病降糖藥物(胰島素促泌劑、雙胍類、α-葡萄糖苷酶抑制劑及胰島素)及降血壓、降血脂藥物治療半年-2年。觀察組在此治療基礎(chǔ)上加用抗抑郁藥物多賽平25mg每日三次,療程8周。觀察并比較兩組患者治療前后空腹血糖、餐后2小時血糖、糖化血紅蛋白、血壓和血脂的治療效果,并觀察抑郁癥狀的變化。結(jié)果兩組患者治療前FBG、2h PG和Hb A1C比較無明顯統(tǒng)計學(xué)差異(P〉0.05),治療8周后,兩組患者FBG、2h PG和Hb A1C均較治療前明顯下降(P〈0.05或P〈0.01),且觀察組下降幅度較對照組更顯著(P〈0.05)。觀察組抗抑郁療效明顯優(yōu)于對照組(P〈0.05)。結(jié)論2型糖尿病和抑郁癥均與精神心理因素有關(guān),都普遍存在著精神障礙如焦慮和抑郁的情緒,兩者相互影響,互為因果,糖尿病合并抑郁癥的患者,單一用降血糖的藥物對控制血糖不明顯者,如果加用抗抑郁癥的藥物治療效果會明顯增加,并且可以顯著改善心理和軀體兩方面的癥狀。多塞平是一種安全、有效的抗抑郁癥藥物,對于糖尿病合并抑郁癥患者的抑郁情緒以及間接可以降低血壓、血糖及血脂。
[Abstract]:Objective to investigate the relationship between type 2 diabetes mellitus and depression and the efficacy of antidepressants. Patients with diabetes, like many other internal diseases, are prone to depression for a variety of reasons, and the tricyclic antidepressant drug doxepin can also improve fasting blood glucose in diabetics, in addition to improving their depressive symptoms. 2 hours postprandial blood sugar, glycosylated hemoglobin, blood pressure and blood lipids. Methods Thirty inpatients with type 2 diabetes and depression who met the diagnostic criteria of 1999WHO diabetes from June 2010 to June 2013 in Qianfushan Hospital of Shandong Province were selected. The patients were randomly divided into two groups: observation group (n = 16), male (n = 6), female (n = 10), control group (n = 14), male (n = 6), female (n = 8). Fasting blood glucose (FPG), triglyceride (TG), (CH), glycosylated hemoglobin (Hb A1c) were measured in plasma and venous blood samples were taken 2 hours after breakfast for 2 h postprandial blood glucose (2 h PG). According to the Hamilton Depression scale (24 items of Hamilton Depression Scale HAMD), 30 patients were assessed by the medical staff. The patients in both groups were given diabetes control diet, diabetes hypoglycemic drugs (insulin secreting agent, biguanidine, 偽 -glucosidase inhibitor and insulin), hypotension and blood lipids treatment for six months to two years. The treatment group was treated with the antidepressant doxepin 25mg three times a day for 8 weeks. The effects of fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin, blood pressure and blood lipids before and after treatment were observed and compared between the two groups, and the changes of depressive symptoms were observed. Results there was no significant difference in FBG,2h PG and Hb A1C between the two groups before treatment (P > 0. 05). After 8 weeks of treatment, the FBG,2h PG and Hb A1C of the two groups were significantly lower than those before treatment (P < 0. 05 or P < 0. 01), and the decrease of FBG,2h PG and Hb A1C in the observation group was more significant than that in the control group (P < 0. 05). The antidepressant effect of the observation group was significantly better than that of the control group (P < 0.05). Conclusion both type 2 diabetes mellitus and depression are related to psycho psychological factors, and there are common mental disorders such as anxiety and depression. The two affect each other and cause and effect each other. The effects of hypoglycemic drugs alone on the control of blood sugar were significantly increased if antidepressant drugs were added, and the psychological and physical symptoms could be significantly improved. Doxepin is a safe and effective antidepressant for depression in diabetics with depression and indirectly reduces blood pressure, blood sugar and blood lipids.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R587.1;R749.4
本文編號：2276849
[Abstract]:Objective to investigate the relationship between type 2 diabetes mellitus and depression and the efficacy of antidepressants. Patients with diabetes, like many other internal diseases, are prone to depression for a variety of reasons, and the tricyclic antidepressant drug doxepin can also improve fasting blood glucose in diabetics, in addition to improving their depressive symptoms. 2 hours postprandial blood sugar, glycosylated hemoglobin, blood pressure and blood lipids. Methods Thirty inpatients with type 2 diabetes and depression who met the diagnostic criteria of 1999WHO diabetes from June 2010 to June 2013 in Qianfushan Hospital of Shandong Province were selected. The patients were randomly divided into two groups: observation group (n = 16), male (n = 6), female (n = 10), control group (n = 14), male (n = 6), female (n = 8). Fasting blood glucose (FPG), triglyceride (TG), (CH), glycosylated hemoglobin (Hb A1c) were measured in plasma and venous blood samples were taken 2 hours after breakfast for 2 h postprandial blood glucose (2 h PG). According to the Hamilton Depression scale (24 items of Hamilton Depression Scale HAMD), 30 patients were assessed by the medical staff. The patients in both groups were given diabetes control diet, diabetes hypoglycemic drugs (insulin secreting agent, biguanidine, 偽 -glucosidase inhibitor and insulin), hypotension and blood lipids treatment for six months to two years. The treatment group was treated with the antidepressant doxepin 25mg three times a day for 8 weeks. The effects of fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin, blood pressure and blood lipids before and after treatment were observed and compared between the two groups, and the changes of depressive symptoms were observed. Results there was no significant difference in FBG,2h PG and Hb A1C between the two groups before treatment (P > 0. 05). After 8 weeks of treatment, the FBG,2h PG and Hb A1C of the two groups were significantly lower than those before treatment (P < 0. 05 or P < 0. 01), and the decrease of FBG,2h PG and Hb A1C in the observation group was more significant than that in the control group (P < 0. 05). The antidepressant effect of the observation group was significantly better than that of the control group (P < 0.05). Conclusion both type 2 diabetes mellitus and depression are related to psycho psychological factors, and there are common mental disorders such as anxiety and depression. The two affect each other and cause and effect each other. The effects of hypoglycemic drugs alone on the control of blood sugar were significantly increased if antidepressant drugs were added, and the psychological and physical symptoms could be significantly improved. Doxepin is a safe and effective antidepressant for depression in diabetics with depression and indirectly reduces blood pressure, blood sugar and blood lipids.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R587.1;R749.4
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相關(guān)期刊論文 前2條
1 田睿;趙志剛;袁慧娟;汪艷芳;秦貴軍;閆鏞;李清楚;;河南省糖尿病和代謝綜合征流行病學(xué)調(diào)查及相關(guān)因素分析[J];中華實用診斷與治療雜志;2009年11期
2 孫曉敏;黃曉萍;袁翠萍;崔焱;;健康信念和應(yīng)對方式對2型糖尿病患者自我管理行為的影響[J];護理學(xué)報;2012年01期
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