【摘要】：目的:了解高血壓患者伴焦慮、抑郁合并用藥的降壓療效,探討更佳的治療方案。方法:系統(tǒng)檢索Pubmed,CNKI,萬方數(shù)據(jù)庫,中國生物醫(yī)學文獻數(shù)據(jù)庫以及Internet 2008-2017年間發(fā)表的文獻。檢索詞為高血壓,焦慮,抑郁,降壓藥物,抗焦慮藥物,抗抑郁藥物(主題詞與自由詞組合)。采用Jadad法對各研究進行質(zhì)量評價,利用Meta分析文獻中對高血壓病伴發(fā)焦慮、抑郁患者,應用降壓藥聯(lián)合抗焦慮、抗抑郁治療的降壓效果,觀察指標為兩組治療后降壓有效例數(shù),兩組治療后收縮壓及舒張壓變化。效應指標分別采用比值比(Odds Ratio,OR),加權(quán)均數(shù)差(Weighted Mean Difference,WMD)WMD,95%可信區(qū)間(CI)統(tǒng)計合并效應量,計算I2進行異質(zhì)性檢驗,亞組分析,敏感性分析,評估發(fā)表偏倚。結(jié)果:共收集到相關文獻643篇,符合納入標準的研究為28篇,研究總計2388例患者。18項研究納入的患者診斷為高血壓合并混合型焦慮抑郁障礙,9項研究的研究對象為高血壓合并抑郁障礙患者,入選患者診斷為高血壓伴發(fā)焦慮障礙研究只有1個。其中17項研究統(tǒng)計了試驗組與對照組治療后降壓有效例數(shù),總有效例數(shù)合并的OR值為4.41[95%CI3.30～5.89],P0.00001;21項研究對比了兩組患者治療前后的收縮壓及舒張壓,收縮壓合并的加權(quán)均數(shù)差(WMD)為-12.64[95%CI-15.14～-10.14],舒張壓合并的加權(quán)均數(shù)差(WMD)為-8.78[95%CI-11.51～-6.04],P值均小于 0.00001。結(jié)論:降壓藥物聯(lián)合抗焦慮、抗抑郁治療高血壓伴焦慮、抑郁患者的療效總體上明顯高于單獨降壓藥物治療組。
[Abstract]:Objective: to investigate the antihypertensive effect of anxiety and depression in patients with hypertension. Methods: Pubmed,CNKI, Wanfang database, Chinese biomedical literature database and Internet published from 2008 to 2017 were searched systematically. The key words are hypertension, anxiety, depression, antihypertensive drugs, antianxiety drugs and antidepressants (combination of subject words and free words). Jadad method was used to evaluate the quality of each study. The antihypertensive effect of antihypertensive drugs combined with antianxiety and antidepressant treatment was evaluated by Meta analysis literature for patients with hypertension associated with anxiety and depression. The observed indexes were the effective cases of hypotension after treatment in the two groups. Systolic and diastolic blood pressure changes after treatment in both groups. Ratio (Odds Ratio,OR), weighted mean difference (Weighted Mean Difference,WMD), WMD,95% confidence interval (CI) (CI) were used to calculate I2 for heterogeneity test, subgroup analysis and sensitivity analysis. Evaluation of publication bias. Results: a total of 643 articles were collected, 28 of which met the inclusion criteria. A total of 2388 patients were included in the study. The 18 subjects were diagnosed as hypertension with mixed anxiety and depression. Nine studies were conducted in patients with hypertension and depression, and only one patient was selected to be diagnosed as hypertension with anxiety disorder. Among them, 17 studies counted the effective cases of hypotension after treatment in the test group and the control group, the OR value of the total effective cases combined with the total effective cases was 4.41 [95%CI3.30~5.89], P 0.00001; 21 studies compared systolic and diastolic blood pressure before and after treatment. The weighted mean difference (WMD) of systolic blood pressure combined with systolic blood pressure was -12.64 [95%CI-15.14~-10.14]. The weighted mean difference (WMD) of the combined diastolic blood pressure was -8.78 [95%CI-11.51~-6.04], P < 0.00001. Conclusion: the efficacy of antihypertensive drugs combined with antianxiety and antidepressant therapy in patients with hypertension and anxiety is significantly higher than that in patients treated with antihypertensive drugs alone.
【學位授予單位】：北京協(xié)和醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R544.1;R749

【參考文獻】

相關期刊論文 前10條

1 陳永新;朱利芳;宋昊;李煥芬;黃素培;張瑞嶺;;米氮平聯(lián)合氨氯地平治療老年高血壓伴焦慮抑郁的療效觀察[J];現(xiàn)代藥物與臨床;2016年09期

2 賴小航;楊沛華;;黛力新對高血壓合并抑郁患者降壓療效及生活質(zhì)量的影響探討[J];當代醫(yī)學;2016年18期

3 盧轉(zhuǎn)娣;王要有;王迪;;抗抑郁治療對高血壓合并抑郁患者的血壓影響的臨床觀察[J];安徽醫(yī)藥;2016年04期

4 徐天兵;;氟哌噻噸美利曲辛聯(lián)合卡托普利治療高血壓合并抑郁焦慮療效觀察[J];當代醫(yī)學;2016年12期

5 劉曉崢;陳勤;;西酞普蘭聯(lián)合降壓藥治療原發(fā)性高血壓伴焦慮抑郁患者療效觀察[J];現(xiàn)代醫(yī)藥衛(wèi)生;2016年06期

6 李海聰;李求兵;楊毅玲;朱赫;王燕;田心;陳曉光;李淵;楊學青;;抗抑郁治療對老年高血壓合并抑郁障礙患者血壓的影響[J];中華老年心腦血管病雜志;2016年02期

7 侯敏;程新耀;王漢橋;徐炎;黃菲菲;;氟西汀聯(lián)合倍博特治療老年原發(fā)性高血壓伴抑郁癥臨床研究[J];中國實用神經(jīng)疾病雜志;2015年23期

8 陳雪端;;抗焦慮抑郁治療對高血壓合并焦慮抑郁者降壓效果的影響分析[J];數(shù)理醫(yī)藥學雜志;2015年04期

9 潘德玲;胡英;文曉波;慕容敏;張琪;;心理干預聯(lián)合氟哌噻噸美利曲辛片對老年高血壓伴焦慮抑郁患者血壓的影響[J];現(xiàn)代生物醫(yī)學進展;2015年09期

10 郭雷生;胡光玲;周湘鴻;黃莉莉;王留義;崔天祥;;抗焦慮治療高血壓并焦慮患者的療效分析[J];中國實用神經(jīng)疾病雜志;2014年16期

，

本文編號：2367046