范辉 李超 何秀丽 王晓峰

摘要：目的探讨芪红解郁方治疗慢性心力衰竭（CHF）合并抑郁症患者的临床疗效。方法将120例慢性心力衰竭合并抑郁症患者采用随机数字法分为对照组和观察组，各60例。观察组给予芪红解郁方加减，对照组服用帕罗西汀片加减，治疗期间均给予患者心理辅导干预8周，其后每2个月进行一次随访，共随访3次。结果观察组Lee氏心衰疗效总有效率为86.67%，优于对照组的71.67%（P<0.05）;观察组抑郁症疗效总有效率88.33%，对照组为81.67%，组间比较差异无统计学意义（P>0.05）;治疗后观察组Lee氏心衰评分、汉密尔顿抑郁量表（HAMD）评分均低于对照组（P<0.01）;观察组左室射血分数（LVEF）和心搏出量（CO）高于对照组（P<0.01）;观察组N端脑钠肽前体（NTproBNP）水平低于对照组（P<0.01）;对照组不良反应发生率高达58.3%，观察组未发现明显不良反应。结论芪红解郁方对CHF合并抑郁症患者能够改善临床症状及心功能，改善患者实际生活能力并能促进心理康复的过程。

关键词：慢性心力衰竭;芪红解郁方;抑郁;心功能

中图分类号：R541R289文献标识码：A

doi：10.3969/j.issn.16721349.2015.01.006

文章编号：16721349（2015）01001403

Effect of Qihong Jieyu Decoction for Treatment of Chronic Heart Failure Complicated with Depression

Fan Hui，Li Chao，He Xiuli，Wang Xiaofeng

The Hospital of Traditional Chinese Medicine，Xinjiang Medical University， Urumqi 830000，Xinjiang，China

Corresponding Author：Wang Xiaofeng

Abstract：ObjectiveTo evaluate the clinical efficiency of Qihong Jieyu decoction （QJD） for treatment of chronic heart failure complicated with depression（CHFD）.MethodsOne hundred and twenty patients with CHFD were randomized by digital table into two groups：The control group （n=60） treated by paroxetine and the observation group（n=60） treated with QJD for 8 weeks.

Results The total efficiency of Lees heart failure was 86.67% in observation group，which was higher than that in control group（71.67%，P<0.05）.The total efficiency of depression was 88.33% in observation group and 81.67% in control group（71.67%，P<0.05）.There was no significant difference between the two groups（P>0.05）.After treatment，Lees failure score and HAMD score in observation group were lower than that in control group （P<0.01）.The left ventricular end diastolic diameter（LVED）and cardiac output（CO）in observation group were better than that in control group（P<0.01）.The levels of Nterminal proBtype natriuretic peptide （NTproBNP） in observation group was lower than that in control group （P<0.01）.The adverse reaction rate was 58.3% in control group.There was no obvious adverse reaction in observation group.ConclusionQJD  could improve the relative symptoms and heart function in patients with CHFD，enhance their quality of life and actual living ability and promote the psychological rehabilitation.

Key words：chronic heart failure;Qihong Jieyu decoction;depression;heart funcfion

抑郁作為慢性心力衰竭（CHF）的常见合并症，对CHF的预后存在不良影响，明显增加住院率和病死率，严重影响患者生活质量。抑郁情绪为CHF预后不良的独立危险因素之一[1]，二者相互影响，越来越受到学者的关注。因此心血管医生应高度重视患者的心理状况，及时识别和处理心血管病的精神问题，对CHF伴抑郁患者应采取心身相结合的治疗原则[2]。我院在长期临床实践中结合新疆地域、饮食等特点，认为气虚血瘀证是新疆地区心力衰竭合并抑郁症的主要证型，以益气活血，解郁安神为主要治则，应用中药芪红解郁方加减治疗慢性心力衰竭合并抑郁症患者，旨在评估其临床疗效。

1资料与方法

1.1临床资料本组120例患者均来源于新疆医科大学附属中医医院2012年1月—2013年6月心内科住院部。随机按数字法分为对照组和观察组，各60例。……