何逸　肖南海

[摘要]目的 探讨耳穴压豆联合氟哌噻吨美利曲辛片治疗老年高血压合并轻中度抑郁患者的临床效果。方法 选取2016年1～6月在我院住院的70例老年高血压合并轻中度抑郁患者，随机分为观察组和对照组，各35例。对照组采用常规降压+氟哌噻吨美利曲辛片治疗，观察组在对照组的基础上加用耳穴压豆（取穴心、肾、神门、交感）。治疗结束后，观察两组血压、心率及抑郁自评量表（SDS）评分的变化。结果 两组治疗后的收缩压、舒张压和心率均低于治疗前，差异有统计学意义（P<0.05）。观察组治疗后的收缩压、舒张压和心率低于对照组治疗后，差异有统计学意义（P<0.05）。两组治疗后的SDS评分低于治疗前，差异有统计学意义（P<0.05）。观察组治疗后的SDS评分显著低于对照组治疗后，差异有统计学意义（P<0.01）。结论 耳穴压豆联合氟哌噻吨美利曲辛能改善老年高血压合并轻中度抑郁患者的抑郁情况，同时明显提高降压效果。

[关键词]耳穴压豆；氟哌噻吨美利曲辛；老年高血压；轻中度抑郁

[中图分类号] R544.1 [文献标识码] A [文章编号] 1674-4721（2017）07（b）-0151-03

[Abstract]Objective To investigate the clinical efficacy of ear buried seeds combined with Flupentixol/Melitracen in the treatment of elderly hypertensive patients with mild to moderate depression.Methods 70 elderly hypertensive patients with mild to moderate depression from January to June in 2016 in our hospital were selected and randomly divided into the observation group and the control group，35 cases in each group.The control group was treated with conventional antihypertensive plus Flupentixol/Melitracen Tablets，while the observation group was treated with ear buried seeds （acupoints：Xin，Shen，Shenmen，Jiaogan ） on the basis of the control group.After the treatment，the changes of blood pressure，heart rate and self-rating depression scale （SDS） score were observed in the two groups.Results The systolic blood pressure，diastolic blood pressure and heart rate in the two groups after treatment was lower than that before treatment，with significant difference （P<0.05）.The systolic blood pressure，diastolic blood pressure and heart rate after treatment in the observation group was lower than that in the control group after treatment，with significant difference （P<0.05）.The SDS scores in the two groups after treatment was lower than that before treatment，with significant difference （P<0.05）.The SDS scores after treatment in the observation group was lower than that in the control group after treatment，with significant difference （P<0.01）.Conclusion Ear buried seeds combined with Flupentixol/Melitracen can improve depression condition of elderly hypertensive patients with mild to moderate depression，meanwhile，significantly improve the antihypertensive effect.

[Key words]Ear buried seeds；Flupentixol/Melitracen；Elderly hypertension；Mild to moderate depression

隨著社会经济的发展、生产和生活水平的提高、人口平均年龄的增加以及饮食结构的改变，高血压病的发病率和患病率逐年上升，控制高血压从而减轻心、脑血管疾病的危害已成为一项重大的公共卫生问题。近年来，心理社会因素与高血压病的关系越来越受到重视。心理社会因素在高血压的发生、发展和转归过程中起重要作用。焦虑、抑郁等情绪障碍是高血压发生、发展的一个独立危险因素，抑郁情绪不仅影响降压药物的疗效，还影响高血压患者的转归、预后和生活质量[1]。目前，临床上对于高血压病合并抑郁的患者，在常规降压的同时给予抗抑郁药物，但部分患者效果欠佳，尤其是老年高血压病合并抑郁的患者。如何有效地治疗高血压合并抑郁的患者是一个临床需要重点关注的问题。……