翟晶 王凤荣

摘要 冠心病PCI术后伴焦虑抑郁状态患者逐年增多，严重影响患者预后及生命质量，因此，我们需要将心理干预与心血管疾病的防治置于同等地位。对此，系统收集和整理冠心病PCI术后伴心理问题的相关文献，共计28篇文献，有完整处方名称25首，没有处方名称自拟方3首，涉及中藥15类79种中药，治疗患者2 099例。使用频率较多的中药种类：补虚药、理气药、安神药、活血化瘀药、清热药。28篇文献中应用随机对照试验文献26篇，心理因素评估最常用的方式为汉密尔顿焦虑量表及汉密尔顿抑郁量表。

关键词 双心医学;冠心病;PCI术后;焦虑;抑郁;中药;量表;药物分析

Abstract The number of patients with anxiety and depression after postoperative PCI is increasing，which seriously affects the prognosis and quality of life of patients.Therefore，we need to put psychological intervention and prevention and treatment of cardiovascular diseases in the same position.To this end，we systematically collected and collated the relevant literature on psychological problems after postoperative PCI for coronary heart disease.A total of 28 papers were collected，including 25 complete prescriptions，3 self-made prescriptions without names，involving 15 types of Chinese medicines，a total of 79 kinds of Chinese medicines，totaling 2099 patients.The types of Chinese medicines used frequently are：medicines of tonifying deficiency，medicines of regulating qi，medicines of tranquilizing mind，medicines of activating blood circulation and removing blood stasis，and medicines of clearing away heat.Among them A total of 26 randomized controlled trials were collected.Hamilton Anxiety Scale and Hamilton Depression Scale were the most commonly used methods for assessing psychological factors.

Keywords Psycho-cardiology; Coronary heart disease; Postoperative PCI; Anxiety; Depression; Traditional Chinese medicine; Scale; Drug analysis

随着“双心医学”即生物-心理-社会医学模式的形成，双心医学诊疗模式逐渐受到关注。双心医学指心血管疾病合并心理障碍，是探究和处理与心血管疾病相关的情绪、社会环境及行为问题的科学[1]。冠状动脉粥样硬化性心脏病（简称冠心病）是心血管病最常见疾病之一，威胁着人类的身心健康。经皮冠状动脉介入治疗（Percutaneous Coronary Intervention，PCI）是指经心导管技术疏通狭窄，甚至闭塞的冠动管腔，从而改善心肌的血流灌注的治疗方法。近年来，该项技术越来越成熟且安全有效，越来越多的冠心病患者接受并选用此项技术进行治疗，是目前治疗冠心病的主要方法之一，尤其急性心肌梗死的治疗取得了突破性进展。但由于支架造成的经济问题、术后长期服药、担心手术并发症等原因，这些负面情绪使交感神经系统亢进，体内儿茶酚胺浓度升高，极大地影响临床疗效和远期预后。……