张晨 丘伟燕 刘勇

【摘要】 目的：探討正念减压疗法（MBSR）对冠心病（CHD）合并抑郁症状患者的生活质量和社会功能的影响。方法：选择2019年1-12月本院住院部心内科CHD合并抑郁患者60例。采用随机数字表法将患者分为观察组30例和对照组30例。对照组给予常规CHD护理治疗，观察组在常规CHD护理治疗的基础上增加正念减压疗法（MBSR）治疗。比较两组患者干预前后的心理健康调查量表（PHQ-9）、广泛焦虑障碍量表（GAD-7）、简版健康相关生存质量量表（SF-12）和个人与社会功能量表（PSP-CHN）。结果：干预前，两组PHQ-9、GAD-7、PCS、MCS和PSP-CHN评分比较，差异均无统计学意义（P>0.05）;干预8周后，观察组的PHQ-9和GAD-7评分均低于对照组，PCS、MCS和PSP-CHN评分均高于对照组，差异均有统计学意义（P<0.05）。结论：MBSR可以缓解冠心病合并抑郁症状患者的抑郁和焦虑症状，提高社会功能和生活质量。

【关键词】 正念减压疗法 冠心病 抑郁症状 社会功能 生活质量

Effect of Mindfulness-based Stress Reduction on Quality of Life and Social Function in Patients with Coronary Heart Disease Complicated with Depressive Symptoms/ZHANG Chen， QIU Weiyan， LIU Yong. //Medical Innovation of China， 2021， 18（10）： 0-088

[Abstract] Objective： To investigate the effect of mindfulness-based stress reduction （MBSR） on the quality of life and social function of patients with coronary heart disease （CHD） complicated with depressive symptoms. Method： A total of 60 patients with CHD complicated with depression were selected from the inpatient department of cardiology of our hospital from January to December 2019. The patients were divided into observation group （30 cases） and control group （30 cases） by random number table method. The control group was given routine CHD nursing treatment， and the observation group was given MBSR on the basis of routine CHD nursing treatment. Patient health questionnaire 9 （PHQ-9）， generalized anxiety disorder 7 items （GAD-7）， simple health-related quality of life scale （SF-12） and Chinese version of personal and social performance scale （PSP-CHN） before and after intervention were compared between the two groups. Result： Before intervention， there were no significant differences in PHQ-9， GAD-7， PCS， MCS and PSP-CHN scores between the two groups （P>0.05）. After 8 weeks of intervention， PHQ-9 and GAD-7 scores in the observation group were lower than those in the control group， while PCS， MCS and PSP-CHN scores were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： MBSR can alleviate depression and anxiety symptoms， improve social function and quality of life in patients with coronary heart disease complicated with depressive symptoms.

[Key words] Mindfulness-based stress reduction Coronary heart disease Depressive symptoms Social function Quality of life

First-authors address： Guangdong Provincial Peoples Hospital， Guangzhou 510080， China

doi：10.3969/j.issn.1674-4985.2021.10.020

冠心病（CHD）是全球最常见的死亡原因，尽管死亡率正在下降[1]。抑郁是CHD患者心血管疾病发病率和死亡率的主要危险因素，有焦虑或抑郁症状的CHD患者死亡率增加2.2倍[2]。随着生物-心理-社会医学模式的不断发展，在临床实践中不仅要关注CHD患者的疾病治疗效果，还应重视CHD患者的心理健康问题，尤其是合并抑郁症状。因此，如何改善CHD患者抑郁焦虑症状和提高其生活质量是目前亟待处理的科学问题。

正念减压疗法（mindfulness-based stress reduction， MBSR）由Jon Kabat Zinn在20世纪80年代早期开发，协助患者处理压力、疼痛和疾病，同时将正念定义为：通过有意识地觉察当下，并对每时每刻所觉察的体验不加评判，从而产生的一种觉察力[3]。MBSR已经被广泛用于改善抑郁症状的治疗，深受国内外学者推荐[4]。CH……