黄金双参加味颗粒干预冠心病PCI术后焦虑抑郁障碍患者的临床疗效及对炎症因子的影响

Clinical Efficacy and Effect on Inflammatory Cytokines of Huangjin Shuangshen Jiawei Granules in Treating Patients with Postoperative Anxiety and Depression After PCI for Coronary Heart Disease

摘要:

目的 探讨黄金双参加味颗粒干预冠心病经皮冠状动脉介入术（PCI）后焦虑抑郁障碍患者的临床疗效及对炎症因子的影响。方法 将94例诊断为冠心病PCI术后焦虑抑郁的患者随机分为两组采用双盲方法，在常规西医治疗基础上，观察组（47例）予以黄金双参加味颗粒治疗12周，对照组（47例）予以模拟安慰剂治疗12周。比较两组患者汉密尔顿焦虑和抑郁量表（HAMA-14、HAMD-24）、匹兹堡睡眠质量评分表（PSQI）、西雅图心绞痛评分（SAQ）、中医证候积分及疗效、超敏C反应蛋白（hs-CPR）、肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6血清水平、主要心血管不良事件（MACE）和不良反应情况。结果 与本组治疗前比较，治疗后两组HAMA-14、HAMD-24和PSQI的评分均明显下降（P<0.05，P<0.01）；治疗后与对照组比较，观察组HAMA-14、HAMD-24和PSQI的指标评分明显降低（P<0.05）。与本组治疗前比较，治疗后两组SAQ的评分均显著上升（P<0.01）；治疗后观察组各个维度评分指标上升情况优于对照组（P<0.05）。与本组治疗前比较，经治疗两组中医证候积分均下降（P<0.01）；治疗后观察组的中医证候评分低于对照组（P<0.05）；治疗后观察组的中医证候总有效率高于对照组（χ2=9.225，P<0.01）。与本组治疗前比较，治疗后两组hs-CPR、IL-6、TNF-α水平均下降（P<0.01）；治疗后与对照组比较，观察组hs-CPR、IL-6、TNF-α降低更明显（P<0.05）。研究结果显示，随访期90 d内观察组MACE发生率低于对照组（χ2=4.242，P<0.05）。在试验期间未观察到使用黄金双参加味颗粒相关不良反应。结论 黄金双参加味颗粒能够缓解冠心病PCI术后焦虑抑郁障碍患者的不良情绪，改善睡眠，减轻躯体症状，提高生活质量，减轻炎症损伤，改善预后，临床使用安全。

Abstract:

Objective To explore the clinical efficacy of Huangjin Shuangshen Jiawei （HJSSJW） granules in treating postoperative anxiety and depression after percutaneous coronary intervention （PCI） for coronary heart disease and the effects of this medicine on inflammatory cytokines.Method Ninety-four patients diagnosed with anxiety and depression after PCI were randomized into observation and control groups （47 cases） by the double-blind method. On the basis of conventional Western medical treatment， the observation group was treated with HJSSJW granules for 12 weeks， and the control group with the simulant of HJSSJW granules for 12 weeks. The two groups were compared in terms of Hamilton Anxiety and Depression Scales （HAMA-14， HAMD-24）， Pittsburgh Sleep Quality Inventory （PSQI）， Seattle Angina Score （SAQ）， TCM symptom scores， traditional Chinese medicine （TCM） symptom score and response rate， serum levels of hypersensitive-C reactive protein （hs-CPR）， tumor necrosis factor （TNF）-α， and interleukin （IL-6）， and incidence of major adverse cardiovascular events （MACEs） and adverse reactions.Result After treatment， both groups showed declined scores of HAMA-14， HAMD-24， and PSQI （P<0.05， P<0.01） and the observation group had lower scores of HAMA-14， HAMD-24， and PSQI than the control group （P<0.01）. The scores of SAQ in both groups increased after treatment （P<0.01）， and the observation group had higher score of each dimension than the control group （P<0.05）. The TCM symptom scores decreased in both groups after treatment （P<0.01）， and they were lower in the observation group than in the control group （P<0.05）. The total response rate regarding TCM symptoms in the observation group was higher than that in the control group （χ²=9.225， P<0.01）. After treatment， the levels of hs-CPR， IL-6， and TNF-α became lowered in both groups （P<0.01）， and the observation group had lower levels of hs-CPR， IL-6， and TNF-α than the control group （P<0.05）. The incidence of MACEs in the observation group was lower than that in the control group during the 90 d of the follow-up period （χ²=4.242， P<0.05）. No adverse reactions associated with the use of HJSSJW granules were observed during the trial period.Conclusion HJSSJW granules can alleviate the bad mood， improve sleep， mitigate somatic symptoms， improve the quality of life， reduce inflammatory damage， and improve prognosis， being safe for clinical use in patients with postoperative anxiety and depression after PCI for coronary heart disease.