心理干预对原发性高血压患者治疗效果的评价研究

　摘要
研究背景
  高血压是一种原因不明，以血压增高为主要临床表现的独立疾病，该病的发生除了与遗传、饮食和体重等因素有关外，还与精神、情绪的持续紧张有关，许多研究表明，原发性高血压病人存在着不同程度的焦虑、抑郁，且由于生理功能下降，社会角色改变，再加上高血压的影响，更加重了其焦虑抑郁的程度，焦虑抑郁既是高血压的促发因素，也是高血压预后不良的因素。

研究目的
观察应用综合性行为干预措施对原发性高血压患者的血压及心理状态的影响

研究方法
选择2007年4月~2008年12月在我院住院的100例原发性高血压伴抑郁患者为研究对象。入组标准：①选择符合WHO1999年诊断标准的高血压患者②无继发性高血压，无严重的高血压并发症和精神病史。③焦虑自评量表（SAS）、抑郁自评量表（SDS）>=50分。将入组病例随机分为心理干预组与对照组，各50例。心理干预组男36例，女14例，年龄67~80(平均72，2+-5.6)岁，平均病程（4.7+-3.2）年，平均受教育年限（8.1+-3.1）年，平均血压（154.3+-16.8）/（102.7+-9.2）mmHg对照组男35例，女15例，年龄65~79（平均73.1+-4.4）岁，平均病程（4.9+-3.1）年，平均受教育年限（8.3+-3.2）年，平均血压（154.3+-16.1）/（102.3+-9.8）mmHg。两组年龄、性别、病程、受教育年限、血压水平无显著性差异。

研究结果
两组患者治疗前后SAS、SDS评分比较  两组患者干预前SAS、SDS评分差异无显著性意义（p>0.05）.心理干预组SAS、SDS评分显著低于对照组及同组治疗前评分（p<0.01）。
两组患者治疗前后血压比较  两组患者治疗前SBP、DBP均无显著差异（均P>0.05）.治疗后实验组SBP、DBP显著低于对照组及同组干预前水平（均P<0.01）.

研究结论
  本研究显示，心理干预能显著改善原发高血压患者的焦虑，抑郁情绪，治疗前后SAS、SDS评分有显著性差异。

关键词
心理干预；高血压病；原发高血压；抑郁情绪.
Summary
Background
  Hypertension is a cause is unclear, with blood pressure as the main clinical manifestations of independent disease, the incidence of the disease in addition to genetic, diet and weight and other factors, but also with the spiritual, emotional about the continuing tension, and many studies have shown that the original onset hypertension patients with different degrees of anxiety, depression, and because the decline in physical function, social role changes, coupled with the impact of high blood pressure, exacerbated by the extent of their anxiety, depression, anxiety and depression is the trigger for high blood pressure and also poor prognosis factors of hypertension.

Research purposes
Observe the comprehensive behavioral intervention on blood pressure in patients with essential hypertension and mental state

Research Methods
Select April 2007 ~ December 2008 in our hospital 100 cases of primary hypertension in patients with depression in this study. Into the set of criteria: ① selection criteria for the diagnosis found WHO1999 ② no secondary hypertension high blood pressure, high blood pressure without serious complications and history of mental illness. ③ Self-rating Anxiety Scale (SAS), self-rating depression scale (SDS)> = 50 points. Will be enrolled were randomly divided into psychological intervention group and control group, 50 cases each. Psychological intervention group 36 males and 14 females, aged 67 to 80 (mean 72,2 + -5.6) years, mean duration (4.7 + -3.2), the average years of education (8.1 + -3.1), the average blood pressure (154.3 + -16.8) / (102.7 + -9.2) mmHg in control group of 35 males and 15 females, aged 65 to 79 (mean 73.1 + -4.4) years, mean duration (4.9 + -3.1), the average education years (8.3 + -3.2), the average blood pressure (154.3 + -16.1) / (102.3 + -9.8) mmHg. Two groups of age, gender, disease duration, years of education, blood pressure levels were not significantly different.

Results
Two groups of patients before and after SAS, SDS scores between the two groups before intervention in patients with SAS, SDS score difference was not significant (p> 0.05). Psychological intervention group SAS, SDS scores were significantly lower than the control group and with the score before treatment (p <0.01).
Blood pressure before and after treatment both groups of patients before treatment were compared SBP, DBP were not significantly different (all P> 0.05). Experimental group after treatment, SBP, DBP was significantly lower than the control group and the level of the same group before the intervention (all P <0.01) .

Conclusions
  This study shows that psychological intervention can significantly improve the primary hypertensive patients with anxiety and depression, before and after treatment SAS, SDS score were significantly different.

Keywords
Psychological intervention; Hypertension; primary hypertension; depression.
Paper type: research report

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