多塞平对2型糖尿病合并抑郁症作用的临床观察
发布时间：2018-10-17 13:46
【摘要】：目的探究2型糖尿病和抑郁症之间的相互关系以及应用抗抑郁症药物对其的疗效。糖尿病的病人也和许多的其他内科疾病一样,因为各种的原因容易患有抑郁症,三环类抗抑郁症药物多赛平在改善抑郁症状外,也可同时改良糖尿病患者的空腹血糖、餐后2小时血糖、糖化血红蛋白、血压和血脂。方法选择山东省千佛山医院自2010年06月至2013年06月符合1999WHO糖尿病诊断标准的2型糖尿病和同时也符合抑郁症诊断标准的住院患者30例。对其进行随机分为两组,其中观察组16人,男6例,女10例,对照组14人,男6人,女8人,清晨抽取空腹静脉血,取血浆行空腹血糖(FPG)、甘油三酯(TG)、胆固醇(CH)、糖化血红蛋白(Hb A1c)检查,早餐后2 h抽静脉血行餐后2 h血糖(2h PG)检查。并由专业医护人员根据汉密尔顿抑郁量表(24项版本Hamilton Depression Scale HAMD)对其进行问卷调查,对30例患者进行评定抑郁症的分度。两组患者均常规给予控制糖尿病饮食、糖尿病降糖药物(胰岛素促泌剂、双胍类、α-葡萄糖苷酶抑制剂及胰岛素)及降血压、降血脂药物治疗半年-2年。观察组在此治疗基础上加用抗抑郁药物多赛平25mg每日三次,疗程8周。观察并比较两组患者治疗前后空腹血糖、餐后2小时血糖、糖化血红蛋白、血压和血脂的治疗效果,并观察抑郁症状的变化。结果两组患者治疗前FBG、2h PG和Hb A1C比较无明显统计学差异(P〉0.05),治疗8周后,两组患者FBG、2h PG和Hb A1C均较治疗前明显下降(P〈0.05或P〈0.01),且观察组下降幅度较对照组更显著(P〈0.05)。观察组抗抑郁疗效明显优于对照组(P〈0.05)。结论2型糖尿病和抑郁症均与精神心理因素有关,都普遍存在着精神障碍如焦虑和抑郁的情绪,两者相互影响,互为因果,糖尿病合并抑郁症的患者,单一用降血糖的药物对控制血糖不明显者,如果加用抗抑郁症的药物治疗效果会明显增加,并且可以显著改善心理和躯体两方面的症状。多塞平是一种安全、有效的抗抑郁症药物,对于糖尿病合并抑郁症患者的抑郁情绪以及间接可以降低血压、血糖及血脂。
[Abstract]:Objective to investigate the relationship between type 2 diabetes mellitus and depression and the efficacy of antidepressants. Patients with diabetes, like many other internal diseases, are prone to depression for a variety of reasons, and the tricyclic antidepressant drug doxepin can also improve fasting blood glucose in diabetics, in addition to improving their depressive symptoms. 2 hours postprandial blood sugar, glycosylated hemoglobin, blood pressure and blood lipids. Methods Thirty inpatients with type 2 diabetes and depression who met the diagnostic criteria of 1999WHO diabetes from June 2010 to June 2013 in Qianfushan Hospital of Shandong Province were selected. The patients were randomly divided into two groups: observation group (n = 16), male (n = 6), female (n = 10), control group (n = 14), male (n = 6), female (n = 8). Fasting blood glucose (FPG), triglyceride (TG), (CH), glycosylated hemoglobin (Hb A1c) were measured in plasma and venous blood samples were taken 2 hours after breakfast for 2 h postprandial blood glucose (2 h PG). According to the Hamilton Depression scale (24 items of Hamilton Depression Scale HAMD), 30 patients were assessed by the medical staff. The patients in both groups were given diabetes control diet, diabetes hypoglycemic drugs (insulin secreting agent, biguanidine, 伪 -glucosidase inhibitor and insulin), hypotension and blood lipids treatment for six months to two years. The treatment group was treated with the antidepressant doxepin 25mg three times a day for 8 weeks. The effects of fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin, blood pressure and blood lipids before and after treatment were observed and compared between the two groups, and the changes of depressive symptoms were observed. Results there was no significant difference in FBG,2h PG and Hb A1C between the two groups before treatment (P > 0. 05). After 8 weeks of treatment, the FBG,2h PG and Hb A1C of the two groups were significantly lower than those before treatment (P < 0. 05 or P < 0. 01), and the decrease of FBG,2h PG and Hb A1C in the observation group was more significant than that in the control group (P < 0. 05). The antidepressant effect of the observation group was significantly better than that of the control group (P < 0.05). Conclusion both type 2 diabetes mellitus and depression are related to psycho psychological factors, and there are common mental disorders such as anxiety and depression. The two affect each other and cause and effect each other. The effects of hypoglycemic drugs alone on the control of blood sugar were significantly increased if antidepressant drugs were added, and the psychological and physical symptoms could be significantly improved. Doxepin is a safe and effective antidepressant for depression in diabetics with depression and indirectly reduces blood pressure, blood sugar and blood lipids.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.1;R749.4
本文编号：2276849
[Abstract]:Objective to investigate the relationship between type 2 diabetes mellitus and depression and the efficacy of antidepressants. Patients with diabetes, like many other internal diseases, are prone to depression for a variety of reasons, and the tricyclic antidepressant drug doxepin can also improve fasting blood glucose in diabetics, in addition to improving their depressive symptoms. 2 hours postprandial blood sugar, glycosylated hemoglobin, blood pressure and blood lipids. Methods Thirty inpatients with type 2 diabetes and depression who met the diagnostic criteria of 1999WHO diabetes from June 2010 to June 2013 in Qianfushan Hospital of Shandong Province were selected. The patients were randomly divided into two groups: observation group (n = 16), male (n = 6), female (n = 10), control group (n = 14), male (n = 6), female (n = 8). Fasting blood glucose (FPG), triglyceride (TG), (CH), glycosylated hemoglobin (Hb A1c) were measured in plasma and venous blood samples were taken 2 hours after breakfast for 2 h postprandial blood glucose (2 h PG). According to the Hamilton Depression scale (24 items of Hamilton Depression Scale HAMD), 30 patients were assessed by the medical staff. The patients in both groups were given diabetes control diet, diabetes hypoglycemic drugs (insulin secreting agent, biguanidine, 伪 -glucosidase inhibitor and insulin), hypotension and blood lipids treatment for six months to two years. The treatment group was treated with the antidepressant doxepin 25mg three times a day for 8 weeks. The effects of fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin, blood pressure and blood lipids before and after treatment were observed and compared between the two groups, and the changes of depressive symptoms were observed. Results there was no significant difference in FBG,2h PG and Hb A1C between the two groups before treatment (P > 0. 05). After 8 weeks of treatment, the FBG,2h PG and Hb A1C of the two groups were significantly lower than those before treatment (P < 0. 05 or P < 0. 01), and the decrease of FBG,2h PG and Hb A1C in the observation group was more significant than that in the control group (P < 0. 05). The antidepressant effect of the observation group was significantly better than that of the control group (P < 0.05). Conclusion both type 2 diabetes mellitus and depression are related to psycho psychological factors, and there are common mental disorders such as anxiety and depression. The two affect each other and cause and effect each other. The effects of hypoglycemic drugs alone on the control of blood sugar were significantly increased if antidepressant drugs were added, and the psychological and physical symptoms could be significantly improved. Doxepin is a safe and effective antidepressant for depression in diabetics with depression and indirectly reduces blood pressure, blood sugar and blood lipids.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.1;R749.4
【参考文献】
相关期刊论文 前2条
1 田睿;赵志刚;袁慧娟;汪艳芳;秦贵军;闫镛;李清楚;;河南省糖尿病和代谢综合征流行病学调查及相关因素分析[J];中华实用诊断与治疗杂志;2009年11期
2 孙晓敏;黄晓萍;袁翠萍;崔焱;;健康信念和应对方式对2型糖尿病患者自我管理行为的影响[J];护理学报;2012年01期
，本文编号：2276849
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