洪灾区老年高血压患者抗焦虑治疗疗效分析

摘要

目的 探讨洪灾区老年高血压患者应用抗焦虑治疗对血压及相关指标的影响.方法 选取2016年7月～9月于邯郸市中心医院在抗洪救灾期间收治的老年原发性高血压患者276例,其中男性193例,女性83例,年龄61～79岁,平均年龄(69.45±0.37)岁.将患者随机分为治疗组与对照组,每组各138例.治疗组:在常规内科降压药物治疗(硝苯地平缓释片)的基础上,联合应用艾司唑仑治疗,同时给予心理学干预、疏导治疗.对照组仅给予常规内科降压药物治疗.治疗前和治疗8周后测定24 h平均收缩压(24 hSBP)和舒张压(24 hDBP)、汉密尔顿焦虑量表、晨峰血压(MBPS)、24 h收缩压标准差(24 hSSD)、脉压指数(PPI)、动态动脉硬化指数、中心动脉收缩压、脉搏波传导速度.结果 两组治疗后较治疗前24 hSBP、24 hDBP均下降,差异有统计学意义(P均<0.05).两组治疗前均出现焦虑,治疗组治疗后较治疗前HAMA评分下降,差异有统计学意义(P<0.05).与对照组治疗后比较,治疗组24 hSBP、24 hDBP和HAMA评分均下降,差异有统计学意义(P均<0.05).对照组和治疗组治疗8周后,MBPS、24 hSSD、PPI较治疗前均降低,差异有统计学意义(P均<0.05);治疗组较对照组MBPS、24 hSSD、PPI改善更明显,差异有统计学意义(P均<0.05).结论 洪灾及灾后重建易引起老年高血压患者焦虑,在常规内科降压治疗的同时,给予抗焦虑治疗及心理疏导,能有效提高临床血压控制效果.%Objective To investigate the influence of anti-anxiety therapy on blood pressure (BP) and relevant indexes in elderly patients with hypertension in flood-ravaged area.Methods The elderly patients with hypertension (n=276, male 193, female 83, aged from 61 to 79 and average age=69.45±0.37) were chosen from the Central Hospital of Handan City during the period of fighting the flood and providing relief from July 2016 to Sept. 2016. All patients were divided, according to random digital table, into treatment group and control group (eachn=138). The treatment group was given estazolam and psychological dredging treatment on the base of routine antihypertensive drug (Nifedipine Sustained-release Tablets), and control group was only given routine antihypertensive drug. The indexes of 24-h mean systolic blood pressure (SBP), 24-h mean diastolic blood pressure (DBP), Hamilton Anxiety Scale (HAMA), morning blood pressure surge (MBPS), 24-h standard systolic deviation (SSD), pulse pressure index (PPI), ambulatory arterial stiffness index (AASI), central aortic systolic blood pressure (CSBP) and pulse wave velocity (PWV) were detected before and 8 weeks after treatment.Results The levels of 24-h SBP and 24-h DBP all decreased in 2 groups after treatment (all P<0.05). The patients had anxiety in 2 groups before treatment, and scores of HAMA decreased in treatment group after treatment (P<0.05). After treatment, the levels of 24-h SBP, 24-h DBP and scores of HAMA all decreased in treatment group compared with control group (all P<0.05). After treatment for 8 weeks, the levels of MBPS, 24-h SSD and PPI decreased in 2 groups (all P<0.05), and the decreases were more significant in treatment group (all P<0.05).Conclusion Flood disaster and rebuilding after the disaster will cause anxiety in elderly patients with hypertension. At the same time of routine antihypertensive treatment, anti-anxiety therapy and psychological dredging treatment can effectively improve BP control efficacy.