Objective To evaluate the subjective outcomes of sleepiness behavior and mood status applying continuous positive airway pressure（CPAP） in adults of elderly and middle-aged with obstructive sleep apnea syndrome（OSAS）. Methods Nine randomized controlled trails comparing nocturnal CPAP with inactive control appliances in adults with OSAS with the use of computerized search in related medical databases（MEDLINE，EMBASE，CBMdisk，etc） were included.The quality of literature was reviewed，and all data were extracted by two reviewers independently.Meta analysis was conducted used RevMan 4.2 software.Results 9 RCT involving 665 patients of elderly and middle-aged met the inclusion criteria.Meta analysis indicated that the score of Epworth sleepiness scale（ESS） and general health questionnaire-28（GHQ-28） declined significantly after CPAP treatment on effectiveness with WMD（random） －2.94，95 %CI －4.68 to －1.20，or WMD（fixed） －2.26，95 %CI －3.79 to －0.72，Plt;0.01.Nevertheless，hospital anxiety and depression scale（HADS） was not significantly different between CPAP and control with WMD（random） －0.89，95%CI －1.98 to 0.20，Pgt;0.05.Conclusion Current clinical evidence suggested that CPAP was effective in improving day-time subjective outcomes of sleepiness behavior and general mental health status in OSAS patients of elderly and middle-aged，although evidence of improving emotion disorder of anxiety and depression was not confirmed.
Objective To study the effects of anxious condition on asthma symptom burden and asthma control in elderly asthma patients in primary care settings. Methods Totally 128 elderly asthma patients were recruited in this study. The patients were required to fill in the questionnaire，then the score of asthma control test （ACT） and Hamilton anxious meter（HAMA） were calculated. Risk factors of anxious condition were analyzed by logistic analysis. Results The ACT scores in the anxious patients were significantly lower than those of the non-anxious patients [17.45±3.14 vs. 21.45±2.37，Plt;0.05）. The patients with lower incoming and more complications had more severe anxious condition，lower asthma control level，and more asthmatic medications. Meanwhile the latter conditions also increased the incidence of anxiety in the elderly asthma patients significantly （Plt;0.05）. Conclusions The elderly asthma patients in primary care settings are also complicated with anxiety，and the anxious condition can significantly increase asthma symptom burden and decrease asthma control level.
Objective To observe the serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), platelet 5-HT and blood platelet count, emotion and burn injury healing of patients with moderate and severe burn injury and anxiety-depression symptoms. Methods In-patients with moderate and severe burn injury were selected from 2003.4 to 2005.2 and then divided into anxiety-depression group and control group according to their anxiety-depression scores by Hamilton Rating Scale for Depression (HAMD ) and Hamilton Rating Scale for Anxiety (HAMA) 3 days after being burnt. Routine therapy was given to two groups, which lasted 1 month. Their scores of anxiety and depression and the degree of injury healing were observed, and the serum levels of TNF-α and IL-6, platelet 5-HT and blood platelet count were measured in the two groups. Results Fifty-one in-patients with moderate and severe burn injury were divided into the anxiety-depression group (24 cases) and the control group (27 cases). After 30-day treatment, the depression scores did not decrease in the anxiety-depression group (P=0.12), but the anxiety scores decreased (P=0.00). In the anxiety-depression group, the burn injury healing time was postponed (P=0.00), the serum levels of TNF-α increased (P=0.00), and the platelet 5-HT levels decreased (P=0.04) before and after treatment. Conclusion Depressive reaction occurs in patients with moderate and severe burn injury, which is a continuously negative emotion. It can lead to high levels of serum TNF-α, reduction in platelet 5-HT, and delayed burn injury healing time. Due to the limited sample size and different location of patients, there may be some bias in this conclusion. We are prepared to increase the sample size and select patients in the same region in further relevant studies.
Objective To evaluate the effect of music therapy for childbirth. Methods Such databases as The Cochrane Library, PubMed, EMbase, EBSCO host, SpringerLINK Online Journals, CBM and WanFang Data were searched from January of 2000 to December of 2010 to collect randomized controlled trials (RCTs) of music therapy for childbirth. The quality of RCTs was appraised and the data were extracted. Meta-analyses were conducted with RevMan5.02 software for the standarded RCTs. Results A total of nine RCTs were included. Five RCTs indicated the music therapy could alleviate the labor pain; five RCTs indicated the music therapy could reduce the event risk of cesarean section due to the failure of transvaginal trial labor; three RCTs indicated the music therapy could shorten the first stage of labor; two RCTs indicated the music therapy could stabilize the systolic pressure and heart rate when complete cervical dilation was done, and three RCTs indicated the music therapy could relieve anxiety. In addition, music therapy had no influence on neonate Apgar’s score; and the result of meta-analyses on postpartum hemorrhage was not reliable through sensitivity analyses. Conclusion The music therapy applied during childbirth can relieve the labor pain and anxiety, stabilize the heart rate and systolic pressure when complete cervical dilation is done, reduce the event risk of cesarean section due to the failure of transvaginal trial labor, shorten the first stage of labor, and is beneficial to the mind and body of parturient.
Objective To investigate the effect of music therapy plus selective serotonin reuptake inhibitors （SSRIs） on emotion and bum wound healing in bum patients. Methods Moderate and severe bum inpatient.s, aged 12-60 years were selected. Emotional problems were then measured by the Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety within three days after bum injury. Bum patients with depression and anxiety were randomly allocated into the trial group （28 patients） and the control group （27 patients）. Music therapy and SSRIs plus conventional burn care Were applied to the trial group, and conventional bum care to the control group, both for 30 days. The scores of anxiety, depression and the degree of bum wound healing were assessed. Results The differences of depression score and anxiety score before and after treatment were 13. 7 ±6.43 and 6.43 ±2.72 respectively in the trial group, and 4. 74 ±6.75 and 4.44 ±3.36 respectively in the control group. This showed both scores significantly improved compared with the control group （P 〈0. 05）. The time for burn wound healing was shortened in the treatment group （P 〈0. 05）. The anxiety score was positively correlated with bum index, and so was the depression score （P 〈 0.05 ）. Conclusions The anxiety and depression scores are positively correlated with the burn index. Music therapy plus SSrIs can ameliorate the emotional problems （ depression and anxiety）, and shorten the time for burn wound heating.
Objective To evaluate the effect of visual and audiovisual distraction on anxiety and acceptance levels among patients undergoing colonoscopy. Methods A total of 180 consecutive patients undergoing colonoscopy were randomly divided into three groups: group A received visual distraction; group B received audiovisual distraction; and group C received routine care alone. Levels of anxiety and willingness to accept the same intervention if the procedure needed to be repeated were compared among the three groups. Results The reduction of anxiety score after colonoscopy in group A and group B was greater than that in group C, but the difference was not statistically significant. The rate of willingness to accept the same intervention if the procedure needed to be repeated was significantly different among the three groups: the rates for group A and group B were higher than for group C (Plt;0.05). Conclusions Both visual distraction and audiovisual distraction can significantly improve patients’ acceptance of colonoscopy. Visual distraction and audiovisual distraction have no significant effect on reducing anxiety.
Objective To evaluate the clinical effectiveness and safety of Jiu Wei Lv Ping particle in the treatment of generalized anxiety disorder (GAD). Methods The multi-center, randomized double-blind method was used to observe 227 GAD patients who were divided into the treatment group (n=114, treated with Jiu Wei Lv Ping particle 6 g, three times a day) and the control group (n=113, treated with buspirone 10 mg, three times a day). HAMD score, and CGI-GI score were used to evaluate the clinical efficacy. TESS score and the list of symptom-recording were used to observe the safety. All the outcomes for evaluation before and after treatment at week 1, week 2, week 3 and week 4. Results According to intention-to-treat analysis (ITT), the level of decrease of HAMA score from baseline at each observational point of the treatment group was similar to that of the control group (t test, Pgt;0.05). At the end point, the effective rate of treatment group was 87.72％, and the effective rate of the control group was 87.61%. There was no significant difference between the two groups (CMH test, Pgt;0.05). According to the score of CGI-GI at each observational point, there was no difference of the effective rate between the treatment group and the control group (student test, Pgt;0.05). The side effect rate of the treatment group was 16.67%, The frequent symptoms were thirst (8.77%), dizziness (7.02%), nausea (2.63%), constipation (2.63%) and diarrhea (1.75%). The side effect rate of the control group was 30.97%, The frequent symptoms were thirst (15.04%), constipation (6.19%), nausea (4.42%), diarrhea (4.42%), dizziness (3.45%) and tachycardia (1.77%). The side effect of the treatment group was lower than that of the control group. But there was no significant difference between the two groups according to the score of TESS (F test, Pgt;0.05). Conclusions The therapeutic action of Jiu Wei Lv Ping particle in the treatment of GAD is affirmed with less side effects. It is valuable to use clinically.
【摘要】 目的 探讨降高血压药物联合抗焦虑抑郁药物万拉法新治疗老年性原发高血压伴焦虑抑郁障碍的疗效及安全性。 方法 纳入2006年10月-2008年10月我院门诊和住院诊治的老年性原发高血压伴焦虑抑郁障碍患者100例,随机分为干预组和对照组。所有患者给予常规降压药物治疗,干预组另外给予万拉法新治疗,治疗12周后评价临床疗效。结果 干预组临床降压疗效总有效率940%,显著高于对照组总有效率800%(Plt;005)。两组患者的收缩压、舒张压与治疗前比较均显著改善(Plt;005),干预组患者与对照组比较血压明显改善(Plt;005)。干预组临床抗焦虑抑郁疗效总有效率960%,显著高于对照组总有效率580%(Plt;005)。两组均无明显的不良反应。结论 降高血压药物联合抗焦虑抑郁药物万拉法新治疗老年性原发高血压伴焦虑抑郁障碍疗效肯定,且安全可靠,值得临床推广应用。【Abstract】 Objective To investigate the efficacy and safety of antihypertensive drugs combined with antianxiety depression drug venlafaxine for treatment of patients with senile primary hypertension (SPH) and anxietydepression disorder (AD). Methods One hundred SPH patients with AD with were randomly divided into an intervention group and a control group. All cases were given antihypertensive drugs medication,while the intervention group was given venlafaxine. After 12 weeks of treatment,the clinical efficacy was evaluated. Results The antihypertensive efficacy rate in the intervention group was 940%,significantly higher than that of the control group 800% (Plt;005). The systolic blood pressure(SBP)and diastolic blood pressure (DBP) of the two groups significantly improved compared with those before treatment (Plt;005), and the intervention group’ SBP and DBP improved significantly than those of the control group (Plt;005). The total effective rate of antianxiety depression efficacy of the intervention group was 960%, significantly higher than that of the control group 580% (Plt;005). The two groups had no significant adverse reactions. Conclusion For patients with senile primary hypertension and anxietydepression disorder,the combination medication with antihypertensive drugs and venlafaxine was safe,reliable and worthy of clinical application.
ObjectiveTo explore the association between paroxetine (Seroxat) and level of blood sugar and endocrine hormones in pre-diabetes patients with anxiety and depression. MethodsFifty-four pre-diabetes patients with anxiety and depression diagnosed from January 2010 to December 2012 were recruited. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess depression and anxiety. All the patients were treated by paroxetine. The glucose tolerance test (OGTT), ACTH and cortisol were tested in patients at baseline and within 24 weeks. ResultsAfter 24 weeks' treatment, the level of anxiety and depression as well as the OGTT 0.5 h (0.5 h PG), OGTT 1 h (1 h PG), OGTT 2 h (2 h PG), glycated hemoglobin (HbA1c), adrenocorticotropic hormone (ACTH) and cortisol were significantly decreased (P<0.05 or P<0.01). The glycated HbA1c had a positive correlation with adrenocorticotropic hormone (ACTH) and cortisol (F). Before and after treatment, the reduced rate of ACTH and reduced rate of cortisol respectively exhibited a positive correlation with the reduced rate of HbA1c, reduced rate of SAS and reduced rate of SDS. ConclusionAnti-anxiety depression treatment can lower blood sugar level in pre-diabetes patients with anxiety and depression significantly, which may be related to the activity of HPA axis.
ObjectiveTo investigate the effects of a new anti-anxiety-depression drug tandospirone on heart rate variability (HRV) and QT-dispersion in patients with anxiety and depression after intracoronary stent implantation. MethodsEighty-six anxious and depressive patients after intracoronary stent implantation during May 2011 and May 2013 were treated by tandospirone for 6 weeks. We evaluated the changes of HRV and QT dispersion before and after anti-anxiety-depression treatment. ResultsAfter six weeks of treatment, the HRV was increased obviously (P<0.05) and the QT dispersion was decreased significantly (P<0.01). ConclusionThe new anti-anxiety-depression drug tandospirone is effective on cardiac autonomic nervous system in patients with anxiety and depression after intracoronary stent implantation. And the drug is secure with a low rate of adverse reactions.