临床药师在糖尿病伴发抑郁患者临床合理用药治疗中作用研究.docVIP

临床药师在糖尿病伴发抑郁患者临床合理用药治疗中的作用研究 　　[摘要]目的 探讨临床药师在糖尿病伴发抑郁患者临床合理用药治疗中的作用。方法 选取2016年9～12月在山东省济宁市中医院内分泌科住院治疗的90例2型糖尿病伴抑郁患者，按随机数字表法分为A、B、C组，各30例。三组均给予盐酸二甲双胍缓释片抗糖尿病药物治疗，在此基础上，A组给予舍曲林抗抑郁治疗，B组给予舒肝解郁胶囊抗抑郁治疗，C组给予舍曲林联合舒肝解郁胶囊抗抑郁治疗（治疗方案由临床药师配合临床医师制订），三组治疗疗程均为6周。治疗前后，采用糖化血红蛋白（HbA1c）测评三组的血糖水平，采用抑郁自评量表（SDS）评估三组的抑郁程度；采用不良反应量表（TESS）评估三组的药物不良反应；采用Pearson相关分析分析糖化血红蛋白水平与抑郁的相关性。结果 治疗前，三组间HbA1c和SDS评分比较差异均无统计学意义（P0.05），治疗后，C组HbAlc评分明显低于A组与B组（P0.01）；三组SDS评分均较治疗前明显降低（P0.01），A组与B组SDS评分无统计学差异，C组SDS评分明?@低于A组与B租（P0.01），B组无不良反应，A组不良反应发生率为38.4%，明显高于C组的14.7%（χ2=14.258，P0.01）；C组治疗有效率为97.4%，明显高于A组的84.6%和B组的86.1%（χ2=9.902、8.350，P0.01）；Pearson相关分析显示HbA1c与抑郁成正相关（r=0.246，P0.05）。结论 临床药师参与糖尿病伴抑郁患者用药治疗，可取得良好的临床治疗效果。 　　[关键词]临床药师；糖尿病；抑郁；合理用药；疗效 　　[中图分类号] R969.3 [文献标识码] A [文章编号] 1674-4721（2017）04（c）-0134-04 　　[Abstract]Objective To explore the effect of clinical pharmacists′ in clinical rational drug usage of patients with diabetes and depression.Methods Altogether 90 cases of patients with type 2 diabetes and depression who were hospitalized in Department of Endocrinology of Jining Municipal Hospital of Traditional Chinese Medicine from September to December 2016 were selected and randomly divided into group A，group B and group C by random number table，with 30 cases in each group.All the three groups were treated with antidiabetic drug （Metformin Hydrochloride Sustained Release Tablets），group A was given Sertraline for antidepressant treatment，group B was given Liver-Smoothing and Depress-Relieving Capsules for antidepressant treatment，group C was given the combination of Sertraline and Liver-Smoothing and Depress-Relieving Capsules for antidepressant treatment in addition，and the schene was maken by clinical pharmacists and clinicist；the course of treatment for three groups was 6 weeks. The glycosylated hemoglobin （HbA1c） was adopted for evaluation of pre- and post-treatment blood glucose level in three groups；the self-rating depression scal（SDS） was used for assessment of the pre- and post-treatment depres