正念认知行为干预联合氟哌噻吨美利曲辛对PCI术后抑郁患者服药依从性及预后的影响

Effect of Mindfulness-Based Cognitive Behavioral Intervention Combined with Flupentixol and Melitracen on Medication Compliance and Prognosis in Patients with Depression after PCI

摘要: 目的：探讨正念认知行为干预联合氟哌噻吨美利曲辛对PCI术后抑郁患者服药依从性及临床预后的影响。方法：选取金乡县人民医院2021年12月1日至2024年12月1日收治的PCI术后抑郁患者294例，根据干预治疗方法分为联合组(125例)和对照组(169例)。对照组给予氟哌噻吨美利曲辛药物治疗与常规健康指导，联合组在对照组基础上实施正念认知行为干预，比较两组的抑郁评分、服药依从性，干预12周后的服药依从性达标率，以及随访6个月的主要不良心血管事件发生率、再入院率。结果：干预6周、12周后，两组患者MADRS评分均较干预前降低，DAI-30评分均较干预前升高，且联合组上述指标改善幅度均优于对照组(P < 0.05)；干预12周后，联合组服药依从性达标率高于对照组(P < 0.05)。随访6个月，联合组MACE发生率、再入院率均低于对照组(P < 0.05)。结论：正念认知行为干预联合氟哌噻吨美利曲辛可显著改善PCI术后抑郁患者的抑郁症状，提高其服药依从性，降低不良心血管事件发生率及再入院率。

Abstract: Objective: To explore the effect of mindfulness-based cognitive behavioral intervention combined with flupentixol and melitracen on medication compliance and clinical prognosis of patients with depression after PCI. Methods: A total of 294 patients with post-PCI depression admitted to Jinxiang County People’s Hospital from December 1, 2021, to December 1, 2024 were enrolled and divided into a combination group (n=125) and a control group (n=169) based on intervention methods. The control group received fluoxetine-melitracen pharmacotherapy and routine health guidance, while the combination group additionally underwent mindfulness cognitive behavioral intervention. Comparison was made between the two groups regarding depression scores, medication adherence, medication adherence compliance rate after 12 weeks of intervention, as well as the incidence of major adverse cardiovascular events and readmission rates at 6-month follow-up. Results: At 6 weeks and 12 weeks post-intervention, both groups showed decreased MADRS scores and increased DAI-30 scores compared to baseline levels, with the combination group demonstrating superior improvement in all metrics (P <0.05). At 12 weeks, the combination group exhibited higher medication adherence compliance rates than the control group (P <0.05). At 6 months follow-up, the combination group exhibited lower rates of MACE and readmission compared to the control group (P <0.05). Conclusion: Mindfulness cognitive behavioral intervention combined with fluoxetine-melitracen significantly alleviates depressive symptoms in post-PCI patients, improves medication adherence, and reduces the incidence of adverse cardiovascular events and readmissions.