| Objective: This research through the experimental research on different treatment methods in the application of diabetic patients with comorbid depression,to explore the cognitive behavioral therapy combined with antidepressants treatment of diabetic patients with comorbid depression at all time points of clinical treatment effect and long-term therapeutic effect,and study with the simple use of antidepressant drugs(escitalopram oxalate citalopram)the curative effect of treatment differences,for diabetes patients with comorbid depression to provide more effective clinical treatment.Methods: 100 eligible patients with diabetes mellitus accompanied by depression were randomly divided into experimental group and control group,including 50 cases in the treatment group and 50 cases in the control group.The experimental group was treated with cognitive behavioral therapy combined with the antidepressant Escitalopram oxalate,while the control group was treated with Escitalopram oxalate.In the treatment group,two groups continued to use the original hypoglycemic drugs.HAMD score,scl-90 score,GAF score,GQOLI score for fasting glucose,2h postprandial glucose and TESS score were recorded at 2,4,8 and 12 weeks after treatment,and the Hamilton depression scale(HAMD)and fasting glucose and 2h postprandial glucose scores were followed up for 2 years.The two treatment methods were compared in terms of cure rate,apparent efficiency,effective rate,total effective rate,HAMD score,scl-90 score,GAF score,GQOLI score,fasting blood glucose,2h postpranational blood glucose and TESS score.Results: Before the intervention,there was no significant difference between the experimental group and the control group(P > 0.05).After intervention,the cure rate,apparent efficiency,effective rate and total effective rate of the experimental group were50%,28%,12% and 92% respectively,which were higher than those of the control group(40%,20%,10% and 70%,respectively)(P < 0.05).From the end of the 4th week,the HAMD score of each time point in the control group was significantly lower than that of the previous time points(P < 0.001);From the end of the 2nd week,the HAMD score of each time point in the experimental group was significantly lower than that of the previous time points(P < 0.001),and significantly lower than that of the control group.The scores of somatization,interpersonal relationship,depression,anxiety and other five factors in SCL-90 decreased significantly with time.The scores of somatization,depression,anxiety and other factors in the control group were significantly lower than those in the previous time points(P < 0.001)from the end of the fourth week of treatment;In the experimental group,from the end of the second week,the factor scores of each time point were significantly lower than those of the previous time points,and significantly lower than those of the control group(P < 0.001).From the end of the 4th week,the GAF score of each time point in the control group was significantly higher than that of the previous time points(P < 0.001);In the experimental group,from the end of the second week,the score of each time point was significantly higher than that of the previous time points(P < 0.001);At the end of the 8th and 12 th week,there was significant difference between the experimental group and the control group(P < 0.001).In the control group,at the 8th and 12 th week of treatment,the total score of GQOLI scale at each time point was significantly higher than that at the previous time points(P<0.001);From the end of the 4th week,the total score of GQOLI in each time point in the experimental group was significantly higher than that in the previous time points(P <0.001),and significantly higher than that in the control group;The scores of physical,psychological,social and material factors in the control group were significantly higher than those in the previous time points at the end of the 12 th week after treatment;At the end of the 8th and 12 th week after treatment,the factor scores of each time point in the experimental group were significantly higher than those of the previous time points(P <0.001),and significantly higher than those of the control group(P < 0.001).Before the intervention,there was no significant difference in fasting blood glucose,2 hours postprandial blood glucose and glycosylated hemoglobin between the experimental group and the control group.After the intervention,the fasting blood glucose,2 hours postprandial blood glucose and glycosylated hemoglobin of the two groups were significantly lower than before the intervention(P < 0.05).There was no significant difference in Tess score between the two groups(P > 0.05).After 2 years follow-up,the average HAMD score,fasting blood glucose and 2 hours postprandial blood glucose in the experimental group were significantly lower than those in the control group(P <0.05).Conclusion: Cognitive behavioral therapy combined with antidepressant can effectively and safely treat patients with diabetes comorbid with depression.The clinical treatment effect is better than that of antidepressant alone,which can improve patients’ compliance and long-term treatment effect is better,which has a positive effect on prognosis and prevention of recurrence,and also significantly improves patients’ quality of life. |
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