The Comparative Study Of Duloxetine Combined With Relaxation Technique In The Treatment Of Generalized Anxiety Disorder And The Effect On Heart Rate Variability

Objective: To explore the effect of duloxetine with Bodhi Tree relaxation techniquein the treatment of generalized anxiety disorder and the effect on heart rate variability.Methods: Using the method of random cluster sampling, in hospital patients fromMarch to December in2013, using Zung’s Self-Rating Anxiety Scale (SAS) andHamilton Anxiety Scale (HAMA) screened200patients with anxiety disorders as theobserved object, using the Hamilton Depression Rating Scale (HAMD) in patients withmoderate to severe depression excluded, there are124qualified patients.The patientswere divided into two groups. Namely: intervention group (n=62patients, which dropped2) and non-intervention group (n=62patients, which dropped4). Theintervention group were given a fixed taking Duloxetine (40mg/d), while Bodhi Treerelaxation therapy,2times/week, each lasting50min,8weeks, a total of16times; thenon-intervention group taking duloxetine without Bodhi tree relaxation therapy,monitoring of physiological index value natural resting state.Two groups of patientswere used the Zung’s Self-Rating Anxiety Scale (SAS) and Hamilton Anxiety Scale(HAMA) to assess their mood. They were assessed adverse reactions with TESS aftertreatment. And were monitored heart rate (HR) and heart rate variability (HRV) valuesbefore and after the interventio.Results：1. Comparison of anxiety levels before and after intervention: After theintervention, two groups of SAS and HAMA score were decreased,there was significantdifference between two groups (P <0.01).2. Comparison with two groups in clinical curative effect: The intervention group,cured patients are18cases, effective patients are21cases, progresses are12cases,invalid9cases, the cure rate was30%, and the effective rate was85%. In thenon-intervention group, cured patients are11cases, effective patients are15cases,progress are12cases, invalid18cases, the cure rate was18%, and the effective rate was65%. There was statistical significance between the two groups (P<0.05).3Comparison with two groups in side effects: After8weeks treatment, in theintervention group TESS scale average score was (7.45±3.21); non-intervention was(6.21±2.9). There was no significant difference between the two groups in TESS scores(P>0.05). Before and after treatment, there was no significant difference in bloodroutine, liver function, renal function, ECG (P>0.05).4Comparison with the non-intervention group in heart rate: in the intervention group,there were significantly decreased, and appeared at the12th,13th,14th,15th and16thtime.5. Compared with the non-intervention group in low-frequency heart rate variability (LF)value:in the intervention group,there were significantly decreased at the13th,14th, 15th,16th time.6. Compared with the non-intervention group in high-frequency heart rate variability(HF) value: in the intervention group,there were the trend that the HF value increased atthe13th,14th,15th,16th time.7Compared with the non-intervention group in the ratio of LF/HF: in the interventiongroup, there were significantly decreased at the13th,14th,15th and16th time.8Correlation analysis between anxiety severity index and the ratios of LF/HF: Pearsoncorrelation analysis showed that both showed significant positive correlation (r=0.335,P <0.05).Conclusion:1. The presence of high excitability of the sympathetic nervous system in patientswith generalized anxiety disorder, sympathetic and vagus nerve function imbalance.2. Duloxetine combined with Bodhi Tree relaxation technique in the treatment ofgeneralized anxiety disorder, high safety, good compliance, increase efficiency.3. Duloxetine combined with bodhi tree relaxation technique can improve thefrequency index in patients with HRV, indicates that the treatment reduced cardiacsympathetic excitatory, increased cardiac vagal excitatory, which can improve theautonomic nervous activity of patients.