摘要

摘要
目的 探讨认知行为治疗（Cognitive Behavioral Therapy,CBT）联合帕罗西汀对难治性抑郁症（Treatment-Resistant Depression，TRD）合并高血压患者执行功能的干预效果。

方法 回顾性分析2024年1月至2025年1月宁夏回族自治区宁安医院60例TRD合并高血压患者，对照组（28例）采用帕罗西汀治疗，观察组（32例）联合CBT治疗。比较两组汉密尔顿抑郁量表-17项（Hamilton Depression Rating Scale-17, HAMD-17）评分、临床总有效率、Stroop色词干扰测试（Stroop Color-Word Test,SCWT）执行功能指标、血压水平、脑源性神经营养因子（Brain-Derived Neurotrophic Factor,BDNF）、白细胞介素-6（Interleukin-6，IL-6）、肿瘤坏死因子-α（Tumor Necrosis Factor-α,TNF-α）、健康调查简表（Short Form-36 Health Survey,SF-36）及工具性日常活动能力量表（Instrumental Activities of Daily Living,ADL）评分。

结果 治疗后，观察组HAMD-17评分显著低于对照组，临床总有效率（93.75%）显著高于对照组（75.00%）（P<0.05）。观察组干扰条件反应时间、干扰效应量、错误率及血压水平均显著低于对照组（P<0.05）。观察组BDNF显著升高，IL-6、TNF-α显著降低（P<0.05）。两组不良反应率无显著差异（P>0.05）。观察组SF-36、ADL评分显著高于对照组（P<0.05）。

结论 CBT联合帕罗西汀可显著改善TRD合并高血压患者的抑郁症状、执行功能及血压控制，提升生活质量，且安全性良好。

关键词：关键字：认知行为治疗，帕罗西汀，抑郁症，高血压，执行功能

ABSTRACT

Abstract
Objective To investigate the intervention effects of cognitive behavioral therapy (CBT) combined with paroxetine on executive function in patients with treatment-resistant depression (TRD) and hypertension.

Methods A retrospective analysis was conducted on 60 TRD patients with hypertension at Ning'an Hospital from January 2024 to January 2025. The control group (n=28) received paroxetine, while the observation group (n=32) received combined CBT. Outcomes included Hamilton Depression Rating Scale-17 (HAMD-17), clinical efficacy, Stroop Color-Word Test (SCWT), blood pressure, brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), Short Form-36 Health Survey (SF-36), and Instrumental Activities of Daily Living (ADL) scores.

Results After treatment, the observation group showed significantly lower HAMD-17 scores and higher clinical efficacy (93.75% vs. 75.00%) than controls (P<0.05). Interference reaction time, interference effect, error rate, and blood pressure were significantly lower in the observation group (P<0.05). BDNF increased significantly while IL-6 and TNF-α decreased (P<0.05). Adverse reaction rates showed no significant difference (P>0.05). SF-36 and ADL scores were significantly higher in the observation group (P<0.05).

Conclusion   CBT combined with paroxetine significantly improves depressive symptoms, executive function, and blood pressure control in TRD patients with hypertension, with favorable safety profiles.

Key words: Keywords: Cognitive Behavioral Therapy, Paroxetine, Depression, Hypertension, Executive Function