艾司西酞普兰联合认知疗法对脑卒中后抑郁及神经功能的影响

The Effects of Escitalopram Combined with Cognitive Therapy on Post- stroke Depression and Nerve Function

目的研究艾司西酞普兰联合认知疗法对脑卒中后抑郁及神经功能的影响。方法随机将60例确诊为脑卒中后抑郁的患者分为研究组和对照组各30例,研究组给予艾司西酞普兰20mg/d联合认知疗法,对照组仅单用艾司西酞普兰20mg/d治疗,疗程6周。用汉密尔顿抑郁量表(HAMD)在治疗前及治疗后2、4、6周末评定疗效,脑卒中神经功能缺损量表(NIHSS)评定神经功能缺损,副反应量表(TESS)评定不良反应。结果从治疗第2周开始,两组间HAMD、NIHSS评分比较差异有统计学意义(t=-3.081,-2.690;P<0.05或0.01);在治疗的第6周末,两组间HAMD及NIHSS评分比较均有显著统计学意义(t=-3.254,-3.192;P<0.01)。两组药物不良反应发生率差异无统计学意义。结论艾司西酞普兰联合认知疗法治疗脑卒中后抑郁起效较快,效果更好,对患者神经功能的改善更为明显。

Objective To investigate the effects of escitalopram combined with cognitive on post- stroke depression（ PSD） and nerve function. Methods Sixty patients with PSD after cerebral stroke were randomized into study and control groups. The study group accepted escitalopram 20 mg / d and cognitive therapy for 6 weeks. And the control group only accepted escitalopram. Side effects and clinical effects were evaluated at 2nd,4th,6th week after treatment with Hamilton Depression Scale（ HAMD） and National Institute of Health stroke scale（ NIHSS） and Treatment Emergent Side Effect Scale（ TESS）. Results The HAMD and NIHSS scores were significantly different between the study group and control group at the end of the 2nd week（ t =-3. 081,-2. 690; P 0. 05 and 0. 01）. The HAMD and NIHSS scores lwere significantly drfferant betreen the study group than in the control group at the end of the 6th week.（ t =-3. 254,-3. 192; P 0. 01）. Adverse reactions of both groups were equivalence. Conclusion Escitalopram combined with cognitive therapy takes effects quicker and have better efficacy on post- stroke depression and nerve function.