抗抑郁治疗对脑卒中后心理及神经功能恢复的作用

Effect of anti-depressive therapy on the rehabilitation of psychological and neurological function after stroke

目的:探讨脑卒中后抑郁者是否需合并抗抑郁剂治疗及不同抗抑郁剂对脑卒中后心理及神经功能恢复的影响。方法:对90例患者随机分为3组。完成观察治疗者87例。对3组患者均在治疗前及治疗后2,4,8,12周分别采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、神经功能缺损程度量表(CNS)及修订的巴氏指数量表(MBI)进行评分。结果:治疗12周后CNS评分比较,帕罗西汀组与对照组比较差异有显著性意义(P<0.01),丙米嗪组与对照组及帕罗西汀组与丙米嗪组比较差异均无显著性意义(P>0.05)。MBI评分比较,帕罗西汀组与对照组比较差异有显著性意义(P<0.01),丙米嗪组与对照组及帕罗西汀组与丙米嗪组比较差异均无显著性意义(P>0.05)。HAMD评分比较,帕罗西汀组与对照组比较差异有高度显著性意义(P<0.001),丙米嗪组与对照组比较差异有显著性意义(P<0.01),帕罗西汀组与丙米嗪组比较差异无显著性意义(P>0.05)。HAMA评分比较,帕罗西汀组与对照组及丙米嗪组与对照组比较差异均有显著性意义(P<0.01),帕罗西汀组与丙米嗪组比较差异无显著性意义(P>0.05)。帕罗西汀与丙米嗪对焦虑、抑郁症状有效率为87%及85%,明显优于对照组缓解率47%,帕罗西汀、丙米嗪和对照组神经功能恢复的有效率分别为90%,70%,57%(帕罗西汀组与对照组比较,P<0.01,丙?

AIM:To investigate whether anti-depressive therapy is needed for patients with post-stroke depression or not,and the effect of different anti-depressive drugs on the rehabilitation of psychological and neurological function after stroke. METHODS:Ninety patients were randomly divided into three groups.Among them,87 patients were observed successfully. Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),Chinese neurologic impairment scale(CNS) and modified Barthel index(MBI) were used to evaluate the scores of patients in three groups before and after two-week, four-week,eight-week and twelve-week treatment. RESULTS:The scores of CNS in Seroxat group were significantly different from that in control group after twelve-week treatment(P< 0.01),however,the score in Imipramine group was not significantly different from that in Seroxat group and control group(P >0.05).The score of MBI in Seroxat group was significantly different from that in control group(P< 0.01),however,the score in Imipramine group was not significantly different from that in Seroxat group and control group(P >0.05).The score of HAMD in Seroxat group was greatly significantly different from that in control group(P< 0.001),and the score in Imipramine group was significantly different from that in control group(P< 0.01),but the score in Seroxat group was not significantly different from that in Imipramine group(P >0.05).The scores of HAMA in Seroxat group were significantly different from that in control group,and the score in Imipramine group was significantly different from the score in control group(P< 0.01),however,that in Seroxat group was not significantly different from that in Imipramine(P >0.05).The effective rates of Seroxat and Imipramine on anxiety and depression were 87%and 85.1%respectively, which was obviously superior to the remission rate(47%) in control group.The effective rates of the neurological functional recovery were 90%,70%and 57%respectively in Seroxat, Imipramine and control group(P< 0.01,Seroxat group vs control group;P >05,Imipramine group vs control group). CONCLUSION:The treatment of anti-depression needs for patients with psychological disorder after stroke,and the effects of both Seroxat and Imipramine are similar against anxiety and depression.The former one has few side effects and good compliance,which is good for the improvement of neurological function.