道家认知疗法治疗脑卒中后抑郁的临床研究

Effects of Taoist cognitive psychotherapy in the treatment of post stroke depression

目的观察道家认知疗法对脑卒中后抑郁的疗效以及对神经功能康复的影响。方法采用随机对照实验,道家认知疗法合并抗抑郁剂为研究组,单独抗抑郁剂治疗为对照组。在治疗前及治疗后不同时间点观察脑卒中后抑郁患者抑郁症状改善程度及神经功能恢复情况。结果治疗1个月时,研究组HAMD、MESSS及ADL分别为6.48±2.66、14.29±3.93、33.94±4.34,与对照组得分8.13±3.11、17.61±4.01、40.48±3.89相比,差异具有统计学意义(P<0.05);治疗6个月时,研究组HAMD、MESSS及ADL分别为6.93±3.47、10.21±4.69、26.89±4.76,与对照组得分10.54±3.39、13.74±3.17、33.5±3.89相比,差异具有统计学意义(P<0.01);治疗后随访6个月时,研究组HAMD、MESSS及ADL分别为9.23±4.63、8.92±2.49、25.5±3.70,与对照组得分12.81±4.94、13.48±3.54、33.09±5.49相比,差异具有统计学意义(P<0.05),研究组患者抑郁症状改善程度及神经功能恢复均好于对照组。结论道家认知疗法合并抗抑郁剂治疗脑卒中后抑郁优于单独应用抗抑郁剂。

ObjectiveTo test the effects of Taoist cognitive psychotherapy in the treatment of post stroke depression. MethodsA randomized, controlled study involved 68 post stroke depression patients who were randomly assigned to Taoist cognitive psychotherapy (TCP) together with fluoxetine (20mg/d) group and conventional treatment group with fluoxetine (20mg/d) only. The results were assessed with Hamilton depression scale (HAMD) and neurological scale.ResultsThere were significant differences on the 4 weeks of treatment in HAMD, MESSS and ADL between the TCP group and control group(6.48±2.66,14.29±3.93,33.94±4.34,8.13±3.11,17.61±4.01,40.48±3.89, P<0.05) There were significant differences on the 6 months of treatment in HAMD, MESSS and ADL between the TCP group and control group(6.93±3.47,10.21±4.69,26.89±4.76,10.54±3.39,13.74±3.17,33.5±3.89, P<0.01) There were significant differences on the 12 months of treatment in HAMD, MESSS and ADL between the TCP group(9.23±4.63,8.92±2.49,25.5±3.70, 12.81 ±4.94,13.48±3.54,33.09±5.49, P<0.05). ConclusionThe effect of Taoist cognitive psychotherapy is better than fluoxetine (20mg/d) only in the treatment of post stroke depression.