帕罗西汀并心理干预治疗卒中后抑郁和焦虑共病者81例临床观察

A Clinical Trial of Paroxetine and Psychotherapy in Patients with Poststroke Depression and Anxiety

目的:探讨脑卒中后抑郁和焦虑共病对患者生活能力和神经功能康复的影响,及帕罗西汀合并心理十预临床疗效。方法:将脑卒中伴抑郁和焦虑障碍共病者81名随机分成3组,分别接受单用帕罗西汀治疗(A 组)、帕罗西汀并心理治疗(B 组)以及单用脑血管药物治疗(C 组)。采用斯堪的那维亚脑卒中量表、Barthel 指数、汉密尔顿抑郁量表、汉密尔顿焦虑量表评估疗效。结果:脑卒中患者中,抑郁和焦虑的共病率为65.9%,A 组、B 组各项评分与C 组比较,差异均有统计学意义。结论:卒中后抑郁和焦虑病人单用帕罗西汀或合并心理治疗均能促进患者神经功能康复和提高生活质量,且帕罗西汀并心理干预的疗效更好。

Objective：To study the efficacy ofparoxetine and psychotherapy in patients with poststroke depression and anxiety. Methods： 81 patients who met the CCMD-3 criteria of depression and anxiety after acute brain stroke were recruited and randomized into 3 groups. Group A was treated with routine antistroke medication and paroxetine; Group B was treated with routine antistroke medications, paroxetine plus psychotherapy; Group C （ control ） was treated with routine antistroke medication. All patients were treated for 6 weeks and evaluated with SSS, HAMD, HAMA as measures of efficacy and side effects. Results：The comorbidity rote of poststroke depression and anxiety was 65.9%. According to the reduction of SSS, HAMD and HAMA scores, and increase of BI score, significant improvement has been showed in all patients. There was significant difference among group A, B and the control group （P 〈0.05）. Conclusion： In patients with poststroke depression and anxiety, routine antistroke medication, paroxetine plus psychotherapy is more effective than routine antistroke medication and paroxetine.