老年脑卒中后抑郁的综合治疗观察

Effect of comprehensive therapy on depression post stroke

目的观察不同治疗方法对脑卒中后抑郁患者的抑郁症状以及日常生活活动能力改善的影响。方法68例首次发病的急性脑卒中并伴有抑郁症状的患者,随机分为综合治疗组和对照组。对照组仅采用Bobath法,综合治疗组在Bobath法的基础上,加用中药舒郁散、针刺治疗抑郁症状。两组治疗前、治疗中、治疗后采用汉密尔顿抑郁量表(HAMD)、日常生活活动能力(ADL)评分进行疗效评定。结果治疗3周后,两组HAMD、ADL评分较治疗前有好转,但无显著性差异;治疗6周后综合治疗组的HAMD、ADL积分的变化较治疗前有明显好转,并优于对照组(P<0·05)。结论中药舒郁散、针刺治疗可以缓解脑卒中后抑郁患者的抑郁症状,促进日常生活活动能力的恢复,优于单纯采用Bobath法。

Objective To observe the effect of rehabilitation on post stroke depression with different treatment methods. Methods 68 post stroke depression patients were randomly divided into treatment group, who accepted Bobath approach combined with Chinese herbs and acupuncture, and,control group, who accepted Bobath approach only. Evaluation was conducted before treatment and 3 and 6 weeks after treatment with Hamilton Assess Depression Scale （HAMD）, and activity of daily living （ADL）. Results There was no significant difference before the treatment between these two groups. 3 weeks after treatment, the score improved, but no significant enough in the both groups. 6 weeks after treatment, the scores of MBI and HAMD in treatment group significantly improved compared with that before treatment（P〈0.05）. Conclusion Bobath approach combined with Chinese medicine is effective on improving depressive symptoms and ADL in post stroke depression patients.