心理治疗与5-羟色胺再摄取抑制剂对脑卒中后抑郁患者神经功能康复的影响

Psychotherapy and serotonin reuptake inhibitor for rehabilitating nerve function after stroke

目的比较常规治疗、心理治疗、5-羟色胺再摄取抑制剂、心理治疗合并5-羟色胺再摄取抑制剂治疗这4种不同方法对脑卒中后抑郁患者神经功能康复的影响。方法120例脑卒中后抑郁患者随机分为4组,分别为常规治疗组(A组)、5-羟色胺再摄取抑制剂治疗组(B组)、心理治疗组(C组)和心理治疗并5-羟色胺再摄取抑制剂治疗组(D组),分别于治疗前、后用Zung量表(SDS)进行抑郁程度评定和用斯堪的那维亚卒中量表(MESSS)进行肌力评定。结果在治疗8周后,各种抗抑郁治疗对抑郁有明显的改善,其中以D组最为明显；但各组肌力改善均直至第12周才有统计学意义,且亦以D组最为显著。结论心理治疗并5-羟色胺再摄取抑制剂对脑卒中后抑郁神经功能康复有明显的疗效。

Objective To compare the efficacy of conventional therapy, psychotherapy, serotonin reuptake inhibitor, and psychotherapy combined with serotonin reuptake inhibitor in rehabilitating nerve function in the treatment of post-stroke depression. Methods One hundred and twenty patients with post-stroke depression were divided into a control group（A）, a group treated with serotonin reuptake inhibitor（ B ）, a psychotherapy group （C） and a group in which psychotherapy was combined with serotonin reuptake inhibitor（D）. These groups were graded with the SDS for the degree of their depression and with the MESSS for their muscle strength before andafter treatment. Results The anti-depression therapies showed significantly different effects in improving depression. After eight weeks, group D showed significantly less depression than the others. However, muscle strength did not show statistically significant differences until twelve weeks, when group D again showed better progress than the others. Conclusion Psychotherapy combined with serotonin reuptake inhibitor can promote the rehabilitation of nervous function-after stroke.