氟西汀治疗脑梗塞后抑郁障碍临床观察

Clinical observations of fluoxetine in post-cerebral-infarction depression

目的探讨氟西汀治疗脑梗塞后抑郁障碍的疗效及安全性。方法将98例脑梗塞后抑郁障碍患者随机分为研究组52例,对照组46例,两组均在脑梗塞常规治疗及心理治疗基础上分别给予氟西汀和阿米替林治疗3 mo。于治疗前及治疗1 w,2 w,4 w,6 w末采用汉密顿抑郁量表及欧洲卒中量表评定临床疗效。结果研究组治疗2w末汉密顿抑郁量表及欧洲卒中量表评分较治疗前显著下降(P<0.05),对照组4w末显著下降(P<0.05),两组间同期比较有显著性差异(P<0.05)。研究组未发现明显不良反应,对照组有43%出现口干、便秘、乏力、嗜睡等不良反应。结论氟西汀治疗脑梗塞后抑郁障碍较阿米替林起效快,疗效显著,安全性高,依从性好。

Objective To explore the curative effect and safety of fluoxetine in the treatment of post-cerebral-infarction depression. Methods 98 patients were randomly divided into research group（n = 52） taking routine treatment and psychotherapy combining fluoxetine and control group（n= 46 ） combining amitriptyline for 3 months. Curative effects were assessed with the HAMD and Europe Stroke Scale（ESS） before treatment and at the ends of lst,2nd,4th and 6rh week treatment. Results Compared with pre-treatment, scores of both the HAMD and significantly decreased at the end of the 2nd week in the research group（P〈0.05） and at the end of 4th week in the control group（P〈0.05）,comparisons of the 2 groups in the corresponding period showed significant difference（P〈0.05）. The research group had no adverse effects, 43% of the controls showed up dry mouth, constipation, debilitation, drowsiness etc. Conclusion Fluoxetine takes effect faster and has notable curative effect, higher safety and better compliance in the treatment of post-cerebral-infarction depression.