帕罗西汀治疗脑卒中后抑郁症疗效研究

Effect of paroxetine in the treatment of patients with poststroke depression

目的探讨帕罗西汀对卒中后抑郁、焦虑患者日常生活能力和神经功能康复的影响。方法采用抑郁自评量表(SDS)、焦虑自评量表(SAS)对272例脑卒中患者进行抑郁、焦虑状态评定,其中患有卒中后抑郁合并焦虑的81例患者分别接受帕罗西汀治疗、帕罗西汀联合心理干预治疗以及不干预。采用斯堪的那维亚脑卒中量表(SSS)、Barthel指数(BI)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评测治疗前后的疗效。结果急性脑卒中病人卒中后抑郁并焦虑患病率为2978%,抑郁与焦虑共病率为65.85%;治疗组I和治疗组ⅡHAMD、HAMA、SSS评分减少和BI评分增加与对照组比较均有显著性差异(P<0.01)。结论卒中后抑郁、焦虑病人给予帕罗西汀治疗能提高患者神经功能康复程度和生活能力恢复。

Objective To study the effects on post stroke depression patients treated with paroxetine. Methods In this study, a total of 272 patients with acute brain stroke were assessed with SDS, SAS. Of these 272 patients 81 who meet the criteria of depression and anxiety after acute brain stroke of ICD-10 were recruited. These 81 patients were treated with routine antistroke medication （Control group）, routine antistroke medication with Paroxetine （Group Ⅰ ） and routine antistroke medication with Paroxetine joint psychotherapy （Group Ⅱ ） respectively for 6 weeks. The rating scales such as SSS, HAMD, HAMA, and BI and so on were used to evaluate the symptoms improvement and side effects. Results The rate of poststroke depressive combined with anxiety in acute stroke was 29.78%, the comorbidity was 65.85%. According to the decline of SSS score, HAMD score, HAMA score, and increase of BI score of the patients, significant improvement has been showed in all patients. There were significant difference between trial group Ⅰ or trial group Ⅱ and the controlled group （P 〈 0 01）. Conclusions All of the three projects had effects on the patients with Poststroke depression with anxiety, routine antistroke medication with Paroxetine is better.