婚姻治疗对产后抑郁症患者临床疗效的影响

The curative effect of couple therapy for patients with postpartum depression

目的研究给予抗抑郁药合并婚姻治疗对产后抑郁症（PPD）患者的临床疗效。方法将符合诊断标准首次诊断为产后抑郁症的67例患者按初诊序号分为研究组和对照组，分别给予抗抑郁药（盐酸帕罗西汀）联合婚姻治疗或单独应用抗抑郁剂。治疗前与治疗12周后分别进行汉密尔顿抑郁量表、爱丁堡产后抑郁量表和OLSON婚姻质量问卷评定，对比两种方法的疗效。结果（1）从汉密尔顿抑郁量表的评定结果来看，研究组和对照组的总有效率差异无显著性（P〉0．05），而完全缓解率分别为78．6％和46．2％，差异有显著性（P〈0．05）。（2）从汉密尔顿抑郁量表和爱丁堡产后抑郁量表总分来看，2组在治疗前差异无显著性（P〉0．05），而在治疗后研究组低于对照组，差异有显著性（P〈0．05）；而2组治疗前后分别自身对照差异有显著性（P〈0．05）。（3）从OLSON婚姻质量问卷结果来看，从2组治疗后各维度评分除了性生活维度外，其他均差异有显著性（P〈0．05），研究组的婚姻质量改善优于对照组。结论两种治疗方法对产后抑郁症均有明显疗效；抗抑郁药联合婚姻治疗有利于改善婚姻质量，对产后抑郁症疗效优于单独抗抑郁剂治疗。

Objective To investigate curative effect thymoleptics with couple therapy for the patients with postpartum depression （PPD） Methods 27 patients first time diagnosed with PPD consistent with DSM-Ⅳ were randomly divided into study group and control group. The study group received regular thymolepties with couple therapy, a control group were administered solo thymoleptics. Hamilton Depression Rating Scale（ HAMD-17 ） and Edinburgh Postnatal Depression Scale （EPDS-10） and OLSON marriage quality questionnaire assessed the efficacy of each group before treatment and after 12 weeks treatment. Results （1） According to the total effective rate, there was no significantly differences in two groups after 12 weeks treatment from evaluation of HAMD-17 （P〉0.05 ）, but complete remission of study group was higher than control group（78.6% ,46.2% ; P〈0.05 ）. （2） After 12 weeks treatment there were significantly differences in mean scores of HAMD-17 and EPDS-10 between two groups （P〈0.05）. The most decreased scores of HAMD-17 and EPDS-10 was found in the study group,and mean scores of each group was lower than pretherapy（P〈0.05）.（3） There was no significant difference on the scores of eight factors in OLSON marriage quality questionnaire between the two groups before treatment （P〉0.05）. After 12 weeks treatment the study group had higher score than control in seven factors in addition to sexual life factor （P〈0.05）. Conclusion Thymoleptics with couple therapy can improve the marriage quality and increase curative effects outstrip solo thvmoleDtics for the patients with postpartum depression.