卒中后抑郁两种治疗方法效果评价

Evaluation of Therapetic Effects of Psychotherapy Alone and Combined with Prozac on Post-stroke Depression

目的研究卒中后抑郁(PSD)患者经抗抑郁治疗后抑郁好转及生活质量改善的状况,比较单纯心理治疗与心理治疗联合盐酸氟西汀(百忧解)治疗对于不同抑郁程度患者的治疗效果。方法收集急性脑卒中并发抑郁患者70例,入院后将患者分为两组,单纯心理治疗组给予单纯心理治疗,联合治疗组给予心理治疗和百忧解治疗。入院后进行汉密尔顿抑郁量表21项、中风病患者生存质量量表(QOLIS 1.0版)评分。结果应用重复测量方法比较,可知随着时间的推移单纯心理治疗组和联合治疗组患者抑郁程度均明显减轻,生活质量均明显提高。采用非参数检验分别比较轻度抑郁患者和中重度抑郁患者,经单纯心理治疗或联合治疗后,轻度抑郁患者两种治疗方法治疗效果无统计学意义,而中重度抑郁患者两种治疗方法治疗效果有统计学意义,联合治疗优于单纯心理治疗。结论卒中后抑郁患者经单纯心理治疗或心理治疗联合百忧解治疗后,抑郁程度明显减轻,生活质量均明显改善。

Objective To study the quality of life and the improvement of the depression following the antidepressant therapy by psychotherapy alone and combined with prozac in post-stroke patients（pts） with depression.Methods Seventy pts suffered from acute stroke with depression were collected and divided into two groups：Psychotherapy alone group and psychotherapy combined with Prozac group.Hamilton depression rating scales-21 and quality of instruments for stroke patients（QOLISP 1.0） were used for evaluation in all pts after admission.Results By repeating survey method,the degree of depression in two groups was lower,and the quality of life was higher with time passing（P0.05）.By non-parameter method to compare the therapeutic effect,there was no differences in pts with mild depression,but there was differences in therapeutic effect for the pts with moderate or severe depression.The effect of psychotherapy with Prozac was better than that of psychotherapy alone.Conclusion Following psychotherapy alone or psychotherapy combined with prozac,depression level of pts showed significantly decreased and the quality of life was improve significantly.Psychotherapy alone was effective for pts with mild depression,and psychotherapy with prozac were effective for pts with moderate or severe depression.