帕罗西汀联合心理干预治疗脑卒中后抑郁的疗效观察

Therapeutic Effects of Paroxetine plus Psychological Treatment on Depression After Cerebral Infarction

目的观察帕罗西汀联合心理干预对脑卒中后抑郁及神经功能康复的影响。方法本院2009年1月-2010年8月住院治疗的恢复期脑卒中后抑郁患者96例随机分为治疗组(帕罗西汀联合心理干预)和对照组(帕罗西汀治疗)。对照组患者给予帕罗西汀20 mg/d,治疗组患者在给予帕罗西汀20 mg/d的基础上进行心理干预,疗程均为8周。两组患者分别在治疗前、治疗4周及8周,分别采用汉密尔顿抑郁量表(HAMD)评定抑郁症状、美国国立卫生院神经功能缺损量表(NIHSS)评定神经功能以及脑卒中专用生活质量评定量表(SS-QOL)评定患者的日常生活质量。结果治疗后两组患者HAMD评分、NIHSS评分和SS-QOL评分均降低,并且治疗组显著低于对照组(P<0.05);治疗组的治疗效果优于对照组(P<0.05)。结论帕罗西汀联合心理干预可明显改善脑卒中后抑郁程度,并能促进神经功能康复,提高患者生活质量。

Objective To observe the effect of paroxetine plus psychological treatment on depression after cerebral infarction and recovery of neurological function. Methods Ninety-six patients with depression in the recovery period of cerebral infarction hospitalized to the First Affiliated Hospital of Medical College of Xi＇an Jiaotong University from January,2009 to August,2010 were randomly divided into treatment group（paroxetine plus psychological treatment） and control group（paroxetine treatment）.The patients in control group received paroxetine 20 mg/d,while the patients in treatment group received paroxetine 20 mg/d plus psychological treatment.The treatment period of the two groups was eight weeks.Before the treat ment and 4 weeks and 8 weeks after the treatment,the patients＇ depression symptoms were evaluated by Hamilton Depression Scale（HAMD）,nervous functions were evaluated by National Institutes of Health Stroke Scale（NIHSS）,and Qualities of life were evaluated by Stroke-specific Quality of Life Scale（SS-QOL）. Results After the treatment,HAMD score,NIHSS score and SS-QOL score of the two groups were significantly decreased（P〈0.05）,and the parameters in treatment group were significantly lower than those in control group（P〈0.05）.The curative effect in treatment group was superior to that in control group（P〈0.05）. Conclusions Paroxetine plus psychological treatment can significantly improve the level of depression after cerebral infarction,promote neurological rehabilitation,and improve the patient＇s quality of life after cerebral infarction.