强化心理治疗联合万拉法新对卒中后抑郁患者神经缺损的影响

Effect of Venlafaxine plus strengthening psychotherapy on neurologic defect of patients with post-stroke depression

目的 探讨强化心理治疗联合万拉法新对急性卒中后抑郁患者神经缺损的影响.方法 将126例急性脑卒中后并发早发性抑郁症患者按入选顺序随机分为对照组、万拉法新组和强化心理治疗＋万拉法新组（联合治疗组）,每组各42例.在治疗前,治疗4周、6周及90 d随访时对各组患者分别采用汉密尔顿（HAMD）抑郁量表、美国国立卫生研究院卒中（NIHSS）量表及Barthel指数量表进行疗效评价.结果 治疗前3组患者NIHSS评分及Barthel指数评分差异无统计学意义（P〉0.05）,治疗4周、6周及90 d随访时联合治疗组HAMD评分、NIHSS评分及Barthel指数评分较对照组、万拉法新组明显改善,差异均有统计学意义（P〈0.05）.结论 强化心理治疗作为抗抑郁药物治疗的辅助措施能显著增加卒中后抑郁患者的康复机会,疗效也更持久和稳定,能明显提高卒中患者的生活质量.

Objective To evaluate the effect of Venlafaxine plus psychotherapy on neurologic defect of patients with post-stroke depression （PSD）. Methods One hundred and twenty-six patients with PSD were equally randomized into control group （treating with ordinary medicine and rehabilitation）, Venlafaxine treatment group （ordinary treatment combined with venlafaxine） and therapeutic alliance group （ordinary treatment combined with venlafaxine and psychotherapy）. The Hamilton Depression Rating Scale （HAMD）, Barthel index （BI） and NIHSS were employed to evaluate the treatment efficacy before the treatment, 4 and 6 week and 90 d after the treatment. Results No significant differences in NIHSS scores and Brothel indexes among the 3 groups were noted before the treatment （P〉0.05）. Four and 6 week and 90 d after the treatment, the HAMD scores, NIHSS scores and Barthel indexes in the therapeutic alliance group improved significantly as compared with those in control group and Venlafaxine treatment group （P〈0.05）. Conclusion Strengthening psychotherapy, as an assistant measure of anti-depression drug therapy, can obviously increase the rehabilitation patents＇chances and heal efficacy. It is lasting, stable, and worth to popularizing, and can improve the life quality of stroke patients.