早期康复训练配合帕罗西汀治疗老年人卒中后抑郁的临床研究

The clinical study on the paroxetine and early physical therapy on old patients′ poststroke depression

目的:探讨早期康复训练配合帕罗西汀治疗老年人卒中后抑郁(PSD)的疗效。方法:前瞻性研究我院2008年1月～2010年12月收治的80例PSD患者,按析因设计分为常规治疗、康复治疗、药物治疗及康复联合药物治疗4组,每组20例分别于治疗前后使用汉密尔顿抑郁量表(HAMD)、神经功能缺损评分(SSS)、Fugl-Meyer运动功能评分(FMA)、Borthel指数(BI)评价患者的抑郁程度、神经功能缺损程度、运动功能及日常生活的活动能力。结果:治疗后,康复联合药物治疗组患者的HAMD、SSS、FMA、BI评分均显著优于常规治疗组、康复治疗组及药物治疗组。结论:早期康复训练配合帕罗西汀治疗能显著改善老年人卒中后抑郁患者的抑郁程度,促进其神经功能恢复,提高运动功能及日常生活活动能力。

Objective：To observe the curative effect of paroxetine and early physical therapy on poststroke depression（PSD） of old patiants.Methods：80 PSD patients treated in our hospital from January 2008 to December 2010 were divided into four groups according to the reasons,which were conventional therapy group,rehabilitation therapy group,medicine therapy group and rehabilitation combined medicine therapy group.To evaluate the depression degree,neurological deficit,motor function and activities of daily living by HAMD,SSS,FMA,BI scale before and after treatment.Results：The scores of HAMD,SSS,FMA,BI indicated that the patients who were treated by rehabilitation combined medicine therapy expressed better results than that treated by conventional therapy,rehabilitation therapy and medicine therapy.Conclusion：Early physical therapy and paroxetine can significantly reduce the depression degree of poststroke depression of old patients,stimulate nerve function recovery,and improve the motor function and activities of daily living.