帕罗西汀治疗卒中后焦虑的疗效观察

The Clinical Efficacy of Paroxetine in Patients with Post-Stroke Anxiety

目的:观察帕罗西汀治疗卒中后焦虑及对神经功能恢复的疗效。方法:将脑卒中后94例患者随机分为2组,治疗组49例和对照组45例。2组均给予卒中常规治疗,治疗组加用盐酸帕罗西汀每日20mg晨起顿服,总疗程8周。对照组加用劳拉西泮0.5mg,每日3次,总疗程8周。治疗前、治疗8周后观察汉密尔顿焦虑量表评分(HAMA)、神经功能缺损评分(NIHSS),治疗8周后观察临床疗效总评量表(CGI)中的疗效总评(GI)及疗效指数(EI)。结果:治疗组与对照组在治疗前HAMA分别为27.4±7.1、26.5±6.8,治疗后分别为10.3±4.2、19.6±5.8;治疗前NIHSS分别为14.1±6.4、13.3±5.5,治疗后分别为4.4±2.0、8.5±3.1;2组HAMA、NIHSS均较治疗前下降(P<0.01),治疗8周后治疗组均低于对照组(P<0.01)。治疗后治疗组GI低于对照组(1.78±0.64vs2.12±0.91,P<0.05),EI高于对照组(3.43±1.26vs2.11±1.08,P<0.01)。结论:帕罗西汀有利于脑卒中后焦虑患者心理及躯体神经功能恢复,安全性好。

Objective：To evaluate the clinical efficacy of Paroxetine in patients with post-stroke anxiety（PSA）.Methods：Ninety-four patients with PSA were randomly divided into two groups,treatment group（n=49） and control group（n=45）.The routine management？was given to patients with stroke in two groups.Paroxetine hydrochloride（20 mg/d for 8 weeks） was added to the treatment in patients of treatment group.Lorazepam（0.5 mg,3 times/d for 8 weeks） was added to the therapy in patients of control group.The NIHSS and HAMA scales were estimated before and after treatment in patients of two groups.The scales of GI and EI of CGI were detected after 8-week treatment.Results：The scores of NIHSS and HAMA were 27.4±7.1 and 26.5±6.8 before treatment in patients of two groups.After 8-week treatment,the scores were 10.3±4.2 and 19.6±5.8.The scores were significantly higher before treatment in treatment group（14.1±6.4） and control group（13.3±5.5） than those after treatment in two groups（4.4±2.0 and 8.5±3.1,P 0.01）.But the scores of NIHSS and HAMA were significantly lower after 8-week treatment in treatment group than those of control group（P 0.01）.The score of GI was lower in treatment group than that in control group（1.78±0.64 vs 2.12±0.91,P 0.05）,but the score of EI was higher in treatment group than that of control group（3.43±1.26 vs 2.11±1.08,P 0.01）.Conclusion：Paroxetine is likely to help patients with post-stroke anxiety.