舍曲林早期联用氟哌噻吨美利曲辛治疗卒中后抑郁患者的疗效观察

Observation of therapeutic effects of the early combination of sertraline and flupentixol melitracen in treatment of post-stroke depression

目的:探讨舍曲林在治疗卒中后抑郁患者的早期联用氟哌噻吨美利曲辛的疗效。方法:将90例患者随机分为两组,联合用药组采用舍曲林联用氟哌噻吨美利曲辛治疗,两周后停用氟哌噻吨美利曲辛;对照组仅予舍曲林治疗。于治疗前及治疗第1、2、4周末进行HAMD、NIHSS及BI指数评分。结果:与治疗前相比,两组治疗后的HAMD、NIHSS评分均随着治疗时间下降,BI指数随着治疗时间逐渐好转,差异均有统计学意义(P<0.05);联合用药组于治疗1、2周末的HAMD、NIHSS评分较对照组下降更明显,BI指数评分较对照组好转更明显,差异有统计学意义(P<0.01);两组于治疗4周末的HAMD、NIHSS评分,BI指数比较差异无统计学意义(P>0.05);联合用药组的不良反应发生率少于对照组,差异有统计学意义(P<0.05)。结论:卒中后抑郁患者给予舍曲林早期联合氟哌噻吨美利曲辛治疗,起效快,抗抑郁效果好,不良反应减少,依从性好,有利于神经功能的康复及日常生活能力的恢复。

Objective： To explore clinical effectiveness of early combination sertraline and flupentixol melitracen in the treatment of post-stroke depression. Methods： Ninety patients were randomly divided into two groups, combined treatment group （ treated with combination of sertrline and flupentixol melitracen for 2 weeks and then treated with sertraline for 2 weeks） and control group （ with sertraline） for four weeks. All the patients were scored by Hamilton Depression Scale （HAMD） ,National Institutes of Health Stroke Scale （NIHSS） and Barthel index （BI） scores before treatment and at the end of 1st, 2nd, and 4th week after treatment. Results： Compared with pre-treatment in both groups, the HAMD,NIHSS scores after treatment were decreased with treatment time （ P 〈 0.05 ）, the BI index with the treatment time gradually improved and there were more significant difference （ P 〈 0.05 ）. there were more significant difference of HAMD, NIHSS and BI scores at the end of 1 st and 2nd week between 2 groups. There were little difference at the end of 4th week （P 〉 0.05 ）. The incidence of adverse effects in combined treatment group were signifi- cantly less than the control group （ P 〈 0.05 ）. Conclusion： The early combination of sertraline and flu- pentixol melitracen in the treatment of post-stroke depression works fast and has better clinical effectiveness, less adverse effects, better compliance, and is conductive to the rehabilitation of neurological function and activities of daily living recovery.