早期抗抑郁治疗对脑卒中患者康复的疗效观察

Efficacy of early antidepressant therapy on the rehabilitation of stroke patients

目的观察早期抗抑郁治疗对脑卒中患者康复的疗效。方法选取我院内科住院的脑卒中患者72例,随机分为对照组与研究组,对照组只给予单纯物理治疗,研究组采用物理治疗+药物治疗(氟西汀)+心理治疗。比较2组治疗前及治疗后1个月的汉密尔顿抑郁量表(HAMD)评分及Zung抑郁自评量表评分,并采用Barthel指数比较2组患者的日常活动能力,评估2组患者的神经功能缺损情况。结果治疗前2组患者HAMD评分及Zung评估比较差异无统计学意义(P>0.05)。而1个月后研究组HAMD评分(11.32±1.21)及Zung评分(12.42±2.64)均明显低于对照组。而研究组Barthel指数评分(58.61±6.25)也明显低于对照组(67.42±4.52)。经治疗后对照组神经功能缺损(17.28±3.22)明显比对照组(11.32±2.12)严重。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论对于脑卒中患者,早期抗抑郁治疗有助于减轻患者的抑郁程度,提高日常活动能力,减轻神经功能缺损程度。

Objective To observe the efficacy of early antidepressant therapy on the rehabilitation of stroke patients. Methods A total of 72 stroke patients were randomly divided into control group and study group, the control group was only given physical therapy alone. The study group was treated with physical therapy ＋ medication （fluoxetine） ＋ psychotherapy. Hamilton Depression Scale （HAMD） score and Zung Self Rating Scale score were compared before and one month after treatment of the two groups, and Barthel index score was compared in patients with activities of daily living, and the neurological deficit of patients in two groups was assessed. Results Before treatment, HAMD and Zung assessment of the two groups showed no significant statistically difference. The HAMD score （ 11.32±1.21） and Zung score （ 12.42±2.64） of study group after one month were significantly lower than the control group. Barthel index of the study group （58.61± 6.25） was also significantly lower than the control group （67.42±4.52）. The neurological deficit of control group after treatment （17.28± 3.22） was higher than the control group （11.32±2.12）. The incidence of adverse reactions of the two groups had no signifi- cant difference. Conclusion For stroke patients, early antidepressant treatment can alleviate the patient＇s severity of depression, and improve the activities of daily living, reduce the degree of neurological deficits.