氟西汀联合理情行为疗法治疗脑卒中后抑郁的疗效观察

Clinical effects of fluoxetine combined with rational-emotive-behavior therapy for patients with post stroke depression

目的探讨氟西汀联合理情行为疗法治疗脑卒中后抑郁的临床疗效。方法 110例脑卒中后抑郁患者随机均分为观察组和对照组,对照组给予氟西汀20 mg/d口服+常规治疗,观察组在对照组的基础上联合理情行为疗法。观察两组治疗前、治疗15 d、30 d、60 d的神经功能缺损程度评分(NIHSS评分)、Barthel指数及汉密尔顿抑郁量表(HAMD)评分的变化,记录治疗60 d的效果。结果治疗前、治疗15 d两组的NIHSS评分、Barthel指数、HAMD量表评分比较差异无统计学意义(P>0.05);治疗30 d、60 d,观察组的NIHSS评分(5.4±2.7,3.1±1.2)、HAMD量表评分(15.3±4.2,9.8±2.3)和Barthel指数(44.5±7.6,75.8±12.3)分别明显低于和高于对照组的(7.7±3.7,5.5±1.1)、(21.5±7.5,14.8±3.9)和(34.7±6.5,60.8±10.4)(P<0.05)。观察组治疗有效率为85.5%,高于对照组的69.1%(P<0.05)。结论氟西汀联合理情行为疗法治疗脑卒中后抑郁具有较好的临床疗效。

Objective To observe the clinical effects of fluoxetine combined with rational-emotive-behavior therapy for patients with post stroke depression.Methods 110 cases of post stroke depression patients were randomly divided into observation group and control group,control group was given fluoxetine 20 mg/d oral ＋ conventional treatment,observation group received rational-emotive-behavior therapy on the basis of the control group.The changes of neurological deficit score（NIHSS score）,Barthel Index and the Hamilton Depression Scale （HAMD）score were observed before and after treatment of 15 d,30 d,60 d in two groups,the effect was recorded after treated for 60 d.Resuits There was no significant difference in NIHSS,Barthel Index,HAMD Scale score before and after treatment of 15 d （P ＞ 0.05）.The scores of NIHSS （5.4 ＋ 2.7,3.1 ＋ 1.2）,HAMD （15.3 ± 4.2,9.8 ± 2.3） and Barthel index （44.5 ＋ 7.6,75.8 ± 12.3）were significantly lower and higher in observation group than those[（7.7 ＋ 3.7,5.5 ± 1.1）,（21.5＋ 7.5,14.8 ± 3.9）,（34.7 ＋ 6.5,60.8 ± 10.4）] in control group after treatment of 30 d,60 d （P ＜ 0.05）.The therapy effective rate in observation group （85.5 ％） was higher than that in control group （69.1％） （P ＜ 0.05）.Conclusion Fluoxetine combined with rational-emotive-behavior therapy for patients with post stroke depression has better clinical efficacy.