心理干预联合抗抑郁药治疗脑卒中后抑郁的临床研究

A Clinical Study of Psychotherapy Combined with Antidepressants Treatment of Post-stroke Depression

目的:研究心理干预联合抗抑郁药治疗卒中后抑郁(PSD)的临床疗效。方法:将60例PSD患者随机分为心理干预组和对照组各30例,2组均给予常规脑血管病治疗,心理干预组还给予心理干预,疗程均为6周。使用汉密尔顿抑郁量表(HAMD)、美国国立卫生院神经功能缺损评分(NIHSS)和日常生活活动量表(ADL)评价抑郁程度、神经功能及日常生活能力。结果:治疗6周后,2组的痊愈率、有效率和HAMD评分无统计学差异。在治疗2、4周后,心理干预组的HAMD评分改善程度高于对照组(P<0.01),治疗6周后心理干预组的NIHSS评分明显低于对照组(P<0.01),ADL评分明显高于对照组(P<0.01)。结论:心理干预联合抗抑郁药能快速改善PSD患者的抑郁症状,促进神经功能恢复,提高患者日常生活能力。

Objective： To study the effects of psychotherapy combined with antidepressants in treating post-stroke depression （PSD）. Methods： A total of 60 PSD patients were divided into groups psychological and control （n=30） randomly. All the patients were given conventional treatment of cerebral vascular disease, and the psychological group was given psychotherapy. The course of treatment was 6 weeks for 2 groups. Hamilton De- pression Rating Scale （HAMD）, National Institute of Health Stroke Scale （HIHSS） and Activity of Daily Living Scale （ADL） were employed to measure the effort of treatment, neurological function and capability of daily self-care. Results： After six weeks treatment, there were no statistically significant difference in the reminssion, efficiency and HAMD scores between the 2 groups. The improvement of HAMD scale in psychological group were much better than control group in 2 weeks and 4 weeks （P〈0.01）, the scale of NIHSS in psychological group were lower than control group （P〈0.01）, and the ADL scale in psychological group were higher than con- trol group （P〈0.01）. Conclusion： Antidepressants combined with psychotherapy could improve the symptom of PSD rapidly, rehabilitate the neurological function and the ability of daily self-care.