艾司西酞普兰联合意象对话治疗卒中后抑郁的临床疗效观察

Clinical observation of escitalopram combined with imagery dialogue in treatment of post-stroke depression

目的观察艾司西酞普兰联合意象对话对卒中后抑郁症状及神经功能缺损的临床疗效。方法保定市急救中心2012年1月—2013年7月符合纳入标准的卒中后抑郁患者108例,随机分成药物组(36例)、心理组(36例)和联合组(36例),分别给予艾司西酞普兰、意象对话治疗及两者联合治疗,在治疗前,治疗后1个月及2个月分别评测抑郁程度HAMD及神经功能缺损NFI评分,比较3组患者的临床疗效。结果经治疗后,3组患者的HAMD及NFI评分均较治疗前明显下降;治疗1个月和2个月后,联合组HAMD及NFI评分均较药物组和心理组下降更明显(P<0.05、0.01)。结论艾司西酞普兰联合意象对话治疗卒中后抑郁能更加有效地改善患者的抑郁症状,同时能促进卒中后患者神经功能的恢复。

Objectives To observe the effects of escitalopram combined with imagery dialogue in the treatment of clinical depression and neurological impairment of post-stroke depression （PSD）. Methods The patients （108 cases） diagnosed with with PSD in Baoding Emergency Center from January 2012 to July 2013 were randomly divided into drug （36 cases）, psychological （36 cases）, and combination （36 cases） groups. The patients in the three groups were given with escitalopram, imagery dialogue, and the combination therapy treatment. Hamihon depression scale （HAMD） and neurologic function impairment （NFI） scores were assessed before the treatment, one and two months after the treatment to evaluate the clinical efficacy of three groups. Results After the treatment, HAMD and NFI scores of the three groups were more significantly decreased than those before the treatment. One and two months after the treatment, HAMD and NFI scores of the combination group were decreased more obviously compared with those of patients with PSD in the drug and psychological groups （P 〈 0.05, 0.01）. Conclusion Escitalopram combined with the imagery dialogue could improve the depressive symptoms more effectively in the patients with PSD, and at the same time, the therapy could promote the recovery of the neuronal function after stroke.