心理康复对老年脑卒中后抑郁患者免疫功能的影响

Influence of psychological rehabilitation nursing on immune function in elderly patients with post-stroke depression

目的 探讨心理康复对老年脑卒中后抑郁患者免疫功能的影响. 方法 选择80例脑卒中后抑郁症老年患者随机分成康复组和对照组,康复组采取常规药物治疗、辅助运动疗法及心理疏导等综合康复治疗措施,对照组仅采用常规药物和辅助运动疗法治疗,均治疗3个月.患者治疗前和治疗3个月后分别进行Barthel指数、汉密尔顿抑郁量表（HAMD）评定和免疫功能检测. 结果 治疗前康复组与对照组间Barthel指数、HAMD评分、免疫功能指标测定差异无统计学意义（P＞0.05）.治疗3个月后,康复组与对照组比较Barthel指数明显提高（P=0.000）、HAMD评分明显下降（P=0.000）、T淋巴细胞亚群水平增高（P＜0.05）、免疫球蛋白水平显著提高（P＜0.01）. 结论 心理康复、运动训练与药物相结合治疗方法,有利于脑卒中后抑郁患者免疫功能康复,提高患者的生活质量.

Objective To investigate the influences of psychological rehabilitation nursing on immune function in post stroke depression patients.Methods A total of 80 elderly patients with post stroke depression were recruited from the inpatients in geriatric neurology department at Tianjin Medical University General Hospital.All patients were divided into two groups：the control group received only conventional and auxiliary exercise therapy for 3 months; rehabilitation group received psychological rehabilitation nursing added to the above therapy for 3 months.Barthel indexes,Hamilton Depression Scale （HAMD） scores and immune function were detected at recruit and three months after treatment.Results There were no statistically significant differences in clinical data between the rehabilitation group and control group （all P〉0.05）.There were no statistically significant differences in Barthel indexes,Hamilton Depression Scale （HAMD） scores and immune function between rehabilitation group and control group before treatment （all P〉 0.05）.Compared with control group,the rehabilitation group showed that the Barthel Indexes were increased （P=0.000）,Hamilton Depression Sale （HAMD） scores were decreased （P=0.000）,the levels of T lymphocyte subpopulation （P〈 0.05） and immunoglobulin （P〈 0.01） were increased after three months treatment.Conclusions The combination treatment of psychological rehabilitation nursing,auxiliary exercise and drug are helpful to recover immune function and improve the quality of life in patients with post stroke depression.