认知行为治疗改善脑卒中后抑郁状况及生活质量的疗效研究

Effect study of cognitive behavioral intervention on depression status and quality of life in patients with stroke

目的：探讨认知行为治疗对脑卒中后处于抑郁状态的患者抑郁状况及生活质量的疗效。方法选择78例脑卒中后抑郁住院患者以简单随机分组的方法随机分为对照组和干预组，对照组采用神经内科常规治疗及康复训练，干预组在对照组的基础上增加认知行为治疗。两组采用抑郁自评量表（SDS）、Fugl－Meyer运动功能量表（FMA）、日常生活活动能力量表（ADL）和生活满意度量表（SWLS）评定疗效。结果（1）干预后两组患者抑郁评分存在组间差异（ F ＝6．310，P ＜0．05）；在不同干预时间两组患者抑郁评分差异有统计学意义（ F ＝161．531，P ＜0．01）；干预时间与组间有交互作用（ F ＝10．622，P＜0．01）。（2）干预后两组患者日常生活能力评分在组间差异无统计学意义（ P＞0．05）；在不同干预时间两组患者ADL评分差异有统计学意义（F＝152．713，P ＜0．01）；干预时间与组间存有交互作用（F＝7．742，P＜0．01）。（3）干预后两组患者SWLS评分组间差异有统计学意义（F ＝5．039， P ＜0．05）；在不同干预时间两组患者SWLS评分差异有统计学意义（F ＝181．010，P ＜0．01）；干预时间与组间有交互作用（ F ＝3．901，P ＜0．05）。（4）干预后两组患者FM A评分在组间、干预时间上差异无统计学意义（P ＞0．05）。结论认知行为治疗能有效促进脑卒中后处于抑郁状态患者的心理康复、改善生活自理能力、提高生活质量。

Objective To explore the curative effect of cognitive behavior therapy on depression status and quality of life in patients with stroke .Methods Selecting 78 cases of hospitalized patients with depression after stroke were randomly divided into control group and intervention group .The control group received Neurology conventional treatment and rehabilitation training ,intervention group recived cognitive behavioral therapy on basis of the control group .Using Self -Rating Depression Scale（SDS） , Fugl-Meyer Motor Funtion Scale（FMA） ,Activities of Daily Living Scale（ADL） and Life Satisfaction Scale（SWLS）to assess curative effect .Results （1）After intervention ,the depression scores of the two groups had inter-group difference （F= 6 .31 ,P〈 0 .05）;Depression scores of intervention at different times between the two groups were statistically significant （F= 161 .53 ,P〈 0 .01）;There was a interac‐tion role between intervention time and inter-group （F= 10 .622 ,P〈 0 .01） .（2）Activities of daily liv‐ing score was no significant difference between the two groups of patients after the intervention （P 〉0.05）;Daily living score of intervention at different times between the two groups was statistically significant （F= 152 .71 ,P〈 0 .01）;There was a interaction role between intervention time and inter-group （F=7 .742 ,P〈 0 .001） .（3）There was statistically significant in life satisfaction scores after intervention be‐tween the two groups （F = 5 .039 ,P 〈 0 .05）;There was statistically significant in life satisfaction scores of intervention at different times between the two groups （F= 181 .01 ,P〈 0 .001）;There was an interaction role between intervention time and inter-group （F= 3 .901 ,P〈 0 .05） .（4）Two groups of patients after intervention on motor scores were no significant difference between the inter -group and intervention time （P〉 0 .05） .Conclusions Cognitive behavioral therapy can effectively promote the psy‐chological rehabilitation in a state of depression after stroke patients ,improve life self -care ability and improve the quality of life .