帕罗西汀联合问题解决疗法在脑卒中后抑郁治疗中的效果

Effect of the Paroxetine combined with problem-solving therapy in the treatment of post stroke depression

目的探讨帕罗西汀联合问题解决疗法在脑卒中后抑郁治疗中的效果。方法选择2012年1月-2014年12月四川省自贡市第一人民医院神经内科59例脑卒中后抑郁患者为研究对象,采用随机数字表法将其分为观察组（29例）和对照组（30例）,对照组患者给予帕罗西汀治疗,观察组患者给予帕罗西汀联合问题解决疗法治疗。治疗前和治疗后6、12周观察并比较两组患者神经功能缺损程度评分（CSS）及汉密尔顿抑郁量表（HAMD）评分情况;治疗12周对患者进行日常生活活动能力（ADL）评分。结果两组患者治疗后6、12周后HAMD、CSS及ADL评分均较治疗前明显降低,且观察组明显低于对照组（P〈0.05）;治疗后12周,两组患者HAMD评分及CSS评分较治疗后6周明显降低（P〈0.05）。治疗后12周,两组患ADL评分明显优于治疗前,且观察组优于对照组（均P〈0.05）。结论帕罗西汀联合问题解决疗法在脑卒中后抑郁治疗中具有显著疗效,其能促进患者的神经功能恢复,提高患者生命质量,并降低病死率,值得临床推广应用。

Objective To discuss the clinical effect of Paroxetine combined with problem-solving therapy in the treatment of post stroke depression. Methods 62 patients with post stroke depression from January 2012 to December 2014 in the Department of Neurology, the First People＇s Hospital of Zigong City were selected as study objects, and they were divided into observation group（29 cases） and control group（30 cases） according to the random number table. Patients of the control group were given the treatment of Paroxetine, and patients of the observation group were given Paroxetine combined with problem-solving therapy. The HAMD and CSS scores before and 6, 12 weeks after treatment of two groups were compared and the activities of daily living（ADL） scores 12 weeks after treatment of two groups were compared. Results 6 and 12 weeks after treatment, HAMD and CSS scores of the two groups were significantly lower than before treatment, and those scores of the observation group were significantly lower than those of the control group,the differences were statistically significant（all P〈0.05）. 12 weeks after treatment, HAMD score of the two groups was significantly lower than that in 6 weeks after treatment, and the CSS score of the observation group was significantly lower than that in 6 weeks after treatment, the differences were statistically significant（P〈0.05）. 12 weeks after treatment, ADL scores of the two groups were significantly improved than before treatment, the ADL score of the observation group was better than that of the control group, the differences were statistically significant（P〈0.05）. Conclusion Paroxetine combined with problem solving treatment has a significant effect in the treatment of patients with post stroke depression, can promote the recovery of neural function effectively, so as to improve the life quality of patients with cerebral apoplexy, reduce the mortality. It is worthy of clinical application.