文拉法辛联合心理治疗对脑卒中后抑郁患者预后的影响

Effects of venlafaxine plus psychotherapy on prognosis of pa-tient with post-stroke depression

目的：探讨文拉法辛联合心理治疗对脑卒中后抑郁患者抑郁症状及神经功能康复的影响。方法将84例脑卒中后抑郁患者随机分为联合组43例，药物组41例，两组均进行神经内科常规治疗及康复治疗，口服文拉法辛治疗，联合组在此基础上联合心理治疗，观察4周。治疗前后采用汉密顿抑郁量表评定抑郁状况，美国国立卫生研究院脑卒中量表评定神经功能康复状况。结果治疗2周末起两组各量表评分均较治疗前显著下降（P＜0．05或0．01），联合组治疗2周末汉密顿抑郁量表评分，治疗4周末汉密顿抑郁量表、美国国立卫生研究院脑卒中量表评分均显著低于药物组（P＜0．01）。结论文拉法辛联合心理治疗能显著缓解脑卒中后抑郁患者的抑郁症状，同时能促进患者神经功能的康复，对提高患者的生活质量具有重要作用。

Objective To explore the effects of venlafaxine plus psychotherapy on depressive symptoms and nervous function rehabilitation of patient with post‐stroke depression （PSD） .Methods Eighty‐four PSD patients were randomly assigned to combination （n = 43） and drug group （n = 41） ,both groups re‐ceived routine and rehabilitative treatment the patients of neurology department and took orally venlafax‐ine ,and on this basis combination group was plus psychotherapy for 4 weeks .Depressive conditions were assessed with the Hamilton Depression Scale （HAMD） and nervous function rehabilitation with the Na‐tional Institute of Health Stroke Scale （NIHSS） before and after treatment .Results Since the end of the 2nd week the HAMD and NIHSS scores of both groups lowered more significantly compared with pretreat‐ment （P〈 0 .05 or 0 .01） ,the HAMD score at the end of the 2nd week and the HAMD and NIHSS 4th were significantly lower in combination than in control group （ P 〈 0 .01） .Conclusion Venlafaxine combined with psychotherapy could relieve the depressive symptoms of PSD patients ,promote nervous function re‐habilitation ,and has an important significance for improving patients’ quality of life .