焦点解决短期疗法联合舍曲林治疗脑卒中后抑郁的临床研究

Clinical research of solution-focused brief therapy with sertraline for post-stroke depression

目的:研究焦点解决短期疗法(SFBT)联合抗抑郁药舍曲林对卒中后抑郁(PSD)患者的情绪状态及神经功能恢复的影响。方法:将78例PSD患者随机分为对照组40例和观察组38例,2组患者给予内科常规治疗及抗抑郁药治疗,观察组则在此基础上予以SFBT进行心理干预,疗程为8周,分别在治疗前、治疗4和8周后采用汉密尔顿抑郁量表(HAMD)、美国国立卫生院神经功能缺损评分(NIHSS)及改良Barthel指数(MBI)评定。结果:治疗4及8周时,2组患者的HAMD、NIHSS、MBI评分较治疗前均逐渐显著改善(P<0.01),且两个时间点观察组各项评分均较对照组改善更显著(P<0.05,0.01)。结论:焦点解决短期疗法联合舍曲林较单一的抗抑郁药治疗更快速、更显著地改善卒中后抑郁患者的抑郁程度,促进其神经功能恢复,提高日常生活活动能力。

Objective： To investigate the effects of solution-focused brief therapy （SFBT） with sertraline for patients with post-stroke depression. Methods： Seventy-eight patients with post-stroke depression were randomly assigned to the control group （n=40） and experimental group （SFBT plus sertraline treatment, n=38） and treated for 8 weeks. The efficacy was assessed with Hamilton depression scale （HAMD）, National Institute of Health Stroke Scale （NIHSS） and modified Barthel index （MBI） before and 4 and 8 weeks after treatment. Results： After treatment for 4 and 8 weeks, HAMD, NIHSS and MBI scores in two groups were improved significantly （P〈 0.01）, more significantly in the experimental group than in control group at two time points （P〈0. 05）. Conclusion： It was concluded that SFBT with sertraline could more quickly and effectively improve the symptoms of post-stroke depression, rehabilitate the neurological function and promote the ability of daily life.