黛力新联合认知行为疗法治疗脑卒中后抑郁患者31例疗效观察

Deanxit Combined with Cognitive Behavioral Therapy in Treating 31 Cases of Post-stroke Depression

目的:探讨黛力新联合认知行为疗法治疗脑卒中后抑郁的临床疗效。方法:将60例患者数字随机分为实验组31例和对照组29例,实验组给予黛力新联合黛力新治疗,对照组仅接受认知行为疗法治疗。4周为1个疗程,共治疗2个疗程。2组治疗前后采用汉密尔顿抑郁量表(HAMD)评分,以HAMD减分量评估治疗效果;采用美国国立卫生研究院脑卒中量表(NIHSS)、改良Barthel指数(MBI)评估患者神经功能恢复状况;应用副反应量表(TESS)评估药物安全性。结果:①实验组治疗总有效率(93.5%)高于对照组(79.3%),差异有统计学意义(P<0.05);②经1个疗程治疗后,2组HAMD评分明显下降,组内治疗前后比较,差异有统计学意义(P<0.01);2组间每周评分比较,第1周末2组差异有统计学意义(P<0.05),第2周末2组差异有统计学意义(P<0.01);③2组治疗1、2、4、8周后NIHSS评分明显下降(P<0.01),2组间1、4、8周NIHSS评分比较,差异有统计学意义(P<0.01),2组间2周NIHSS评分比较,差异有统计学意义(P<0.05);④2组间1、2、4、8周MBI评分比较,差异有统计学意义(P<0.01);⑤2组治疗期间均未见明显不良反应。结论:黛力新联合认知行为疗法治疗卒中后抑郁疗效好,安全性高。

Objective：To investigate the curative effects of Deanxit combined with cognitive behavioral therapy for the treatment of post-stroke depression. Methods：60 patients with post-stroke depression were randomly assigned to treatment group（n=30） and control group（n=30）,the treatment group received Deanxit combined with cognitive behavioral therapy,and the control group received Deanxit only for two courses,four weeks as a course. The curative effect was assessed by Hamilton depression scale（HAMD）,the neurologic function recovery was measured by national institutes of health stroke scale（ NIHSS） and modified Barthel index（MBI）,and the drug safety was evaluated by treatment emergent symptom scale（TESS）. Results：After two courses,the total effective rate of the experimental group（93.5%） was higher than that of the control group（79.3%）,and the difference was significant（P〈0.05）;after a course of treatment,the HAMD score in the two groups was decreased significantly compared with that before the treatment（P〈0.01）;the weekly score in the treatment group was lower than that of the control group,and the difference was significant at the first weekend and the second weekend（P〈0.05,P〈0.01）. After treatment of one week,two weeks,four weeks and eight weeks,the NIHSS score in the two groups was respectively decreased,and MBI score was respectively increased compared with that before treatment;the NIHSS score in the treatment group was lower than that of the control group,the MBI score was higher than that of the control group,and the difference was significant after treatment of one week,four weeks and eight weeks（P〈0.05,P〈0.01）.No obvious adverse reactions appeared in the two groups during the treatment process. Conclusion ：Deanxit combined with cognitive behavior therapy has good efficacy and safety for post-stroke depression.