度洛西汀联合认知行为治疗改善产后抑郁症功能失调性认知损害的效果观察

Effect Observation on Duloxetine Combined with Cognitive Behavior for Treating and Improving Dysfunctional Cognitive Impairment of Postpartum Depression

目的观察度洛西汀联合认知行为治疗产后抑郁症对患者功能性失调认知损害的临床疗效。方法选取鹤峰县中心医院2014年3月—2015年12月收治的产后抑郁症患者70例,随机分为两组,对照组及观察组,各35例。对照组给予盐酸度洛西汀肠溶片进行治疗,观察组在对照组基础上给予认知行为治疗。两组患者治疗前后均进行DAS(功能性失调认知损害评定量表)评定,对比两组患者治疗临床疗效及认知损害改善情况。结果观察组治疗前HADM评分(22.97±3.17)分,与对照组(22.76±3.66)分比较差异无统计学意义(t=0.257,P>0.05),治疗后患者HAMD评分均较治疗前有明显下降,观察组治疗后HAMD评分(7.34±3.18)分,与对照组(8.31±3.69)分相比较差异无统计学意义(t=1.178,P>0.05);观察组治疗8周后DAS总分(t=5.141)、脆弱性(t=5.308)、完美化(t=6.335)、依赖性(t=5.308)、自主性态度(t=3.958)评分较治疗前均明显下降(P<0.05);对照组DAS各项因子分值较治疗前差异无统计学意义(P>0.05)。两组之间治疗后比较,观察组DAS总分(t=3.246)、脆弱性(t=3.673)、完美化(t=4.252)、依赖性(t=4.553)、自主性态度(t=2.521)改善均优于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率(97.14%)明显高于对照组(77.14%),差异有统计学意义(P<0.05)。结论度洛西汀联合认知行为治疗产后抑郁症较单纯使用度洛西汀治疗疗效更显著,产妇治疗后功能失调性认知损害得到明显改善,能有效缓解产妇抑郁症状。

Objective To observe the clinical efficacy of duloxetine combined with cognitive behavior for treating dys- functional cognitive impairment of postpartum depression. Methods 70 selected patients with postpartum depression ad- mitted into the Central Hospital of Hefeng County from March 2014 to December 2015 were randomly divided into con- trol group and observation group, 35 cases in each. Control group was given duloxetine hydrochloride enteric tablets, and on this basis, observation group was given treatment of cognitive behavior. All the patients were given DAS （dys- functional assessment scale） before and after treatment, and clinical efficacy and improvement of cognitive impairment of two groups were compared. Results The HADM score of the observation group before treatment （22.97±3.17）points,and control group （22.76±3.66）points compared with no significant difference （t=0.257, P 〉 0.05）, each time point after treatment of two patients with HAMD were significantly decreased compared with before treatment, after 8 weeks of treatment, the observation group HAMD score （7.34±3.18）points, and control group （8.31±3.69）points phase difference was not significant （t=1.178, P〉0.05）;8 weeks after treatment, the total DAS score（t=5.141）, vulnerability（t=5.308）, per- fectness （t=6.335）, dependence （t=5.308）, autonomous attitude （t=3.958） scores of observation group significantly de- creased compared with pre-treatment（P〈0.05）; There was no significant difference in DAS factor scores in control group compared with pre-treatment （P〉0.05）. After treatment, the improvement of DAS total score（t=3.246）, vulnerability（t= 3.673）, perfectness（t=4.252）, dependence（t=4.553）, autonomous attitude（t=2.521） scores of observation group were better than control group （P〈0.05）; The total effective rate of observation group （97.14%） was significantly higher than control group（77.14%）, difference with statistically significant（P〈0.05）. Conclusion The effect of duloxetine combined with cognitive behavior for treating postpartum depression is more significant than pure duloxetine, which can significantly improve dysfunctional cognitive impairment and effectively relieve depressive symptoms of maternal.