氟西汀对卒中后抑郁的预防效果及神经功能康复的促进作用观察

The effect of Fluoxetine on the prevention of post stroke depression and the improvement of neurological function recovery

目的探讨观察氟西汀对卒中后抑郁的预防及神经功能康复的促进作用。方法选取2016年1月至2017年1月该院收治的60例卒中患者为研究对象，分为对照组与观察组各30例，两组均给予神经内科常规和康复治疗和护理。在此治疗基础上，观察组患者服用氟西汀分散片，对照组给予茴拉西坦片作为安慰剂行对照治疗。治疗8周后对比两组的汉密尔顿焦虑量表（HAMD）评分、Barthel指数评分、临床神经功能缺损程度评价表（CSS）评分及Rankin疗效分级情况。结果治疗前两组HAMD评分分别为（21．42±3．21）分与（22．34±3．56）分，组间比较差异无统计学意义（P〉0．05）；治疗后观察组降为（5．36±2．32）分，对照组降为（8．67±2．98）分，观察组低于对照组，差异有统计学意义（P〈0．05）。治疗前两组BI评分分别为（51．74±7．43）分与（52．54±7．38）分，组间比较差异无统计学意义（P〉0．05）；治疗后观察组BI评分升至（89．52±9．34）分，对照组为（62．34±6．24）分，观察组高于对照组，差异有统计学意义（P〈0．05）。治疗前两组CSS评分分别为（22．47±3．21）分与（20．54±3．04）分，组问比较差异无统计学意义（P〉0．05）；治疗后观察组CSS评分（4．84±1．21）分，对照组为（10．46±2．37）分，观察组低于对照组，差异有统计学意义（P〈0．05）。观察组治疗有效率为83．3％，对照组为56．7％，组间比较观察组高于对照组，差异有统计学意义（P〈0．05）。结论氟西汀可有效预防脑卒中后抑郁，促进神经功能恢复，改善患者肢体运动，疗效确切，且副作用较少，对于提高卒中患者生存质量具有重要意义。

Objective To investigate the effect of fluoxetine on the prevention of post stroke depression and rehabilitation of neurological function. Methods 60 cases of patients with stroke admitted to our hospital from January 2016 to January 2017 were randomly divided into control group and observation group with 30 cases in each group. The patients of the two groups were given conventional and rehabilitation nursing cares by neurology department. On the basis of the treatment,the patients in the observation group were treated with Fluoxetine dispersible tablets,while the patients in control group were treated with Aniracetan Dispersible Tablets as a placebo for contrast treatment. After 8 weeks of treatment, the scores of Hamilton Anxiety Scale （Hamilton Anxiety Scale, H AMD） evaluation,Barthel index, clinical neurological impairment （CSS） and the curative effect classification of Rankin were compared for patients in two groups. Results Before treatment, the HAMD scores of the two groups were （21.42 ± 3.21） and （22.34 ± 3.56） in two groups, and there was no significant difference between the two groups （P〈0.05） ;After treatment, it was reduced to （5.36±2.32） in observation group,and reduced to （8.67±2.98） in control group so that the observation group was lower than that of the control group and the difference was significant （P〈0.05）. Before treatment, the BI scores of the two groups were （51.74±7.43） and （52.54±7.38） respectively,and there was no significant difference between the two groups （P〉0.05） ; After treatment,the BI score of the observation group was increased to （89.52±9.34） ,and increased to （62.34±6.24） in control group so that the observation group was higher than that of the control group, and the difference was significant （P〈0.05）. Before treatment,the CSS scores of the two groups were （22.47±3.21） and （20.54±3.04） respectively,and there was no significant difference between the two groups （P〈0.05） After treatment, the CSS scores of the observation group was （4.84±1.21）, and was （10.46±2.37） in control group, so that the observation group was lower than that of the control group, and the difference was significant （P〈0.05）. The total effective rate was 83.3% in the observation group and was 56.7% in the control group so that the observation group was higher than that of the control group with regard to comparison between groups, and the difference was sta- tistically significant （P%0.05）. Conclusion Fluoxetine can effectively prevent post-stroke depression,promote the recovery of neu- rological function,and improve limb movement with clear curative effect and fewer side effects so that it is of great significance for improving the life aualitv of oatients with stroke.