帕罗西汀联合行为干预治疗脑卒中后抑郁的疗效探讨

Therapeutic effect of paroxetine combined with behavioral intervention on post-stroke depression

目的评价帕罗西汀联合行为干预治疗脑卒中后抑郁(PSD)的疗效。方法从2015年12月开始以神经内科、康复科接待的PSD患者为研究对象,截止2016年12月,共纳入PSD患者50例,采用随机数字表法将所有患者分为对照组和观察组,各25例。对照组患者进行帕罗西汀治疗,观察组在对照组基础上联用行为干预治疗。分析对比两组患者的HAMD及社会消极应对评分,不良事件发生情况。结果随着治疗时间的延长,两组患者的HAMD及消极应对评分均呈降低趋势;且治疗前,治疗第4周、第8周,两组患者的HAMD及消极应对评分比较,差异没有统计学意义(P<0.05);治疗第12周,观察组患者的HAMD及消极应对评分低于对照组(P<0.05)。观察组患者治疗期间的不良事件总发生率低于对照组(P<0.05)。结论帕罗西汀联合行为干预治疗PSD效果较好,不良事件发生率较低。

Objective To evaluate the therapeutic effect of paroxetine combined with behavioral intervention on post-stroke depression（PSD）. Methods From December 2015 to December 2016, the PSD patients in the department of neurology, rehabilitation subjects were selected as the study objects, 50 cases of PSD patients were enrolled, all the patients were divided into control group and observation group with random number table method. The control group was treated with paroxetine, and the observation group was treated with behavioral intervention on the basis of the control group. The HAMD and social negative response scores, adverse events were analyzed in the two groups. Results With the prolongation of treatment time, the HAMD and negative response scores of the two groups showed a decreasing trend; there were no significant differences in the HAMD and social negative response scores between the two groups before treatment and at 4, 8 weeks after treatment（P〈0.05）; at 12 weeks after treatment, the HAMD and negative response scores in the observation group were lower than those of the control group（P〈0.05）. The overall incidence of adverse events during the treatment in the observation group was lower than that of the control group（P〈0.05）. Conclusion Paroxetine combined with behavioral intervention treatment has better effect in patients with PSD and lower incidence of adverse events.