5-羟色胺再摄取抑制剂联合系统心理干预治疗对老年卒中后抑郁疗效的观察

Effects of 5-hydroxytryptamine Reuptake Inhibitors Combined with Therapy of Systematic Psychological Intervention on Senile Post-stroke Depression

目的探究5羟色胺再摄取抑制剂联合系统心理干预治疗对老年卒中后抑郁的疗效。方法选取自2014年1月~2016年1月我院收治的200例脑卒中后抑郁的老年患者,按随机数表将其分为4组,即A、B、C、D组,每组各50例。A、B、C、D组分别给予常规治疗、常规治疗+5羟色胺再摄取抑制剂、常规治疗+系统心理干预、常规治疗+5羟色胺再摄取抑制剂+系统心理干预。比较四组患者治疗前后的抑郁程度、肌力、神经功能及日常生活能力评分情况。结果与治疗前相比,四组患者治疗后抑郁程度评分、神经功能缺损程度(neural function defect score,NFDS)评分均显著下降,肌力评分、Barthel指数(Barthel index,BI)评分均显著升高,治疗前后比较差异具有统计学意义(P<0.05);以D组患者治疗后的抑郁程度评分、NFDS评分最低,肌力评分、BI评分最高,与其他三组治疗后比较差异具有统计学意义(P<0.05)。结论 5-羟色胺再摄取抑制剂联合系统心理干预治疗老年脑卒中后抑郁的效果显著,优于单独治疗,值得在临床上广泛应用。

Objective To explore the effect of serotonin reuptake inhibitor combined with systemic psychological intervention on senile patients with post-stroke depression. Methods 200 cases of post-stroke depression in elderly patients selected from January 2014 to January 2016 in our hospital will be divided into four groups according to the random number table, namely A, B, C, D group, each group of 50 cases. A, B, C, D group were respectively given conventional treatment, conventional treatment ＋5 serotonin reuptake inhibitor, conventional treatment ＋ systemic psychological intervention, conventional treatment ＋5 serotonin reuptake inhibitor ＋ systemic psychological intervention. The scores of depression, muscle strength, nerve function and daily living ability were compared between the four groups before and after treatment. Results Compared with before treatment, scores of the depression and neurological function defect scale of four groups were significantly decreased, muscle strength scores and Barthel index scores were significantly higher than those before treatment （P〈 0.05 ） . The score of depression and NFDS score in D group were the lowest, muscle strength score and BI score were the highest after treatment （P〈 0.05 ）, and the difference was significant （P 〈 0.05 ） after treatment compared with the other three groups. Conclusion The combination of serotonin reuptake inhibitor and systemic psychological intervention is more effective than single therapy in the treatment of senile patients with post -stroke depression. It is worthy to be widely used in clinical practice.