综合性心理干预联合药物治疗对脑血管病伴发抑郁患者的情绪和生活质量的影响

Effects of comprehensive psychological intervention combined with medicines on mood and quality of life in cerebrovascular disease patients with depression

目的探讨综合性心理干预对脑血管病伴发抑郁患者的情绪、认知功能和生活质量的影响。方法选取我院2015年1月~2016年1月期间收治的100例脑血管病伴发抑郁患者作为研究对象,随机分为观察组(n=50)和对照组(n=50),两组患者均接受脑血管疾病的基础治疗(包括改善微循环、对症治疗及护理等),并予以口服舍曲林进行抗抑郁治疗,观察组在此基础上加以实施综合性心理干预进行治疗。分别采用汉密尔顿焦虑量表(HAMA)、抑郁自评量表(SDS)、焦虑自评量表(SAS)以及蒙哥马利抑郁量表(MARDS)的分值变化对两组患者治疗前后的心理状态进行评定,并采用简易智能量表(MMSE)对两组患者的认知功能进行评估,以及随访一年的生活质量。结果观察组患者治疗后的HAMA、SDS、SAS和MARDS评分低于治疗前和对照组(P<0.05);两组患者治疗前的MMSE评分明显低于治疗后,治疗后观察组MMSE评分更低(P<0.05);经随访的一年发现,观察组患者的生活质量评分明显高于对照组(P<0.05)。结论在常规抗抑郁药物的基础上加以综合心理干预可以有利于改善脑血管病伴发抑郁患者的情绪,同时提高患者认知功能和生活质量。

Objective To investigate the effects of comprehensive psychological intervention combined with medicines on mood and quality of life in cerebrovascular disease patients with depression. Methods From January 2015 to January 2016, 100 cases of cerebrovascular disease patients with depression in our hospital were selected and randomly divided into observation group （n=50） and control group （n=50） . The patients in two groups received basic treatment of cerebrovascular disease （ including improving microcirculation, symptomatic treatment and nursing etc. ）, and antide- pressant therapy （ oral sertraline ）; the patients in observation group received comprehensive psychological intervention extra. The mood status changes of patients in two groups were assessed by Hamilton Anxiety Scale （ HAMA ）, Self--rating Depression Scale （ SDS ）, Self--rating Anxiety Scale （SAS） and Montgomerie Depression Scale （ MARDS ）; The cognitive function and the quality of life of patients in two groups were followed for one year and assessed by Mini-mental State Examination （ MMSE ） and GQOLI--74. Results After treatment, the HAMA, SDS, SAS and MARDS score of patients in the observation group were lower than those in the control group （ P 〈 0.05 ）; After treatment, MMSE score of patients in two groups was significantly increased, and which in the observation group was increased much more （P 〈 0.05 ）; After one year follow-up, the life the quality score in observation group was significantly higher than those in the control group （P 〈 0.05 ）. Conclusion Antidepressant drugs combined with comprehensive psychological intervention can improve the mood state, cognitive function and quality of life in cerebrovascular disease patients with depression.