康复训练联合舍曲林对脑卒中后抑郁患者临床疗效及认知功能的影响

Effects of rehabilitation training combined with sertraline on post-stroke depression and cognitive function

目的探讨康复训练联合舍曲林对脑卒中后抑郁患者临床疗效及认知功能的影响.方法将90例脑卒中后抑郁患者按随机数字表法分为观察组和对照组,每组45例,均给予规范化脑卒中治疗及康复训练,观察组在此基础上联合舍曲林治疗,观察2个月.治疗前后采用汉密顿抑郁量表评定抑郁状况,简易智能量表、蒙特利尔认知评估量表评定认知功能状况,神经功能缺损程度量表评定神经功能状况,肢体运动功能评分量表评定肢体运动功能,生活活动能力指数量表评定生活活动能力,统计两组康复训练依从状况及不良反应发生率.结果治疗后两组汉密顿抑郁量表、神经功能缺损程度量表评分均较治疗前持续下降,观察组评分显著低于对照组(P<0.01);两组简易智能量表、蒙特利尔认知评估量表、肢体运动功能评分量表、生活活动能力指数量表评分均较治疗前持续升高,观察组评分显著高于对照组(P<0.01);观察组康复训练依从优良率(93.33%)显著高于对照组(77.78%)(P<0.05),不良反应发生率(26.67%)与对照组(28.89%)比较差异无统计学意义(P>0.05).结论康复训练联合舍曲林治疗脑卒中后抑郁患者具有协同增效作用,能显著改善患者的抑郁症状、神经功能、认知功能、肢体功能及日常生活活动能力,提高康复治疗依从性,临床效果显著,安全性高.

Objective To explore the influence of rehabilitation training combined with sertraline on post-stroke depression and cognitive function. Methods 90 cases of patients with post-stroke depression were randomly divided into observation group and control group, 45 cases in each group. They were treated by regulate stroke treatment and rehabilitation training, on the basis of the treatment, the observation group were treated by sertraline. Patients were observed for 2 months. Before and after treatment, HAMD was used to assess depression status, MMSE and MoCA were used to assess cognitive function status, NIHSS was used to assess neurological function status, Fugl-Meyer was used to assess limb motor function, and BI was used to assess life activity ability. The compliance status of the two groups of rehabilitation training and the incidence of adverse reactions were counted. Results After treatment, the HAMD and NIHSS scores of the two groups were lower than those before treatment, and the observation group was signifi-cantly lower than the control group (P<0. 01). The MMSE, MoCA, Fugl-Meyer, and BI scores of the two groups were higher than those before treatment. The observation group was significantly higher than the control group (P<0. 01). The excellent rate of rehabilitation training compliance in the observation group (93. 3%) was significantly higher than that in the control group (77. 78%)(P<0. 05). There was no significant difference in the incidence of adverse reactions (26. 67%) compared with the control group (28. 89%)(P>0. 05). Conclusions Rehabilitation training combined with sertraline in patients with stroke depression has synergistic effect, can significantly improve the patients depressive symptoms, neu-rological function, cognitive function, limb function and activities of daily living, improve rehabilitation treatment compliance. The clinical effect is remarkable and the safety is high.