认知行为疗法联合舍曲林治疗脑卒中后抑郁伴失眠的临床观察

Clinical Observation of Cognitive Behavioral Therapy Combined with Sertraline in the Treatment of Post-Stroke Depression with Insomnia

目的:探究分析脑卒中后抑郁伴失眠患者应用舍曲林、认知行为疗法治疗的效果,探究联合治疗的可行性。方法:选取2018年1月至2019年3月徐州医科大学附属医院收治的脑卒中后抑郁伴失眠患者104例作为研究对象。按照不同的治疗方案分为对照组和观察组,每组52例。2组患者均给予常规对症治疗,对照组患者联合舍曲林治疗,观察组患者联合舍曲林、认知行为疗法治疗。分别应用抑郁量表、睡眠质量量表、不良反应量表评估患者的抑郁(HRSD)、睡眠质量(PSQI)、不良反应(TESS)情况。结果:2组患者治疗前,抑郁、睡眠质量2项指标比较,差异无统计学意义(P>0.05)。2组患者进行相应治疗后,抑郁、睡眠质量两项指标均有改善(P<0.05)。观察组52例患者治疗后的抑郁、睡眠两项指标水平均小于对照组(P<0.05)。治疗期间,2组患者均产生了不良反应,观察组52例治疗后的不良反应评分与对照组比较,差异无统计学意义(P>0.05)。结论:脑卒中后抑郁伴失眠患者应用舍曲林、认知行为疗法治疗,安全性高,效果理想,可有效改善患者的抑郁、睡眠情况。

Objective:To explore and analyze the effect of sertraline and cognitive behavioral therapy in patients with post-stroke depression and insomnia,and to explore the feasibility of combined therapy.Methods:From January 2018 to March 2019,104 patients with post-stroke depression and insomnia were admitted to our hospital.Patients were grouped according to different treatment regimens,52 cases in each group.Two groups of patients were given routine symptomatic treatment.Control group(n=52)patients combined with sertraline treatment,and observation group(n=52)patients combined with sertraline,cognitive behavioral therapy treatment.Depression Scale,Sleep Quality Scale and Side Response Scale were used to evaluate the depression(HRSD),sleep quality(PSQI)and side effects(TESS)of patients.Results:There was no difference in depression and sleep quality between the two groups before treatment(P>0.05).After treatment,depression and sleep quality were improved in both groups(P<0.05).The levels of depression and sleep of 52 patients in the observation group after treatment were lower than those in the control group(P<0.05).During the treatment period,both groups had side effects.There was no difference in the side effects score between the observation group and the control group(P>0.05).Conclusion:The application of sertraline and cognitive behavioral therapy in the treatment of post-stroke depression with insomnia is safe and effective,and can effectively improve the depression and sleep of patients.