康复训练辅助药物对老年脑卒中后抑郁患者神经和认知功能的影响

Effects of rehabilitation training coupled with pharmacotherapy on neurological and cognitive functions in the elderly patients with post-stroke depression

目的观察康复训练辅助药物对老年脑卒中后抑郁(PSD)患者的治疗效果及对神经功能和认知功能的影响。方法选取2017年5月至2018年2月在广元市精神卫生中心心身疾病科接受治疗的老年PSD患者80例为研究对象。依据治疗方法分为2组:观察组和对照组,每组40例。2组患者均接受药物治疗,观察组在此基础上给予康复训练,治疗8周。对比2组患者治疗前后汉密尔顿抑郁量表(HAMD)评分、美国国立卫生院神经功能缺损量表(NIHSS)评分、脑卒中专门化生活质量量表(SS-QQL)评分、简易精神状态评估量表(MMSE)评分和满意度。采用SPSS 13.0软件进行统计分析。2组间比较采用t检验或χ2检验。结果与治疗前相比,2组患者治疗后的HAMD、NIHSS、MMSE和SS-QQL评分均得到显著改善(P<0.05)。与对照组相比,治疗后观察组患者的HAMD[(16.22±2.06)和(19.55±3.12)]和NIHSS[(6.04±1.03)和(9.68±1.44)]评分显著降低(P<0.05),而MMSE[(23.29±3.38)和(18.15±3.23)]和SS-QQL[(178.62±3.66)和(151.58±6.35)]评分显著升高(P<0.05)。观察组患者治疗后的满意率显著高于对照组(97.5%和85.0%,χ2=3.914,P=0.048)。结论康复训练辅助药物治疗对老年PSD患者的治疗效果较好,可明显改善患者的认知功能和神经功能,提高患者的生活质量,值得临床推广。

Objective To observe the efficacy of rehabilitation training coupled with pharmacotherapy on the elderly patients with post-stroke depression(PSD)and its effects on neurological function and cognitive functions.Methods From May 2017 to February 2018,a total of 80 PSD elderly patients were selected for the study,who were treated at the Guangyuan Mental Health Center.The patients were divided into control group and observation group(40 patients each).Both groups were treated with drugs for 8 weeks,and the observation group were given additional rehabilitation training at the same time.The two groups were compared in indices measured before and after treatment,including Hamilton rating scale for depression(HAMD),National Institutes of Health neurological defective scale(NIHSS),stroke-specific quality of life scale(SS-QOL),mini-mental state examination(MMSE)and satisfaction.Statistical analysis was performed using SPSS statistics 13.0,and comparison between the two groups was performed using t test orχ2 test.Results Compared with before treatment,HAMD,NIHSS,MMSE and SS-QOL of the two groups were significantly improved after treatment(P<0.05).Compared with the control group,HAMD[(16.22±2.06)vs(19.55±3.12)]and NIHSS[(6.04±1.03)vs(9.68±1.44)]of the observation group were significantly lower after treatment(P<0.05),and MMSE[(23.29±3.38)vs(18.15±3.23)]and SS-QQL[(178.62±3.66)vs(151.58±6.35)]significantly higher(P<0.05).The observation group rated the satisfaction significantly higher than the control group(97.5%vs 85.0%,χ2=3.914,P=0.048).Conclusion Rehabilitation training coupled with medications is effective in the treatment of senile patients with PSD,significantly improving the cognitive and neurological functions and quality of life of the patients,and the paradigm is worth clinical application.