苯二氮卓类药物联合氟哌噻吨美利曲辛治疗脑卒中后抑郁患者的疗效及安全性分析

Analysis of the efficacy and safety of benzodiazepines combined with flupentixol-melitracen in the treatment of post-stroke depression patients

目的探究苯二氮卓类药物联合氟哌噻吨美利曲辛治疗脑卒中后抑郁患者的疗效及安全性。方法选取2018年5月至2019年8月脑卒中后抑郁患者86例,根据治疗方案不同分组,各43例。对照组给予氟哌噻吨美利曲辛治疗,观察组给予苯二氮卓类药物联合氟哌噻吨美利曲辛治疗。对比两组疗效、不良反应发生率及治疗前后汉密尔顿抑郁量表(HAMD)评分、简易智力状态检查量表(MMSE)评分、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力量表(ADL)评分、血清神经生化标志物(S100β)与5-羟色胺(5-HT)水平。结果观察组总有效率高于对照组(95.35%比79.07%,P<0.05);治疗后观察组HAMD评分低于对照组,MMSE评分高于对照组(均P<0.05);治疗后观察组NIHSS、ADL评分均低于对照组(均P<0.05);治疗后观察组血清5-HT水平高于对照组,血清S100β水平低于对照组(均P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论苯二氮卓类药物联合氟哌噻吨美利曲辛治疗脑卒中后抑郁患者,可减轻抑郁程度,改善认知功能、神经功能,提高日常生活能力,调节血清5-HT、S100β水平,疗效显著,安全性高。

Objective To investigate the efficacy and safety of benzodiazepines combined with flupentixolmelitracen in the treatment of post-stroke depression.Methods Eighty-six patients with post-stroke depression in our hospital from May 2018 to August 2019 were selected and were divided into two groups according to the different treatment plans,43 cases in each group.The control group was treated with flupentixol-melitracen,and the observation group was treated with benzodiazepines and flupentixol-melitracen.The efficacy,the incidence of adverse reactions,and the Hamilton Depression Scale(HAMD)score,the Mini-mental State Examination Scale(MMSE)score,the National Institutes of Health Stroke Scale(NIHSS)score,and the daily activity ability scale(ADL)score,serum neurobiochemical marker(S100β)and serotonin(5-HT)levels were compared between the two groups before and after treatment.Results The total effective rate in the observation group was 95.35%,higher than that in the control group(79.07%)(P<0.05).After treatment,the HAMD score in the observation group was lower than that in the control group,and the MMSE score was higher than that in the control group(all P<0.05).After treatment,the NIHSS and ADL scores in the observation group were lower than those in the control group(all P<0.05).After treatment,the serum 5-HT level in the observation group was higher than that in the control group,and the serum S100βlevel was lower than that in the control group(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of benzodiazepines with flupentixol-melitracen in patients with post-stroke depression can reduce the degree of depression and improve cognitive and neurological functions,improve daily living ability,regulate serum 5-HT and S100βlevels,with significant curative effect and high safety.