心理疏导联合帕罗西汀片治疗老年抑郁症的临床效果及对HAMD评分的影响

Clinical effect of psychological counseling combined withparoxetine tablets in the treatment of senile depression and its effect on HAMD score

目的:探究心理疏导联合帕罗西汀片治疗老年抑郁症的疗效。方法:选取2018年8月—2020年8月本院收治的86例老年抑郁症患者,依照随机数字表分成两组各43例。对照组予以盐酸帕罗西汀片治疗,初始剂量为20 mg/次,1次/d,随后根据患者病情调整剂量,对于病情严重者按照10 mg/周逐渐加量,治疗剂量在20~50 mg/次,1次/d。观察组联用心理疏导(采用“1对1”沟通模式、指导患者完成劳动、表扬并鼓励主动劳动者、告知家属应给予患者足够的关心)。比较两组临床疗效、汉密尔顿抑郁量表(HAMD)评分、生活质量量表(WHOQOL-BREF)评分以及不良反应。结果:观察组治疗总有效率为90.70%,高于对照组的69.77%,差异有统计学意义(P<0.05)。治疗前,两组HAMD评分比较,差异无统计学意义(P>0.05);治疗后,两组HAMD评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组社会关系、生理以及心理评分比较,差异无统计学意义(P>0.05);治疗后,两组社会关系、生理以及心理评分高于治疗前,且观察组高于对照组,差异有统计学意义(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:心理疏导联合帕罗西汀片治疗老年抑郁症可有效降低HAMD评分,利于生活质量的提高,临床疗效显著。

Objective:To explore the effect of psychological counseling combined with paroxetine tablets in the treatment of senile depression.Methods:According to the random number table,a total of 86 elderly patients with depression admitted to our hospital from August 2018 to August 2020 were selected and divided into two groups,with 43 cases in each group.The control group was treated with paroxetine hydrochloride tablets with the initial dose of 20 mg/time,once a day,and the dose was adjusted according to the patient's condition.For severe cases,the dose was gradually increased by 10 mg per week,and the treatment dose was 20~50 mg/time,once a day.The observation group was combined with psychological counseling(using the“1-to-1”communication mode,guiding the patients to complete the work,praising and encouraging the active workers,and telling the family members that they should pay enough attention to the patients).The clinical efficacy,Hamilton depression scale(HAMD)score,quality of life scale(WHOQOL-BREF)score,and adverse reactions were compared between two groups.Results:The total effective rate of the observation group was 90.70%,which was higher than that of the control group(69.77%),and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in HAMD scores between the groups(P>0.05).After treatment,HAMD scores in both groups were lower than before treatment,and the observation group was statistically lower than the control group(P<0.05).Before treatment,there were no significant differences in social relationship,physiological and psychological scores between the two groups(P>0.05).After treatment,scores of social relationships,physiological and psychological scores in both groups were higher than before treatment,and the observation group was statistically higher than the control group(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Psychological counseling combined with paroxetine tablets in the treatment of senile depression can effectively reduce the HAMD score and improve the quality of life,with significant clinical efficacy.