回忆疗法对急性缺血性脑卒中患者认知功能障碍、焦虑和抑郁的影响

The effect of reminiscence therapy on cognitive impairment,anxiety,and depression in acute ischemic stroke patients

目的探讨回忆疗法对急性缺血性脑卒中(AIS)患者认知功能、焦虑、抑郁的影响。方法纳入达州市中西医结合医院首次诊断为AIS的患者170例,按随机数字法随机分为对照组和观察组,每组85例,治疗期间,对照组有7例患者因死亡或其他原因被剔除试验,最终有78例患者纳入统计研究;观察组有8例患者因死亡或其他原因被剔除试验,最终有77例患者纳入统计。对照组予以常规治疗,观察组在对照组基础上加上回忆疗法,疗程1年。分别于治疗前(M0),治疗3个月(M3)、6个月(M6)、9个月(M9)和12个月(M12)进行MMSE评分(评估认知功能)、HADS和SAS/SDS评分(评估焦虑和抑郁)。结果观察组在M6、M9、M12时MMSE评分显著高于对照组(P<0.05),M12时认知功能障碍率显著低于对照组(P<0.05);在焦虑方面,观察组在M6、M9、M12时SAS评分显著低于对照组(P<0.05),M9、M12时HADS-A评分显著低于对照组(P<0.05),根据SAS评分M9、M12时观察组焦虑率显著低于对照组(P<0.05),根据HADS-A评分M12时试验组焦虑率显著低于对照组(P<0.05)。在抑郁方面,M12时SDS评分显著低于对照组(P<0.05),M9、M12时HADS-D评分显著低于对照组(P<0.05),但在整个治疗期间,两组抑郁率差异无统计学意义(P>0.05)。结论回忆疗法可减轻AIS患者认知功能障碍、焦虑和抑郁,表明其在脑卒中后管理方面具有一定潜力。

Objective To investigate the effect of reminiscence therapy on cognitive impairment,anxiety,and depression in acute ischemic stroke(AIS)patients.Methods 170 patients with AIS diagnosed for the first time were randomly divided into control group and province,China)experimental group according to the ratio of 1:1 by random number method generated by computer,85 cases in each group.The control group was treated with routine treatment,and the experimental group was treated with reminiscence therapy on the basis of the control group,the course of treatment was 1 year.Mini-Mental State Examination(MMSE),Hospital Anxiety and Depression Scale for anxiety/depression(HADS-A/HADS-D)were assessed at month 0(M0),M3,M6,M9,and M12.Results During the trial,7 patients in the control group were excluded from the trial due to death or other reasons,and 78 patients were finally included in the control group;8 patients in the experimental group were excluded from the trial due to death or other reasons,and 77 patients were included in the experimental group.Experimental group showed higher MMSE score at M6,M9 and M12(P<0.05),lower cognitive impairment rate by MMSE at M12 compared to control group(P<0.05).As to anxiety,SAS score were lower at M6,M9 and M12(P<0.05)and anxiety rate by SAS were lower at M9 and M12(P<0.05),while HADS-A score were lower at M9 and M12(P<0.05)and anxiety rate by HADS-A were lower at M12(P<0.05)in experimental group compared with control group.Regarding depression,SDS score were lower at M12(P<0.05)and HADS-A score were lower at M9 and M12(P<0.05)in experimental group compared with control group,while depression rate by SDS and HADS-D were was no significant difference(P>0.05).Conclusion Reminiscence therapy can reduce cognitive dysfunction,anxiety and depression in AIS patients,suggesting that it has a certain potential in post-stroke management.