艾司西酞普兰治疗在脑卒中后抑郁中的疗效研究

Efficacy Research of Escitalopram in the Treatment of Post-stroke Depression

目的：探讨艾司西酞普兰治疗在脑卒中后抑郁（PSD）的临床效果。方法选择2011年1月～2013年12月我院神经内科62例PSD患者为研究对象，将其随机分为观察组和对照组各31例。对照组患者给予艾司西酞普兰治疗，观察组患者给予艾司西酞普兰联合问题解决治疗。观察并比较两组患者治疗前及治疗后6、12w汉密尔顿（HAMD）抑郁评定量表及神经功能缺损程度评分量表（CSS）评分情况。结果治疗前两组患者HAMD和CSS评分比较，差异均无统计学意义（P＞0.05）；治疗后6、12w，两组患者HAMD及CSS评分均明显低于治疗前，且观察组明显低于对照组，差异均有统计学意义（均P＜0.05）；治疗后12w；观察组患者HAMD评分明显低于治疗后6w，差异有统计学意义（P＜0.05）。结论艾司西酞普兰联合问题解决治疗在PSD患者的治疗中具有显著疗效，可有效促进神经功能的恢复，从而降低脑卒中患者的病死率，可值得临床推广应用。

Objective To discuss the clinical effect of the escitalopram joint problem-solving in the treatment of post-stroke depression. Methods 62 patients with PSD from January 2011 to De-cember 2013 in the neurology department of our hospital were selected as study objects, and they were divided into observation group and control group randomly, with 31 cases in each group. Pa-tients of the control group were given the treatment of Escitalopram, and patients of the observa-tion group were given Escitalopram combined with problem-solving therapy.The HAMD and CSS scores before and 6,12 weeks after treatment of two groups were compared. Results HAMD and CSS scores of two groups before treatment had no statistically significant difference(P>0.05). 6 and 12 weeks after treatment, HAMD and CSS scores of two groups were significantly lower than those before treatment, and scores of observation group were significantly lower than those of control group, the differences were statistically significant (all P<0.05). 12 weeks after treatment, the HAMD score of observation group was significantly lower than that in 6 weeks after treatment, the difference was statistically significant (P<0.05). Conclusion Escitalopram combined with problem-solving therapy has significant effect in the treatment of patients with PSD, can promote the re-covery of neural function effectively, so as to reduce the mortality of patients with cerebral apoplexy, is worthy of clinical application.