摘要
目的探讨帕罗西汀联合心理治疗脑卒中后抑郁的治疗效果。方法将106例脑卒中后抑郁患者随机分为治疗组和对照组,对照组给予心理治疗,治疗组给予心理治疗和帕罗西汀治疗。8周后,对两组患者进行HAMD、MESSS、TESS评分,入院后采用汉密尔顿抑郁量表(HAMD)评定抑郁症状;采用放射免疫法测定两组患者血浆Cor含量。结果经过治疗,治疗组的脑卒中后抑郁的显效率为71.7%,神经功能恢复总有效率为90.6%,均显著高于对照组的43.4%和66%(P<0.05);治疗后两组的HAMD和MESSS评分均显著下降(P<0.05),两组间比较差异有统计学意义(P<0.05);TESS评分差异无统计学意义(P>0.05)。帕罗西汀治疗组血浆Cor含量降低幅度较对照组更明显(P<0.05)。结论脑卒中后抑郁患者经帕罗西汀联合心理治疗后,抑郁程度明显减轻,生活质量均明显改善,血浆Cor含量降低可能是帕罗西汀治疗脑卒中后抑郁症的一种作用机制。
Objective To explore the clinical efficacy of paroxetine combined with psychotherapy on post-stroke depression（PSD）. Methods Totally 106 patients suffered from post-stroke depression were randomly divided into two groups： control group（psychotherapy alone） and therapeutic group（paroxetine combined with psychotherapy）.Hamilton depression rating scales,MESSS and TESS were used to evaluate all the patients after admission.The serum cortisol level was detected by radioimmunity method. Results After 8 weeks of treatment,the total effective rates of post-stroke depression and nerves functional restoration of therapeutic group were 71.7% and 90.6%,respectively,which were significantly higher than those（43.4% and 66%） of control group（P0.05）.There were statistically significant differences between two groups in the total scores of HAMD and MESSS（P0.05）,though there was a significant decreasing in each group（P0.05）.No statistically significant difference was found between two groups in the total scores of TESS（P0.05）.The serum level of cortisol in therapeutic group was decreased significantly than that of control group（P0.05）. Conclusions After the treatment of paroxetine combined with psychotherapy,depression level of the patients showed significantly decreased and the quality of life was improved significantly.The decrease of serum level of cortisol may be one of the mechanisms of paroxetine on PSD.
出处
《实用预防医学》
CAS
2011年第5期880-882,共3页
Practical Preventive Medicine
基金
广东省科技计划项目重点课题(粤科函社字2010-096号)
