药物联合心理干预治疗卒中后抑郁/焦虑的临床研究  

A clinical study of paroxetine joint psychotherapy in treating poststroke depression with anxiety

作　　者：贺燕[1] 王昕[1] 相守武[1] 李霞[1] 

机构地区：[1]济南铁路中心医院神经内科,济南250001

出　　处：《中国实用神经疾病杂志》2006年第1期34-35,共2页Chinese Journal of Practical Nervous Diseases

基　　金：济南铁路局科研基金资助（02Y41-2）

摘　　要：目的探讨帕罗西汀联合早期心理干预对卒中后抑郁/焦虑患者日常生活能力和神经功能康复的影响。方法采用抑郁自评量表(SDS)、焦虑自评量表(SAS)对272例脑卒中患者进行抑郁/焦虑状态评定,其中患有卒中后抑郁合并焦虑的81名患者分别接受单用帕罗西汀治疗、帕罗西汀联合心理干预治疗以及不干预。采用斯堪的那维亚脑卒中量表(SSS)、Barthel指数(BI)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评测治疗前后的疗效。结果急性脑卒中病人卒中后抑郁并焦虑患病率为29.78%,抑郁与焦虑共病率为65.85%;治疗组I和治疗组II HAMD、HAMA、SSS评分减少和BI评分增加与对照组比较均有显著性差异(P<0.01),治疗组II HAMD、HAMA、SSS评分减少和BI评分增加较治疗组I有显著差异(P均<0.05)。结论卒中后抑郁/焦虑病人单用药物帕罗西汀或给予帕罗西汀合并心理干预治疗均能提高患者神经功能康复程度和生活能力恢复,而且帕罗西汀合并心理干预治疗疗效更满意。Objective To study effects of Paroxetine joint psychotherapy in treating poststroke depression with anxiety. Method In this study, a total of 272 patients with acute brain stroke were assessed with SDS,SAS. Of these 272 patients 81 who meet the eriteria of depression and anxiety after acute brain stroke / of ICD - 10 were reeruited. These 81 patients were treated with routine antistroke medication, routine antistroke medication with Paroxetine and routine antistroke medication with Paroxetine joint psychotherapy respectively for 6 weeks. The rating scales sueh as SSS, HAMD, HAMA ,BI and so on were used to evaluate the symptoms improvement and side effects. Results The preoalenee rate of poststroke depressive combined with anxiety in acute strnke was 29.78 % ,the eomorbidity was 65.85 % . According to the decline of SSS score, HAMD score, HAMA score, and increase of BI score of the patients, significant improvement has been showed in all patients. There were significant difference between trial group Ⅰ or trial group Ⅱ and the controlled group（ P 〈 0.01 ）, trial group Ⅰ and trial group Ⅱ （ P 〈 0.05 ）. Conclusion All of the three projects had effeets on the patients with Poststroke depression with anxiety, routine antistroke medication with Paroxetine is better, and routine antistroke medieation with Paroxetine ioint psychotherapy is the best.

关 键 词：脑卒中后抑郁并焦虑 帕罗西汀 心理干预 

分 类 号：R741.05[医药卫生—神经病学与精神病学]