氟西汀联合支持性心理治疗脑卒中后抑郁的疗效观察  

Effect of fluoxetine combined with psychotherapy in the treatment of patients with post-stroke depression

作　　者：刘玲英[1] 罗均[1] 杨期明[1] 李海鹏[1] 

机构地区：[1]湖南省郴州市第一人民医院,423000

出　　处：《中国医学创新》2011年第3期8-10,共3页Medical Innovation of China

摘　　要：目的观察抗抑郁药物氟西汀联合支持性心理治疗对脑卒中后抑郁的临床疗效。方法 118例卒中后抑郁症患者随机分为治疗组和对照组各59例,两组均给支持性心理治疗;治疗组同时予以氟西汀(百忧解)20～40 mg/d,早餐后服用。治疗前和治疗后8周末分别用汉密尔顿抑郁量表(HAMD)、中国卒中量表(CSS)评定其疗效。结果治疗前两组HAMD分值无差异,治疗8周后,两组的HAMD、CSS评分均明显低于治疗前,且治疗组均优于对照组,差异有显著性意义(P<0.01)。治疗组抑郁总有效率、神经功能恢复总有效率分别为93.2%和91.5%,明显高于对照组的81.36%和79.66%(P<0.01)。结论氟西汀联合支持性心理治疗有良好的抗抑郁及促进神经功能恢复的作用,疗效优于单用支持性心理治疗,尤其是精力减退、愉快感缺乏、思维语言行动迟滞等抑郁症的低动力症状改善明显,使抑郁症状改善更彻底,康复动力激活更明显。Objective To study the effects of Fluoxetine combined with psychotherapy in treating post - stroke depression. Methods In this study, a total of 118 patients with post - stroke depression were divided into 2 groups randomly. Among all patients, 59 patients were treated with psychotherapy （Control group） and other 59 patients were treated with Fluoxetine 20 -40 mg every day combined with psychotherapy （Treatment group） for 8 weeks. HAMD and CSS were used to evaluate the symptoms improvement and side effects. Results After 8 weeks treatment, HAMD and CSS scores obviously decreased in two groups, but these scores in the treatment group were lower than those in the control group. There were significant differences in two groups （P 〈0. 01 ）. The total rate of effectual remedy for anti - depression and recovery- neurological function were obviously higher in treatment group （93.2%, 91.5% ） than those in control group （81.36%, 79.66% ）. Conclusion Fluoxetine combined with psychotherapy can obviously improve anti - depression and recovery degree of neurological function exceptionally in depressive hypokinesis symptoms, such as energy dissipated, ahedonia, thinking, speaking, taking action, improved more well, improved symptoms of depression more thoroughly, more significant activation of rehabilitation force.

关 键 词：脑血管意外 卒中后抑郁 氟西汀 支持性心理治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]