脑卒中恢复期抑郁状态现状及中医情志干预的效果研究  

Study on Depression Status and Nursing Intervention Effect of Stroke Patients in Convalescent Period

作　　者：陈兵 王慧凯[1,2] 刘琳琳 韩浩 CHEN Bing;WANG Huikai;LIU Linlin;HAN Hao(Binzhou Medical College Affiliated Hospital,Binzhou 256603,Shandong,China;Binzhou Hospital of Traditional Chinese Medicine,Binzhou 256603,Shandong,China;Binzhou Bincheng People's Hospital,Binzhou 256603,Shandong,China)

机构地区：[1]滨州医学院附属医院,山东滨州256603 [2]滨州市中医医院/滨州医学院附属中医医院,山东滨州256603 [3]滨州市滨城区人民医院,山东滨州256603

出　　处：《实用中医内科杂志》2022年第3期89-92,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：山东省中医药科技发展计划(2019-0510)。

摘　　要：目的对脑卒中患者抑郁状态现状进行调研,提出相应的中医情志干预措施并验证其应用效果。方法采用实地调查分析的方法,对滨州地区滨州医学院附属医院、滨州市中医院、滨城区人民医院的2019年—2020年入住中医科、脑病科及康复科的临床诊断为脑卒中(脑梗死后遗症、脑内出血后遗症)恢复期的患者进行研究,调查患者的一般资料,采用汉密尔顿抑郁量表对患者的抑郁情况进行调研,并对其中确诊抑郁状态的患者按照平行随机对照的方法分为两组,对照组采用口服氟哌噻吨美利曲辛片,观察组在对照组的基础上增加中医情志干预,通过对干预前后进行汉密尔顿抑郁量表评分(HAMD)、神经功能缺损评分(NIHSS)和日常生活能力评分(ADL)验证其应用效果。结果①2019年—2020年,三院共收治脑卒中恢复期患者2467例,经汉密尔顿评分后确诊抑郁状态患者952例,脑卒中恢复期患者抑郁发生率为38.59%(952/2467)。②干预前两组抑郁情况发生率比较,差异无统计学意义(P>0.05)。干预后比较,对照组降到22%,观察组降到13%(P<0.01)。③干预后两组患者的HAMD评分、NIHSS评分均低于干预前,ADL评分高于干预前(P<0.05),观察组显著优于对照组(P<0.01)。结论目前,某地脑卒中后抑郁的发生率较高,对脑卒中后抑郁患者在常规治疗的基础上增加中医情志干预,能够有效地降低抑郁率发生率,减轻患者的神经功能缺损情况,提高患者的日常生活能力,值得临床推广应用。Objective To investigate the depression status of stroke patients,put forward the corresponding traditional Chinese medicine emotional intervention measures and verify its application effect.Methods Using the method of field investigation and analysis,the clinical diagnosis of stroke(cerebral infarction sequelae,intracerebral hemorrhage sequelae)in convalescent period of patients admitted to the Department of traditional Chinese medicine,Department of encephalopathy and Department of rehabilitation from 2019 to 2020 in a tertiary Affiliated Hospital,a tertiary hospital of traditional Chinese medicine and a second class general hospital The patients with depression were investigated and divided into two groups according to their wishes.The control group was given Flupentixol and melitracen tablets,while the experimental group was given traditional Chinese medicine Emotional Intervention on the basis of the control group.Hamilton Depression Scale(HAMD),neurological impairment score(NIHSS)and ability of daily living(ADL)scores were performed before and after the intervention Use the effect.Results①From 2019 to 2020,2467 stroke patients were treated in the three hospitals,and 952 patients were diagnosed with depression after Hamilton score.The incidence of depression in patients with stroke recovery was 38.59%(952/2467).②Before the intervention,the incidence of depression in the two groups was compared(P>0.05).After the intervention,the control group decreased to 22%,the experimental group decreased to 13%(P<0.01).③After the intervention,the HAMD score and NIHSS score of the two groups were lower than those before the intervention,and the ADL score was higher than that before the intervention(P<0.05).After intervention,the experimental group was significantly better than the control group(P<0.01).Conclusion At present,the incidence of post-stroke depression in a certain place is relatively high.On the basis of conventional treatment,the emotional intervention of traditional Chinese medicine can effectively redu

关 键 词：脑卒中后抑郁 现状 中医情志 情志干预 

分 类 号：R749.4[医药卫生—神经病学与精神病学]