草酸艾司西酞普兰联合理情行为疗法治疗卒中后抑郁的可行性  

Feasibility of escitalopram oxalate combined with rational emotive behavior therapy in patients with post-stroke depression

作　　者：黄俭[1] 朱向阳[1] 程小伟 HUANG Jian;ZHU Xiangyang;CHENG Xiaowei(Department of Psychology,Nantong First People's Hospital,Nantong 226000,China)

机构地区：[1]南通市第一人民医院心理科,南通226000

出　　处：《西北药学杂志》2023年第6期137-141,共5页Northwest Pharmaceutical Journal

基　　金：江苏省卫生健康委科研项目(编号:H2019057)。

摘　　要：目的分析草酸艾司西酞普兰联合理情行为疗法(rational emotive behavior therapy,REBT)治疗卒中后抑郁(post-stroke depression,PSD)患者的可行性。方法选取PSD患者64例,用随机数字表法分为对照组和观察组,每组32例。2组均给予基础治疗,在此基础上,对照组给予草酸艾司西酞普兰治疗,观察组给予草酸艾司西酞普兰联合REBT治疗,2组均治疗8周。比较2组的疗效,治疗前、治疗8周后睡眠质量及情绪状态、神经功能、生活质量及神经因子和炎症因子的水平。结果治疗8周后,观察组的总有效率(87.50%)高于对照组(62.50%),P<0.05。治疗8周后,2组匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、美国国立卫生院脑卒中量表(national institutes of health stroke scale,NIHSS)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分,血清中枢神经特异蛋白(central nervous system specific protein,S100β)、白细胞介素(interleukin,IL)-1β、IL-6、神经元特异性烯醇化酶(neuron-specific enolase,NSE)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)均降低,且观察组更低(P<0.05);2组Barthel指数(Barthel index,BI)、脑卒中专用生活质量量表(stroke quality of life scale,SS-QOL)得分均升高,且观察组更高(P<0.05)。结论草酸艾司西酞普兰联合REBT治疗PSD的效果较好,可改善患者的睡眠质量及情绪状态,促进神经功能恢复,改善生活质量,可能与其调节机体神经因子及炎症因子的表达有关。Objective To analyze the feasibility of escitalopram oxalate combined with rational emotive behavior therapy(REBT)in patients with post-stroke depression(PSD).Methods 64 patients with PSD were divided into control group(32 cases)and observation group(32 cases)according to random number table method.The both groups were given same basic treatment.The control group was given escitalopram oxalate treatment,while the observation group was given escitalopram oxalate combined with REBT treatment.The treatment lasted for 8 weeks.The therapeutic effect,sleep quality,emotional state,neurological function nerve factor,inflammatory factor and the quality of life before and after treatment were compared between the 2 groups.Results After treatment,the total effective rate of observation group was 87.50%,higher in the other groups(62.50%,P<0.05).Compared with before treatment,after 8 weeks of treatment,the scores of Pittsburgh sleep quality index(PSQI),Hamilton depression scale(HAMD),national institutes of health stroke scale(NIHSS)and Hamilton anxiety scale(HAMA),the serum levels of central nervous system specific protein(S100β),interleukin(IL)-1β,IL-6,neuron-specific enolase(NSE)and tumor necrosis factor-α(TNF-α)decreased in the both groups,and were lower in the the observation group(P<0.05);the scores of Barthel index(BI)and stroke quality of life scale(SS-QOL)in the 2 groups increased,and higher in the observation group(P<0.05).Conclusion Escitalopram oxalate combined with REBT was effective in the treatment of patients with PSD.The combination could improve the sleep quality and emotional state of patients,promote the recovery of neurological function and quality of life,which might be related to the regulation of the expression of nerve factors and inflammatory factors.

关 键 词：草酸艾司西酞普兰 理情行为疗法 卒中后抑郁 匹兹堡睡眠质量指数量表 炎症因子 

分 类 号：R971[医药卫生—药品]