问题解决疗法联合经颅直流电治疗对老年卒中后抑郁患者康复效果的影响  

Effects of problem-solving therapy combined with transcranial direct current stimulationon the rehabilitation of elderly patients with post-stroke depression

作　　者：赵晖 刘智华 刘永杰 鲁圆圆 李建丰 高超 ZHAO Hui;LIU Zhihua;LIU Yongjie;LU Yuanyuan;LI Jianfeng;GAO Chao(Nanyang Fourth People's Hospital,Nanyang 473000,China;Luoyang Fifth People's Hospital)

机构地区：[1]河南省南阳市第四人民医院,473000 [2]洛阳市第五人民医院

出　　处：《中国健康心理学杂志》2024年第6期849-853,共5页China Journal of Health Psychology

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20200901)。

摘　　要：目的:探讨问题解决疗法联合经颅直流电治疗对老年卒中后抑郁患者康复效果的影响。方法:将纳入卒中后抑郁诊断标准的老年患者127例,依照随机数字表法进行分组,其中观察组64例,对照组63例,两组患者均给予内科常规治疗及护理,在此基础上,对照组患者给予经颅直流电治疗,观察组患者给与问题解决疗法联合经颅直流电治疗。采用汉密尔顿抑郁量表(HAMD-17)、脑卒中自我管理行为评定量表(SSMBS)、简易智力状态检查量表(MMSE)、美国国立卫生研究院卒中量表(NIHSS)、改良Barthei指数(MBI)、慢性疾病病耻感量表简版(SSCI-8)评估两组患者治疗前、治疗4周末得分。结果:两组脱落率比较,观察组的脱落率为3.12%,对照组的脱离率为4.76%,差异无统计学意义(P>0.05);两组有效率比较,观察组的有效率为91.2%,对照组有效率76.7%,差异具有显著的统计学意义(χ^(2)=5.407,P<0.05);干预4周末,两组患者的HAMD-17、SSCI-8、NIHSS评分均较治疗前降低(观察组:t=37.842,-31.005,-26.023,P<0.001;对照组:t=28.255,-24.621,-23.916,P<0.001),但与对照组相比,观察组则下降则更为明显,且差异具有统计学意义(t=4.908,3.220,2.569;P<0.05);干预4周末,两组患者的MMSE、SSMBS、MBI评分均较治疗前升高(观察组:t=23.362,18.921,27.566,P<0.001;对照组:t=14.772,15.126,16.122,P<0.001),但与对照组相比,观察组则升高更为显著,且差异具有统计学意义(t=-3.631,-3.292,-7.913;P<0.01)。结论:问题解决疗法联合经颅直流电干预模式可有效的改善老年卒中后抑郁情绪、认知功能及病耻感,促进患者的神经功能的康复,提高患者的自我管理行为及日常生活能力。Objective:To explore the effects of problem-solving therapy combined with transcranial direct current stimulation on the rehabilitation of elderly patients with post-stroke depression.Methods:A total of 127 elderly patients with post-stroke depression were divided into two groups according to the random number table method,64 cases in the observation group and 63 cases in the control group.Both groups were given conventional treatment and nursing.On this basis,the control group was given transcranial direct current therapy,while the observation group was given problem-solving therapy combined with transcranial direct current therapy.Hamilton Depression Scale(HAMD-17),Stroke Self-Management Behavior Scale(SSMBS),Mini-Mental State Examination(MMSE),National Institutes of Health Stroke Scale(NIHSS),Modified Barthel Index(MBI),and Short Form Chronic Disease Stigma Inventory(SSCI-8)were used to evaluate the scores of the two groups before treatment and at the end of 4 weeks of treatment.Results:The dropout rate in the observation group was 3.12%,while that in the control group was 4.76%,and the difference was not statistically significant(P>0.05).The effective rate in the observation group was 91.2%,while that in the control group was 76.7%,and the difference was statistically significant(χ^(2)=5.407,P<0.05).At the end of the 4-week intervention,the HAMD-17,SSCI-8,and NIHSS scores of both groups decreased compared with those before treatment(The observation group:t=37.842,-31.005,-26.023;P<0.001;The control group:t=28.255,-24.621,-23.916;P<0.001),but the decrease in the observation group was more significant,and the difference was statistically significant(t=4.908,3.220,2.569;P<0.05).At the end of the 4-week intervention,the MMSE,SSMBS,and MBI scores of both groups increased compared with those before treatment(The observation group:t=23.362,18.921,27.566;P<0.001;The control group:t=14.772,15.126,16.122;P<0.001),but the increase in the observation group was more significant,and the difference was statistically signif

关 键 词：问题解决疗法 经颅直流电治疗 老年患者 卒中后抑郁 

分 类 号：R395.5[哲学宗教—心理学] R749.05[医药卫生—医学心理学]