认知行为疗法联合养心疏肝疗法治疗脑卒中后抑郁的临床观察  

Clinical Observation of Cognitive Behavioral Therapy Combined with Heart-Nourishing and Liver-Soothing Therapy in the Treatment of Post-Stroke Depression

作　　者：刘镓雨 谢昕[1] 关辉[2] 绳金池 杨子舒涵 刘晓萌 LIU Jiayu;XIE Xin;GUAN Hui;SHENG Jinchi;YANG Zishuhan;LIU Xiaomeng(Department of Rehabilitation Department,Heilongjiang Provincial Hospital,Harbin,Heilongjiang 150036,China;Department of Integrated Chinese and Western Medicine,Heilongjiang Provincial Hospital,Harbin,Heilongjiang 150036,China;Cadre Ward,The 962th Hospital of PLA Joint Logistic Support Force,Harbin,Heilongjiang 150080,China;Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang 150001,China;Department of Traditional Chinese Medicine,The 962th Hospital of the Joint Logistic Support Force of PLA,Harbin,Heilongjiang 150080,China)

机构地区：[1]黑龙江省医院康复科,黑龙江哈尔滨150036 [2]黑龙江省医院中西医结合科,黑龙江哈尔滨150036 [3]中国人民解放军联勤保障部队第九六二医院干部病房,黑龙江哈尔滨150080 [4]黑龙江中医药大学,黑龙江哈尔滨150001 [5]中国人民解放军联勤保障部队第九六二医院中医科,黑龙江哈尔滨150080

出　　处：《中国医药指南》2025年第4期27-29,共3页Guide of China Medicine

基　　金：黑龙江省中医药管理局中医药科研课题项目(ZHY2023-019)。

摘　　要：目的观察认知行为疗法(CBT)联合养心疏肝疗法治疗脑卒中后抑郁的临床疗效。方法选取2023年4月至2024年3月黑龙江省医院收治的30例脑卒中后抑郁患者为研究对象,就诊序号为奇数的15例为观察组,偶数的15例为对照组。两组患者均进行相同的常规治疗。对照组在常规治疗的基础上予以对症治疗,观察组在常规治疗的基础上实施CBT联合养心疏肝疗法。观察两组治疗前、后患者治疗效果、神经功能、睡眠质量、日常生活活动能力及不良反应。结果观察组治疗总有效率高于对照组(P<0.05);两组治疗前神经功能、睡眠质量及日常生活活动能力得分比较无差异(P>0.05),治疗后两组美国国立卫生院脑卒中量表、匹兹堡睡眠质量指数评分均低于治疗前且观察组更低,Barthel指数评分高于治疗前且观察组更高(P<0.05),观察组不良反应发生率低于对照组(P<0.05)。结论CBT联合养心疏肝疗法可有效提高脑卒中后抑郁患者的治疗效果,并改善睡眠质量及日常生活活动能力,促进神经功能恢复,且不良反应少。Objective Observe the clinical efficacy of cognitive behavior therapy(CBT)combined with nourishing heart and liver therapy to treat depression after stroke.Methods Thirty patients with post-stroke depression admitted to Heilongjiang Provincial Hospital from April 2023 to March 2024 were selected as the study objects.15 patients with odd number were selected as the observation group,and 15 patients with even number were selected as the control group.Both groups received the same routine treatment.The control group was given symptomatic treatment on the basis of conventional treatment,and the observation group was given CBT combined heart-nourishing and liver-soothing therapy on the basis of conventional treatment.The therapeutic effect,neurological function,sleep quality,activity of daily living and adverse reactions were observed before and after treatment.Results The total effective rate of observation group was higher than that of control group(P<0.05).There were no differences in the scores of nerve function,sleep quality and activity of daily living between the two groups before treatment(P>0.05).After treatment,the scores of National Institutes of Health Stroke Scale and Pittsburgh Sleep Quality Index in both groups were lower than before treatment and lower in the observation group,and the Barthel index score was higher than before treatment and higher in the observation group(P<0.05),and the incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusions CBT combined with nourishing heart and liver therapy can effectively improve the treatment effect of patients with depression after stroke,improve sleep quality and daily activity ability,promote neurological recovery,and less adverse reactions.

关 键 词：认知行为疗法 养心疏肝疗法 脑卒中 抑郁 

分 类 号：R743.3[医药卫生—神经病学与精神病学]