SSRIs联合作业疗法对卒中后抑郁患者神经递质、心理水平及日常生活能力改善情况的影响  

Effect of combining SSRIs with occupational therapy on neurotransmitter levels,psychological well-being,and activities of daily living in individuals diagnosed with post-stroke depression

作　　者：王皇予 冯琳 陆丽娜 班维固[2] 滕秀英[2] WANG Huang-yu;FENG Lin;LU Li-na;BAN Wei-gu;TENG Xiu-ying(Heilongjiang University of Chinese Medicine,Harbin 151004,Heilongjiang,China;Department of Rehabilitation II,the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 151004,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨151004 [2]黑龙江中医药大学附属第二医院康复二科,黑龙江哈尔滨151004

出　　处：《川北医学院学报》2025年第3期310-313,318,共5页Journal of North Sichuan Medical College

基　　金：黑龙江省卫生健康委科研项目(20222020011107);黑龙江省中医药科研项目(ZHY2023-104)。

摘　　要：目的:探究选择性血清素再摄取抑制剂(SSRIs)联合作业疗法(OT)对卒中后抑郁(PSD)患者神经递质、心理水平及日常生活能力改善情况。方法:纳入90例PSD患者作为研究对象,按照治疗方式不同分为对照组(n=45)和试验组(n=45)。对照组采用SSRIs治疗;试验组采用SSRIs结合OT治疗。比较两组患者治疗后总有效率、去甲肾上腺素(NE)、5-羟色胺(5-HT)、脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)水平、汉密尔顿抑郁量表(HAMD)评分、日常生活活动(ADL)评分、匹兹堡睡眠质量指数量表(PSQI)评分及不良反应发生情况。结果:两组患者治疗总有效率试验组95.56%高于对照组的80.00%(P<0.05);治疗后,两组患者血清NE、IGF-1、5-HT、BDNF水平均改善(P<0.05),且试验组改善优于对照组(P<0.05);两组患者ADL评分均升高(P<0.05),PSQI评分均降低(P<0.05),且试验组患者ADL、PSQI评分均较对照组改善更佳(P<0.05);试验组患者不良反应总发生率为2.22%,低于对照组的17.78%(P<0.05)。结论:PSD患者使用SSRIs联合OT治疗,能改善心理水平、睡眠质量,调控神经递质,进而提高日常生活能力,增加治疗安全性,优势显著。Objective:To investigate the impact of combining selective serotonin reuptake inhibitors(SSRIs) with occupational therapy(OT) on neurological functioning,psychological well-being,and activities of daily living in individuals diagnosed with post-stroke depression(PSD).Methods:A total of 90 patients diagnosed with post-stroke depression were selected as the research subjects.They were divided into two groups according to different treatment methods,namely the control group(n=45) and the experimental group(n=45).The control group received treatment with SSRIs,while the experimental group received a combination of SSRIs and OT.The overall treatment efficacy,levels of norepinephrine(NE),5-hydroxytryptamine(5-HT),brain-derived neurotrophic factor(BDNF),insulin-like growth factor-1(IGF-1),Hamilton depression scale(HAMD) score,activities of daily living(ADL) score,and Pittsburgh sleep quality Index(PSQ) were compared between the two groups before and after treatment,including the incidence of adverse reactions.Results:The total effective rates of the the experimental group was higher than that of the control group(95.56% vs.80.00%,P<0.05).After treatment,the serum levels of NE,IGF-1,5-HT,and BDNF in both groups exhibited improvement compared to pre-treatment levels(P<0.05).Furthermore,the experimental group demonstrated superior post-treatment serum levels of NE,IGF-1,5-HT,and BDNF when compared to the control group(P<0.05).After treatment,the ADL scores of both groups exhibited a significant improvement compared to pre-treatment levels(P<0.05),the PSQI scores of both groups demonstrated a decrease in comparison to pre-treatment values(P<0.05).Moreover,the experimental group displayed superior post-treatment ADL and PSQI scores when compared to the control group(P<0.05).The incidence of adverse reactions in the two groups was 2.22% and 17.78%,respectively,with a lower rate observed in the experimental group compared to the control group(P<0.05).Conclusion:The use of SSRIs combined with OT treatment in PSD patients can en

关 键 词：选择性血清素再摄取抑制剂 作业疗法 脑卒中 卒中后抑郁 神经递质 心理水平 日常生活能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]