抗抑郁药联合康复训练治疗脑卒中后抑郁症的疗效观察(1)
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[摘要] 目的：观察抗抑郁药西酞普兰联合康复训练对脑卒中后抑郁症的疗效。方法：将96例脑卒中后抑郁症患者随机分为药物治疗组(48例)和对照组(48例)，药物治疗组给予康复训练及抗抑郁药西酞普兰联合治疗，对照组仅给予康复训练。分别于治疗前及治疗后2、4、8周时采用汉密尔顿抑郁量表(HAMD)及日常生活能力量表(ADL)进行疗效评定。结果：两组患者经治疗后，其HAMD、ADL评分均较治疗前明显改善(P<0.05)，并且药物治疗组的改善幅度较显著，与对照组比较差异有统计学意义(P<0.05)。结论：抗抑郁药西酞普兰联合康复训练对脑卒中后抑郁症患者具有进一步改善抑郁症状、并进一步改善患者神经功能及提高日常生活能力的功能。
[关键词] 脑卒中后抑郁症；抗抑郁药物治疗；康复训练
[中图分类号] R743.3 [文献标识码] B [文章编号] 1673-7210(2012)01(a)-164-02
The efficacy of antidepressants combined with rehabilitation training in the treatment of depression after stroke
YUAN Yifu, GE Beihai
Department of Neurology, the People's Hospital of Chibi City, Hubei Province, Chibi 437300, China
[Abstract] Objective: To observe the effects of the antidepressant Citalopram combined with rehabilitation training treatment for depression after stroke. Methods: 96 patients of depression after stroke were randomly divided into drug treatment group (48 cases) and control group (48 cases). The drug treatment group was given antidepressant Citalopram combined with rehabilitation training. The control group was given rehabilitation training. The effects were observed before treatment and after treatment for 2, 4, 8 weeks with hamilton depression rating scale (HAMD) and daily living scale (ADL) respectively. Results: The HAMD scores and ADL scores in both groups were significantly improved after treatment (P<0.05) and the improvement in drug treatment group was more significant than control group (P<0.05). Conclusion: The antidepressant Citalopram combined with rehabilitation training for treating depression after stroke improve significantly the depressive symptoms, and further improve neurological function and the ability of daily living.
[Key words] Depression after stroke; Antidepressant drug treatment; Rehabilitation training
脑卒中是目前人类高发病率的三大疾病之一，国外文献报道[1]，脑卒中后抑郁症(PSD)发病率占脑卒中患者的20%～50%；国内报道其发病率为43.33%[2]。PSD不仅影响患者神经功能缺损的康复及生活质量，还增加患者的病死率，对脑卒中后抑郁症的干预治疗迫在眉睫。本文中观察康复训练联合抗抑郁药西酞普兰对脑卒中后抑郁症状的改善及日常生活能力神经功能康复的影响。现报道如下：
1 资料与方法
1.1 临床资料
选取2009年8月～2011年4月在我院住院治疗的PSD患者96例，所有患者均符合全国第四届脑血管病学术会议制订的脑血管疾病的诊断标准[3] ......
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