| 摘要 |
【摘要】目的:研究盐酸舍曲林联合心理治疗对脑卒中后抑郁及神经功能康复的影响。方法:研究对象选取我院2015年5月到2016年5月间收治的脑卒中后抑郁患者88例，采用随机数字法将其分为观察组及对照组，每组各44例。所有患者均进行常规清除自由基、改善脑部微循环治疗，在此基础上对照组患者服用舍曲林，观察组服用舍曲林并联合心理治疗，所有患者疗程均为4周；在治疗前及治疗后第4、8周末分别使用汉密尔顿抑郁量表（Hamilton depression rating scale，HAMD）及美国国立卫生研究卒中量表（National Institute of Health stroke scale，NIHSS）评估两组患者抑郁症状及神经功能康复情况，同时在治疗完成后根据HAMD减分率评估两组近期治疗效果；随访12个月，在治疗后第6个月及12个月时采用日常生活能力量表（Activities of daily living scale, ADL）评估两组患者的远期恢复情况。结果：两组治疗前HAMD评分及NIHSS评分均未显示出统计学差异（P>0.05），治疗后第4、8周末观察组HAMD评分及NIHSS评分均显著低于对照组（P<0.01），两组治疗后各个时间点HAMD评分及NIHSS评分均显著低于治疗前（P<0.01）;治疗后第8周末观察组的治疗总有效率（90.90%）显著高于对照组（72.73%）（P=0.02,χ2=4.88），随访结果显示，观察组治疗后第6个月及12个月时ADL评分均明显高于对照组（P<0.01）。结论：盐酸舍曲林联合心理治疗能有效缓解脑卒中后抑郁症状，同时促进患者神经功能的恢复，改善生活质量，值得临床推广使用。
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| Abstract |
[Abstract] Objective:To explore the effects of treatment on post-stroke depression and neurological rehabilitation of sertraline combined with psychological depression. 88 cases of stroke patients Methods: a total of 88 patients in our hospital from May 2015 to May 2016 were randomly divided into observation group and control group, 44 cases in each group. All patients were treated with routine scavenging of free radicals to improve the microcirculation of the brain, on the basis of the control group were treated with sertraline, The observation group was treated with sertraline and psychotherapy, all patients were treated for 4 weeks; before and after treatment 4,8 weeks respectively by the Hamilton depression rating scale (HAMD) and the National Institute of Health stroke scale (NIHSS) assessment of two groups of patients with depression and neurological rehabilitation, while after the completion of treatment according to the HAMD reduction rate of assessment of two groups of therapeutic effect; The patients were followed up for 12 months, The daily living ability scale was used at 6th and 12th months after treatment to estimate the Long-term recovery of two groups.Results: Before treatment,the HAMD score and NIHSS score of two groups showed no significant difference (P>0.05), on the weekend of 4th,8th,the HAMD score and NIHSS score of observation group were significantly lower than those in control group (P<0.01),at different time points after treatment the HAMD and NIHSS scores were significantly lower than that before treatment (P<0.01); after eighth weeks of treatment, the total effective rate of observation group (90.90%) was significantly higher than that in control group (72.73%) ( P=0.02 x 2=4.88), follow-up results showed that 6 months and 12 months after treatment, the ADL scores of observation group were significantly higher than that in control group (P<0.01). Conclusion: Sertraline combined with psychotherapy can effectively alleviate post-stroke depression symptoms, and promote the recovery of neurological function and improve the quality of life, is worthy of promotion use.
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