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目的探讨帕罗西汀联合心理治疗脑卒中后抑郁的治疗效果。方法将106例脑卒中后抑郁患者随机分为治疗组和对照组,对照组给予心理治疗,治疗组给予心理治疗和帕罗西汀治疗。8周后,对两组患者进行HAMD、MESSS、TESS评分,入院后采用汉密尔顿抑郁量表(HAMD)评定抑郁症状;采用放射免疫法测定两组患者血浆Cor含量。结果经过治疗,治疗组的脑卒中后抑郁的显效率为71.7%,神经功能恢复总有效率为90.6%,均显著高于对照组的43.4%和66%(P<0.05);治疗后两组的HAMD和MESSS评分均显著下降(P<0.05),两组间比较差异有统计学意义(P<0.05);TESS评分差异无统计学意义(P>0.05)。帕罗西汀治疗组血浆Cor含量降低幅度较对照组更明显(P<0.05)。结论脑卒中后抑郁患者经帕罗西汀联合心理治疗后,抑郁程度明显减轻,生活质量均明显改善,血浆Cor含量降低可能是帕罗西汀治疗脑卒中后抑郁症的一种作用机制。
Objective To investigate the therapeutic effect of paroxetine combined with psychotherapy on post-stroke depression. Methods 106 patients with post-stroke depression were randomly divided into treatment group and control group. The control group was given psychological treatment. The treatment group was given psychotherapy and paroxetine treatment. After 8 weeks, HAMD, MESSS and TESS scores were evaluated in both groups. Depression was assessed by Hamilton Depression Rating Scale (HAMD) after hospital admission. Plasma Cor levels were measured by radioimmunoassay. Results After treatment, the effective rate of post-stroke depression in the treatment group was 71.7% and the total effective rate of neurological recovery was 90.6%, which were significantly higher than those in the control group (43.4% vs 66%, P <0.05) (P <0.05). There was significant difference between the two groups (P <0.05). There was no significant difference in TESS scores between the two groups (P> 0.05). Paroxetine treatment group plasma Cor content decreased more significantly than the control group (P <0.05). Conclusions Paroxetine combined with psychotherapy can significantly reduce the degree of depression and improve the quality of life. Decreased plasma Cor may be one of the mechanisms of Paroxetine in the treatment of post-stroke depression.