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目的观察氟哌噻吨美利曲辛片(黛力新)对脑卒中后抑郁(PSD)及神经康复功能的影响。方法将96例PSD患者按随机数字表法分为治疗组(n=48),给予氟哌噻吨美利曲辛片,每次1片(每片0.5mg+10mg),早上和中午各1次;对照组(n=48)给予盐酸阿米替林,开始每次25mg,早晚各1次,并逐日递增,于第2周末增至150～250mg/d。2组均6周为1个疗程。分别于治疗前、治疗2、4、6周后用汉密尔顿抑郁量表(HAMD)评分法评定其抑郁改善情况,用改良爱丁堡斯堪的纳维亚神经功能缺损评分量表(SSS)评定其神经功能缺损情况。结果 2组在治疗2、4、6周后的HAMD评分及SSS评分均较治疗前下降(P<0.05或P<0.01),且治疗组治疗后不同时间段两种评分均较对照组明显降低(P均<0.05);治疗组副作用总发生率明显低于对照组(25.00%vs81.25%,P<0.01)。结论氟哌噻吨美利曲辛片可明显改善PSD的症状和神经功能缺损,临床副作用少,可作为PSD急性期和长期维持治疗的首选药物。
Objective To observe the effects of flupentixol and melitracen tablets (Deanxit) on post-stroke depression (PSD) and neurological rehabilitation. Methods Ninety-six patients with PSD were randomly divided into treatment group (n = 48), flupenthixol and melitracen tablets (0.5mg + 10mg per tablet), 1 in morning and noon The control group (n = 48) was treated with amitriptyline hydrochloride, starting 25mg every time sooner or later, increasing day by day and increasing to 150 ~ 250mg / d at the end of the second week. 2 groups were 6 weeks for a course of treatment. The improvement of depression was assessed by Hamilton Depression Rating Scale (HAMD) score before treatment, after 2, 4, and 6 weeks of treatment, and the nerve was evaluated by modified Scandinavian Nerve Function Deficit Scale (SSS) Functional deficiencies. Results The HAMD score and SSS score of the two groups after treatment were lower than those before treatment (P <0.05 or P <0.01) after 2, 4 and 6 weeks of treatment, and the two groups in the treatment group were significantly lower than those in the control group (P <0.05). The incidence of side effects in the treatment group was significantly lower than that in the control group (25.00% vs81.25%, P <0.01). Conclusion Flupentixol and melitracen tablets can significantly improve the symptoms and neurological deficits of PSD with less clinical side effects and may be the drug of choice for the acute and long-term maintenance of PSD.