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目的探讨帕罗西汀联合问题解决疗法在脑卒中后抑郁治疗中的效果。方法选择2012年1月~2014年12月四川省自贡市第一人民医院神经内科59例脑卒中后抑郁患者为研究对象,采用随机数字表法将其分为观察组(29例)和对照组(30例),对照组患者给予帕罗西汀治疗,观察组患者给予帕罗西汀联合问题解决疗法治疗。治疗前和治疗后6、12周观察并比较两组患者神经功能缺损程度评分(CSS)及汉密尔顿抑郁量表(HAMD)评分情况;治疗12周对患者进行日常生活活动能力(ADL)评分。结果两组患者治疗后6、12周后HAMD、CSS及ADL评分均较治疗前明显降低,且观察组明显低于对照组(P<0.05);治疗后12周,两组患者HAMD评分及CSS评分较治疗后6周明显降低(P<0.05)。治疗后12周,两组患ADL评分明显优于治疗前,且观察组优于对照组(均P<0.05)。结论帕罗西汀联合问题解决疗法在脑卒中后抑郁治疗中具有显著疗效,其能促进患者的神经功能恢复,提高患者生命质量,并降低病死率,值得临床推广应用。
Objective To investigate the effect of paroxetine combined with problem-solving in post-stroke depression. Methods 59 patients with post-stroke depression who were admitted to the First People’s Hospital of Zigong City, Sichuan Province from January 2012 to December 2014 were enrolled in this study. The patients were divided into observation group (n = 29) and control group (30 cases). Patients in the control group were treated with paroxetine. Patients in the observation group were treated with Paroxetine in combination with problem-solving therapy. The levels of neurological deficit (CSS) and Hamilton Depression Rating Scale (HAMD) were observed before and 6 and 12 weeks after treatment. The ADL scores of patients were evaluated after 12 weeks of treatment. Results The scores of HAMD, CSS and ADL after 6 and 12 weeks of treatment in both groups were significantly lower than those before treatment, and the scores in observation group were significantly lower than those in control group (P <0.05). After 12 weeks of treatment, HAMD score and CSS The score was significantly lower than 6 weeks after treatment (P <0.05). After 12 weeks of treatment, ADL scores of both groups were significantly better than those before treatment, and the observation group was better than the control group (all P <0.05). Conclusion Paroxetine combined with problem-solving therapy has a significant effect in the treatment of post-stroke depression. It can promote the recovery of neurological function, improve the quality of life of patients and reduce the mortality. It is worthy of clinical application.