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目的观察研究帕罗西汀治疗急性期脑卒中后抑郁的疗效和安全性。方法 60例急性期脑卒中后抑郁患者随机分为帕罗西汀组和对照组,各30例。对照组按照脑血管病常规疗法治疗,帕罗西汀组在常规疗法基础上加用帕罗西汀。治疗前及治疗后14、28、56 d进行汉密尔顿抑郁量表(HAMD)评定,根据第56天HAMD评分的减分率为依据评定临床疗效,同时监测不良反应发生情况。结果帕罗西汀组治疗后第28、56天HAMD评分较治疗前明显减低(P<0.01),且与对照组相比差异有统计学意义(P<0.01);帕罗西汀组总有效率高于对照组(P<0.01);没有观察到明确的药物不良反应。结论帕罗西汀能明显改善急性期脑卒中后抑郁,治疗安全有效,值得临床推广应用。
Objective To observe the efficacy and safety of paroxetine in the treatment of post-stroke depression in acute stage. Methods Sixty patients with acute post-stroke depression were randomly divided into paroxetine group and control group, with 30 cases in each group. The control group was treated according to the conventional therapy of cerebrovascular disease. The paroxetine group was treated with paroxetine on the basis of conventional therapy. The Hamilton Depression Rating Scale (HAMD) was assessed before treatment and 14, 28 and 56 days after treatment. The clinical efficacy was assessed based on the reduction rate of HAMD score on the 56th day. The incidence of adverse reactions was also monitored. Results The HAMD score of paroxetine group decreased significantly (P <0.01) 28 and 56 days after treatment compared with that of control group (P <0.01). The total effective rate of paroxetine group was higher than that of control group Group (P <0.01); no clear adverse drug reactions were observed. Conclusion Paroxetine can obviously improve post-stroke depression in acute stage, and is safe and effective. It is worthy of clinical application.