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目的探讨氟哌噻吨美利曲辛联合舍曲林治疗脑卒中后抑郁(PSD)的临床疗效,为采取有效的临床预防措施、改善患者的预后提供依据。方法选择2012年1月至2015年1月东莞市南城医院门诊和住院治疗的PSD患者共100例,按随机数字表法分为观察组和对照组,各50例。对照组给予舍曲林治疗,观察组给予氟哌噻吨美利曲辛联合舍曲林治疗。比较两组患者治疗前后抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分及简明健康调查量表(SF-36)评分。结果治疗前,两组患者SDS评分和SAS评分比较差异均无统计学意义(P均>0.05);治疗后,观察组SDS评分和SAS评分较治疗前均显著降低,且低于对照组治疗后(P均<0.05)。治疗前,两组患者SF-36各维度评分比较差异无统计学意义(P均>0.05);治疗后,观察组SF-36各维度(除躯体疼痛外)评分显著增高,且高于对照组治疗后(P均<0.05);两组患者治疗后不良反应发生率比较无统计学差异(P>0.05)。结论氟哌噻吨美利曲辛联合舍曲林治疗PSD患者,可显著改善患者焦虑及抑郁症状,提高生活质量,其效果优于单纯舍曲林治疗。
Objective To investigate the clinical efficacy of flupenthixol combined with sertraline in the treatment of post-stroke depression (PSD), and to provide evidence for effective clinical preventive measures and improvement of prognosis. Methods A total of 100 PSD patients from outpatient department and hospitalized in Nancheng Hospital of Dongguan City between January 2012 and January 2015 were randomly divided into observation group and control group according to the random number table method, 50 cases each. The control group was given sertraline and the observation group was given flupentixol and melitracen plus sertraline. Pre-and post-treatment depression self-rating scale (SDS), anxiety self-rating scale (SAS) and concise health survey scale (SF-36) were compared between the two groups. Results Before treatment, there was no significant difference between the two groups in SDS score and SAS score (all P> 0.05). After treatment, the scores of SDS and SAS in observation group were significantly lower than those before treatment, and were lower than those in control group (P <0.05). Before treatment, there was no significant difference in scores of SF-36 between the two groups (all P> 0.05). After treatment, the score of SF-36 in the observation group (except somatic pain) was significantly higher than that of the control group After treatment (P <0.05), no significant difference was found in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion The combination of flupenthixol and melitracen combined with sertraline in the treatment of PSD patients can significantly improve the patient’s anxiety and depression symptoms and improve the quality of life, which is superior to sertraline alone.