认知行为团体治疗对住院抑郁症患者的疗效

目的：探讨认知行为团体治疗对住院抑郁症患者的疗效。方法：64例住院抑郁症患者随机分为研究组和对照组各32例。两组均给予盐酸舍曲林治疗,研究组同时接受为期8周,每周1次的认知行为团体治疗。两组分别于入组前及治疗8周接受汉密尔顿抑郁量表（HAMD-17）、汉密尔顿焦虑量表（HAMA）及自动思维问卷（ATQ）的评定;治疗8周后接受团体治疗疗效因子问卷调查。结果：两组HAMD、HAMA及ATQ评分均较治疗前显著降低（P均〈0.01）,以研究组HAMD、HAMA及ATQ评分显著低于对照组（t=-2.63,-2.93,-2.81;P〈0.05或P〈0.01）。研究组团体治疗疗效因子中普同性、情绪宣泄、人际学习（获取）、人际学习（付出）、团体凝聚力等因子显著优于对照组（t=11.74,7.18,5.88,6.09,3.39;P均=0.001）。结论：认知行为团体治疗可有效提高住院抑郁症患者的疗效。     

氨磺必利联合舍曲林在老年抑郁症患者中的应用效果观察

目的观察氨磺必利联合舍曲林在老年抑郁症患者中的治疗效果。方法选取在我院接受住院治疗的老年抑郁症患者82例,随机分对照组(接受舍曲林治疗)和研究组(接受氨磺必利联合舍曲林治疗),均治疗8周。治疗后2周、4周和8周采用HAMD对2组进行疗效评定,采用抗抑郁药副应反量表SERS对2组进行不良反应评定。结果观察组治疗后HAMD评分减分率均明显提高,与对照组比较有显著性差异(P0.05)研究组临床疗效显著优于对照组(P0.05);2组SERS评分比较差异无统计学意义(P0.05)。结论氨磺必利联合舍曲林可明显改善老年抑郁症患者抑郁状态,且不良反应较轻微。     

内观疗法对青少年抑郁症患者的疗效观察

目的 探讨内观疗法对青少年抑郁症患者疗效的影响.方法 86例青少年抑郁症患者随机分为研究组（43例）和对照组（43例）,研究组患者给予疗程为5d的内观治疗联合28 d的舍曲林治疗,对照组患者给予4周的舍曲林治疗,治疗前后采用汉密尔顿抑郁量表（HAMD-17）和社会适应能力诊断量表对两组患者进行疗效评定.结果 治疗5d、28 d后两组HAMD-17评分均较治疗前显著降低（P＜0.01）,研究组HAMD-17评分低于对照组（P＜0.01）.治疗28 d后两组HAMD-17评分均较同组治疗5d后评分降低（P＜0.01）.治疗5d、28 d后两组社会适应量表评分均较治疗前升高（P＜0.01）,研究组社会适应量表评分高于对照组（P＜0.01）.治疗28 d后两组社会适应量表评分均较同组治疗5d后评分升高（P＜0.01）.结论 内观疗法联合抗抑郁药物能有效改善青少年抑郁症患者的抑郁情绪,并提高其社会适应能力.     

中药联合舍曲林对首发抑郁症患者的临床疗效及对血清细胞因子的影响

目的研究中药联合舍曲林治疗首发抑郁症患者的临床疗效及对血清细胞因子白细胞介素-2(IL-2)、IL-6及肿瘤坏死因子-α(TNF-α)水平的影响。方法选取我院2012年5月~2015年11月收治的首发抑郁症患者68例,治疗组患者在对照组舍曲林治疗基础上加用中药方剂柴胡龙牡汤,疗程6周。治疗后对临床疗效、HAMD评分、炎性因子水平、不良反应进行比较。结果治疗组患者临床总有效率(94.1%)显著大于对照组(76.5%)(P0.05);治疗组患者治疗后第4、6周HAMD评分显著小于对照组(均P0.05);治疗组患者治疗后血清IL-2、IL-6及TNF-α水平明显低于对照组(均P0.05);不良反应发生率组间比较,差异无统计学意义(P0.05)。结论中药联合舍曲林治疗首发抑郁症患者效果显著,作用机制可能与减轻患者炎性损伤有关。     

药物治疗联合绘画治疗对抑郁症患者康复效果的影响

目的:探讨绘画疗法联合药物治疗对抑郁症患者康复效果的影响.方法:采用随机数字表法将160例抑郁症分为研究组与对照组,各80例.给予两组患者盐酸舍曲林(50～100 mg/d)抗抑郁治疗;在此基础上研究组患者接受绘画治疗;疗程均为8周.分别于干预前后采用汉密尔顿焦虑量表-14项(HAMA)、汉密尔顿抑郁量表-24项(HA...     

舍曲林联合经颅磁刺激对急性脑梗死后患者神经缺损的影响

目的：探讨对首发脑梗死患者早期应用舍曲林联合经颅磁刺激是否利于神经功能缺损状态的改善,并减少卒中后抑郁的发生。方法将200例首发急性脑卒中患者随机分为对照组、舍曲林组、经颅磁刺激（TMS）组、舍曲林＋ TMS组,对照组为空白对照,4组均接受抗血小板聚集、调脂、改善循环、脑保护等常规治疗,分别应用NIHH评分、ADL评分、汉密顿抑郁量表（HAMD）评价患者入院时、发病12周后神经功能缺损状态、日常生活能力、抑郁状态。结果发病12周后NIHH、ADL、HAMD评分,对照组与舍曲林组、TMS组、舍曲林＋ TMS组间差异均有统计学意义（P＜0·05）,舍曲林组、TMS组与舍曲林＋ TMS组间差异有统计学意义（P＜0·05）。结论舍曲林、TMS均可改善患者的神经功能缺损症状,减少卒中后抑郁的发生,二者联合作用优于单个作用。     

盐酸美金刚对重性抑郁症患者血清脑源性神经营养因子及临床疗效的影响

目的:探讨盐酸美金刚对重性抑郁症患者血清中脑源性神经营养因子(BDNF)及临床疗效的影响。方法:利用随机数字表法将105例重性抑郁症患者随机分为研究组(n=52)与对照组(n=53)。两组给予舍曲林治疗,在此基础上研究组加用20 mg/d盐酸美金刚,对照组加用安慰剂,治疗6周。比较两组治疗2、4、6周时BDNF水平、汉密尔顿抑郁量表(HAMD)评分及汉密尔顿焦虑量表(HAMA)评分。采用治疗中出现的症状量表(TESS)评估不良反应。结果:两组HAMD、HAMA评分均随着治疗时间增长而减少,研究组HAMD、HAMA评分下降幅度与对照组比较差别有统计学意义(P0.05)。治疗后,两组BDNF水平均随着治疗时间增长而增高,研究组增高幅度与对照组比较差别有统计学意义(P0.05)。研究组血清BDNF增加率与HAMD减分率呈正相关(r=0.296,P0.05)。两组不良反应发生率比较差异无统计学意义(P0.05)。结论:盐酸美金刚联合舍曲林在治疗6周内较单用舍曲林能更迅速、更有效降低重性抑郁症患者的临床症状,其原因可能是升高了患者体内的BDNF水平。     

氨磺必利与舍曲林治疗老年抑郁症对照观察

目的：探讨氨磺必利治疗老年抑郁症的有效性及安全性。方法选择符合ICD-10抑郁症诊断标准的老年患者82例,随机分为氨磺必利组和舍曲林组各41例,均治疗8周。于治疗前及治疗后第1周、2周、4周、6周、8周末采用HAMD评定疗效,TESS评定不良反应。结果治疗后2组HAMD评分均较治疗前显著降低（P＜0.01）;治疗后第1周、2周末研究组HAMD评分显著低于对照组（P＜0.01）,第4周、6周、8周末组间比较差异无统计学意义（P＞0.05）。氨磺必利组总有效率95.1％,舍曲林组总有效率90.2％,2组比较差异无统计学意义（P＞0.05）。2组TESS评分差异无统计学意义（P＞0.05）。结论氨磺必利治疗老年抑郁症的疗效、安全性与舍曲林相当,但较舍曲林起效更快,更适合老年抑郁症患者的临床治疗。     

草酸艾司西酞普兰治疗脑卒中后抑郁的疗效分析

目的比较草酸艾司西酞普兰与舍曲林治疗脑卒中后抑郁的疗效及安全性。方法将符合入组标准的70例卒中后抑郁患者随机分为草酸艾司西酞普兰组（研究组）和舍曲林组（对照组）,各入组35例,疗程6周。用汉密尔顿抑郁量表（HAMD-7）评定疗效,治疗中用不良反应量表（TESS）评定安全性。结果两组HAMD评分均较治疗前显著改善,差异有统计学意义（P〈0．01）。治疗1周时研究组HAMD评分显著低于对照组,差异有统计学意义（P〈0．01）;研究组总有效率为94．3％,对照组为91．4％,两组比较差异无统计学意义（x2=66,P〉0．05）;研究组和对照组间不良反应发生率分别为20％和22．8％,差异无统计学意义（x2=0．09,P〉0．05）。结论草酸艾司西酞普兰和舍曲林治疗脑卒中后抑郁症疗效相当,不良反应轻,但前者起效快。     

氨磺必利合并舍曲林治疗老年期抑郁症的对照研究

目的探讨氨磺必利联合舍曲林对老年期抑郁症的治疗作用。方法采用随机开放对照研究,将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的60例老年期抑郁症的患者随机分为研究组(氨磺必利联合舍曲林治疗组)与对照组(单纯舍曲林治疗组),分别在治疗前及治疗后第2、4、6、8周末,采用汉密尔顿抑郁量表(HAMD)、临床总体印象量表(CGI-GI)评定疗效,采用Asberg抗抑郁剂副反应量表(SERS)评定两组的药物副反应。结果研究组HAMD评分在治疗后2周末、4周末、6周末以及8周末与治疗前比较差异有统计学意义(P0.05或0.01);研究组CGI-GI总评分在治疗4周末、6周末以及8周末与治疗前比较差异有统计学意义(P均0.01);治疗后第4、6、8周末,研究组CGI-GI总评分与对照组比较差异有统计学意义(P0.05或0.01);对照组CGI-GI总评分在治疗8周末与治疗前比较差异有统计学意义(P0.01)。治疗后第8周末,对照组SERS评分与研究组比较[(5.4±2.8)分vs.(4.7±2.6)分],差异无统计学意义(P0.05)。结论氨磺必利联合舍曲林对老年期抑郁症的疗效优于单一应用舍曲林治疗,安全性好。     

Factors associated with satisfaction with care among patients with epilepsy

OBJECTIVE: The purpose of the work described here was to determine those variables associated with satisfaction with care among patients with epilepsy. METHODS: We interviewed patients followed at a tertiary epilepsy center. Predictor variables included age, gender, race, education, income, insurance, seizure frequency, and Quality of Life in Epilepsy-10 inventory (QOLIE-10) results. Target variables were the subscales of the Short Form Patient Satisfaction Questionnaire (PSQ-18). We used univariate analysis to identify those variables significantly associated with the subscales and multiple linear regression to determine those independently significant. RESULTS: The study population comprised 193 patients. Lower education and better QOLIE-10 scores were independently associated with general satisfaction with care. The mental health scale was associated with general satisfaction with care. Lower educational level was the only variable independently associated with patient satisfaction with communication, the financial aspect of care, and time spent with physician. CONCLUSION: Lower educational level and better quality of life are the main variables associated with higher general satisfaction with care among patients with epilepsy.     

Treatment with rituximab in patients with polyneuropathy with anti-MAG antibodies

Journal of Neurology -     

Surgical Outcome in Patients with Epilepsy with Occult Vascular Malformations Treated with Lesionectomy

Summary: Purpose: This retrospective study reports the long-term surgical outcome of patients with medically refractory epilepsy and vascular malformations who were treated with lesionectomy. A detailed analysis of surgical failures had been performed in an attempt to define predictors of surgical success and failure.
Methods: Fifteen patients with medically intractable epilepsy and angiographically occult vascular malformations (AOVMs) were treated surgically with lesionectomy at Duke University Medical Center. Lesionectomy consisted of removal of the AOVM and surrounding hemosiderin-stained brain only, without the use of electrocorticography (ECoG) to guide resection.
Results: Eleven (73%) patients are seizure free after lesionectomy. Three showed no significant improvement, and one patient died, presumably after a seizure. Age of onset, duration of seizures, age at resection, and gender did not affect outcome. All patients with neocortical AOVMs in whom EEG findings correlated with the site of the lesion were seizure free after lesional resection. Treatment failures were associated with the presence of multiple intracranial lesions, poorly localized or diffuse EEG findings, discordant positron emission tomography (PET) imaging, or with a lesion in close proximity to the limbic system.
Conclusions: Lesionectomy, with removal of surrounding hemosiderin-stained brain, can be considered the procedure of choice in carefully selected patients with epilepsy with occult vascular malformations.     

Children with ADHD and motor dysfunction compared with children with ADHD only

The purpose of this study was to identify group differences in children with attention-deficit-hyperactivity disorder and motor dysfunction (ADHD-MD) and ADHD only, and to evaluate the medication responsiveness of ADHD-MD. Sixty-three children (49 males and 14 females; mean age 9 years 10 months, SD 2 years 10 months) underwent a triple blind, placebo-controlled crossover study evaluating two dose levels of methylphenidate (0.3 mg/kg and 0.5 mg/kg [corrected], twice daily) and placebo. Forty-nine trials were completed. Nineteen were children with ADHD-MD, 44 had ADHD only. Behavior and functioning were assessed at home and at school. Treatment effects were assessed using the Abbreviated Symptom Questionnaire for Parents and Teachers. Children with ADHD-MD were more likely to have severe ADHD-combined type and other neurodevelopmental and behavioral problems. Both groups of children had a linear dose response to medication (placebo, low, high) and there was no evidence of a group by dose interaction or an overall group effect at home or school. The lack of group effect suggests that these children responded to medication like the other subgroups.     

Chronic headache with vasospasm treated with nimodipine

Journal of Neurology -