认知行为治疗对脑卒中后抑郁、神经功能缺损的疗效观察

目的研究认知行为治疗对脑卒中后抑郁、神经功能缺损康复的作用。方法将脑卒中患者随机分为治疗组、对照组，治疗组在常规治疗基础上给予认知行为治疗，对照组给予常规治疗，于治疗前、治疗第4周后分别进行神经功能缺损和HAMD抑郁量表评分。结果共348例脑卒中患者，其中，治疗组197例，对照组151例；神经功能缺损评分显示：治疗前两组无差异，治疗4周后与治疗前比较，两组评分有极显著性差异（P〈0．001）；4周后治疗组神经功能缺损评分较对照组显著性改善（t=2．044，P=0．045）。治疗组的PSD发生率为23．35％，对照组为34．44％，前者显著低于后者（X^2=66．391，P〈0．001）。结论认知行为治疗可显著改善患者的神经功能，并降低PSD的发生率。

Therapeutic effects of cognitive psychological care in post stroke depression and nervous dysfunction

Objective To observe the effect of cognitive psychological and convalescent care in post stroke depression （PSD） and nervous dysfunction. Methods Cases of stroke were randomly divided into treatment group and control group. Treatment group accepted cognitive psychological and convalescent care on the base of conventional therapy and control group accepted conventional therapy. Before treatment,the nervous dysfunction scale was evaluated. And after treatment lasting for 4 weeks,we repeat evaluating the former nervous dysfunction scale and HAMD depression scale. Results There were totally 348 stroke patients,therapy group had 197 patients, control group had 151 patients. Scores of nervous dysfunction in all patients were significantly less than those after treatment （ P 〈 0. 001 ）. Treatment group was significanfly less than control group after treatment （ P 〈 0.05 ）. The incidence rate of PSD in treatment group was significantly less than that in control group. Conclusion Cognitive psychological care can significantly degrade the incidence rate of PSD and improve nerve function in stake.