氟哌噻吨美利曲辛联合认知行为疗法治疗卒中后抑郁的疗效观察

目的：评价氟哌噻吨美利曲辛联合认知行为疗法治疗卒中后抑郁的的临床疗效及安全性。方法：将78例卒中后抑郁症患者随机分为氟哌噻吨美利曲辛联合认知行为疗法治疗组39例，设为治疗组，阿米替林治疗组39例，设为对照组，疗程8周，于治疗前及治疗1周、2周、4周、6周、8周末采用汉密顿抑郁量表（HAMD）评定临床疗效，采用副反应量表（TESS）评定不良反应。结果：治疗组总有效率为92．31％，对照组总有效率为69．23％，两者比较差异有统计学意义（P〈0．01）。对照组治疗2周末HAMD量表评分与人组时比较差异有统计学意义，但治疗组在治疗1周末即显示出明显疗效（P〈0．01），两组同期HAMD量表评分比较，治疗组较对照组下降更显著（P〈0．05或P〈0．01）；两组治疗后同期相比，TESS总分评定治疗组明显低于对照组，差异有统计学意义（P〈0．05）。结论：氟哌噻吨美利曲辛合并认知治疗对卒中后抑郁症疗效显著，安全性高，依从性好，可以缩短疗程，值得推广应用。

The Clinical Therapeutic Effect of Flupentixol and Melitracen Tablets Combined Perception Treatment on Patients Post-stroke Depression

Objective： To study the efficacy and safy of Flupeutixol and Melitracen Tablets combined Cognitive therapy in the cure of Post-stroke depression.Method： 78 cases of depression patients after stroke were randomly divided into Flupentixol and Melitraeen combined with cognitive behavior therapy in the treatment group of 39 cases, as the treatment group, amitriptyline in the treatment group of 39 cases, as the control group, treatment for 8 weeks.The efficacy was evaluated with Hamilton depression rating scale before and after treatment.The efficacy was evaluated with TESS after treatment. Result： The scores of HAMD were significantly lower after treatment between two groups, the scores of HAMD in Fluoxetine combined Cognitive therapy group were significant than the amitriptyline group after 1 weeks treatments.The scores of HAMD and the decrease rates of HAMD in Fluoxetine combined Cognitive therapy group were sign ificant than the amitriptyline group after 1. 2, 4, 6, 8 week treatment.Tbe scores of TESS in Fluoxetine combined Cognitive therapy group were significant lower than the single citalopram group （P〈0.05） .Conclution： Fluoxetine combined the Cognitive therapy can increase curative effect and shorten the period of treatment. It is an safe therapeutic in the treatment of Post-stroke depression gand demonstrated a better tolerability.