老年慢性躯体疾病合并抑郁症的康复治疗

目的 :探讨单纯抗抑郁药物与心理及药物联合治疗对老年慢性躯体疾病合并抑郁症患者躯体疾病康复的影响。方法 :10 2例确诊为抑郁症的老年慢性躯体疾病患者分为药物组 4 6例 ,综合组 5 6例 ,均在治疗原发病的基础上进行抗抑郁药物治疗 ,综合组同时配合心理治疗。在治疗前、治疗后 2及 8周时 ,2组患者均进行Zung量表和QLI评分表评分。结果 :治疗 2周时 2组Zung量表总分均有下降 ,与治疗前比较差异有显著性 ,2组间比较差异无显著性 ;QLI评分治疗前后及组间比较均差异无显著性。治疗 8周时 2组Zung量表总分明显下降 ,QLI评分开始上升 ,与治疗前比较均差异有显著性 ,2组组间比较 ,综合组更优于药物组 (P <0 .0 5 )。患者躯体症状明显改善 ,无并发症出现 ,绝大多数患者对原发病的预后呈现乐观的心态。结论 :早期识别老年抑郁症 ,并进行积极有效的抗抑郁综合治疗对促进原发疾病的康复具有非常重要的意义。

Rehabilitation Therapy for the Aged Chronic Physical Diseases Associated with Depression

Objective: To explore the effect of the combined treatment of simple anti-depression medicines and psychotherapy on the rehabilitation of the aged chronic physical diseases associated with depression. Methods: 102 patients with chronic physical disease who were diagnosed as having depression were divided randomly into medicine group ( n =46) and combined group ( n =56). On the basis of the routine physical treatment and anti-depression medicament, group B also received psychological therapy. Before the treatment, and 2 weeks and 8 weeks after the treatment, the patients were assessed by Zung-amount form and QLT scoring form. Results: Two weeks after the treatment, the Zung-amount scores in both groups were decreased as compared with those before the treatment. There was no significant difference in the Zung-among scores between the two groups. There was no significant difference in QLT scores before and after the treatment or between the two groups, either. Eight weeks after the treatment, the total Zung-amount scores in both groups were significantly decreased and QLT scores significantly increased as compared with those before the treatment. There was significant difference in Zung-amount scores and QLI scores between the two groups. The physical symptoms of the patients were improved obviously. The original disease has been cured without any complications. Most patients were optimistic toward the prognosis of the primary affection. Conclusion: The recognition of the depression of aged people at an earlier stage and the active and effective treatment are of an essential significance for the rehabilitation of the primary affection.