认知治疗对脑卒中后抑郁症的影响

目的了解认知治疗对脑卒中后抑郁患者的影响。方法 84例患者随机分为研究组和对照组各42例。研究组口服盐酸氟西汀,同时给予认知治疗,对照组单纯口服盐酸氟西汀,两组疗程均为8周。治疗前、治疗后2周、4周、8周进行汉密尔顿抑郁量表(HAMD)评分,疗效依据HAMD减分率评定,生活质量评价采用生活质量综合评定问卷(GQOLI-74)评定。结果治疗8周末研究组有效率高于对照组(χ2=0.01,P0.05)。研究组焦虑/抑郁因子分在治疗4周低于对照组(t=2.37,P0.05),第8周低于对照组(t=2.56,P0.05),治疗第8周时研究组睡眠障碍因子分低于对照组(t=2.61,P0.05)。治疗后研究组心理功能评分高于对照组(t=4.02,P0.01),社会功能评分高于对照组(t=3.68,P0.01)。结论认知治疗有助于提高患者抑郁症的治疗效果,减轻患者的焦虑/抑郁情绪,改善患者的睡眠。在一定程度上能提高患者的生活质量。

Effect of Cognitive Therapy on the Treament of Post-stroke Depression

ObjectiveToexploretheeffectofcognitivetherapyonthetreatmentofpost-strokedepression（PSD）.Methods 84 patients were randomly divided into study group （42cases）and control group（42cases）.Study group were given orally fluoxetine hydro-chloride with cognitive therapy;And control group were given single orally fluoxetine hydrochloride for 8 weeks treatment period .Before treatment,and at the end of 2,4,8 week,we conducted Hamilton Depression Scale （HAMD）,clinical efficacy was evaluated using the re-ducing score rate of HAMD ,quality of life was assessed using General Quality Of Life Questionnaire （ GQOLI-74 ） .Results After 8 weeks treatment,the total effective rate in study group was higher than that in control group （χ2 =0.01,P〈0.05）.At the end of 4 th,8th week,the anxiety /depression factor scores were lower in study group than those in control group （t=2.37,2.56,P〈0.05）.At the end of 8th week,in study group the sleep disorders factor score was lower than that in control group .（t=2.61,P〈0.05）.After treatment, the mental function scores and social function scores in study group were higher than those in control group （respectively t=4.02,3.68;P〈0.01）.Conclusion Cognitive therapy may improve the efficacy on the treatment of post -stroke depression,and it can decrease anxiety and depression ,improve sleep disorders and quality of life in certain extent .