短程认知心理疗法结合中西药治疗老年抑郁症疗效观察

发布时间：2018-03-29 17:45

本文选题：抑郁症　切入点：认知治疗　出处：《广州中医药大学学报》2014年03期

【摘要】：【目的】观察短程认知心理疗法结合中西药治疗老年抑郁症的疗效,探索针对中国老年抑郁症群体的有效短程认知治疗程式。【方法】将71例老年抑郁症患者分为治疗组(中西药物治疗结合短程认知心理治疗者)36例及对照组(单用中西药物治疗者)35例,对照组采用西药氟西汀加中药治郁3号方(乌药、枳实、槟榔、荔枝核、菟丝子、枸杞子、郁金、合欢皮、茯苓、远志)治疗,治疗组在对照组基础上给予每周1次短程认知心理治疗,并于第5周开始日记式三栏技术应用实践。2组均于入组时(治疗前)和治疗2、4、6、8周末及半年后(6个月末)随访进行汉密尔顿抑郁量表(HAMD)评分。【结果】(1)HAMD量表总分情况:从4周末开始,2组的总分均显著降低,差异均有统计学意义(P0.01);且从4周末开始,治疗组的降低作用优于对照组,组间比较差异有统计学意义(P0.01)。(2)HAMD量表中焦虑/躯体化、认识障碍、阻滞、睡眠障碍、绝望感等各因子评分情况:治疗后,2组的HAMD量表各因子评分均有不同程度降低,且治疗组的降低作用优于对照组,其中焦虑/躯体化因子在8周末、6个月末差异有统计学意义(P0.05),认识障碍因子从2周末开始差异有统计学意义(P0.05或P0.01),阻滞因子从6个月末开始差异有统计学意义(P0.05),绝望感因子从4周末开始差异有统计学意义(P0.05或P0.01)。【结论】对老年抑郁症患者,结合短程认知心理疗法的治疗组与单纯中西药物治疗的对照组比较,起效时间无差异,但症状缓解程度及半年随访的疗效均较对照组为佳。
[Abstract]:[objective] to observe the effect of short-term cognitive psychotherapy combined with traditional Chinese and western medicine in the treatment of senile depression. Objective: to explore an effective short-range cognitive therapy program for elderly depression patients in China. [methods] Seventy-one patients with senile depression were divided into treatment group (36 cases treated with Chinese and western medicine combined with short-course cognitive psychotherapy) and control group (single use). 35 cases were treated with Chinese and Western medicine. The control group was treated with western medicine fluoxetine plus traditional Chinese medicine Zhiyu 3 (black medicine, Fructus aurantii, areca nut, litchi seed, dodder seed, Chinese wolfberry fruit, tulip, acacia peel, Poria cocos, Polygala). The treatment group was given short-term cognitive psychotherapy once a week on the basis of the control group. At the 5th week, the diary-type three-column technique was applied in the second group. Group 2 was followed up at the end of 8 weeks and 6 weeks after treatment and half a year after the treatment. [results] the total score of Hamd scale was evaluated. [results] the total score of Hamd scale was evaluated. : from the end of the 4th week, the total scores of the two groups decreased significantly, From the end of the 4th week, the decrease effect of the treatment group was better than that of the control group, and the difference between the two groups was statistically significant. The anxiety / somatization, cognitive disorder, block, sleep disorder in the scale of anxiety / somatization, cognitive disorder, block and sleep disorder were significantly different between the two groups. Scores of factors such as sense of despair: after treatment, the scores of each factor of HAMD scale in the two groups were decreased to some extent, and the effect of the treatment group was better than that of the control group. There were significant differences in anxiety / somatization factor at the end of the 8th week and at the end of 6 months (P 0.05), cognitive impairment factor (P 0.05) and block factor (P 0.05) at the end of 6 weeks. The difference of hopelessness factor from the end of 4 weeks was statistically significant (P 0.05 or P 0.01). [conclusion] in elderly patients with depression, There was no difference in the onset time between the treatment group combined with short-course cognitive psychotherapy and the control group treated with Chinese and western medicine alone, but the degree of symptom relief and the curative effect of half a year follow-up were better than those of the control group.
【作者单位】：深圳市中医院脑病心理科;
【分类号】：R749.4

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