舍曲林联合归因训练对脑卒中后抑郁及神经功能康复的影响

发布时间：2018-01-24 16:02

本文关键词： 脑卒中后抑郁归因训练舍曲林　出处：《中国神经精神疾病杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨舍曲林联合归因训练对脑卒中后抑郁及神经功能康复的影响。方法共78例脑卒中后抑郁患者,随机分为研究组和对照组,研究组给予舍曲林联合归因训练,对照组单用舍曲林治疗,疗程8周。在治疗前及治疗的第2、4、6、8周末用汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)和美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)分别评定抑郁症状和神经功能康复情况。结果经重复测量方差分析显示,患者HAMD总分的时间主效应、分组主效应以及时间与分组交互效应均有统计学意义(P0.05)。其中研究组在2、4、6、8周末HAMD总分均明显低于对照组[(18.25±4.27)vs.(20.81±4.63),(15.94±3.47)vs.(18.12±4.51),(12.85±3.12)vs.(16.54±3.70),(10.42±3.66)vs.(13.09±3.59)],差异有统计学意义(P0.05);研究组与对照组HAMD总分在各个时点均较治疗前降低(P0.01)。治疗8周后研究组有效率(以HAMD减分率评价)高于对照组(77.5%vs.52.6%),差异有统计学意义(P0.05)。两组NIHSS总分的时间主效应有统计学意义(P0.01),分组主效应、时间与分组交互效应无统计学意义(P0.05)。研究组与对照组NIHSS总分在各个时点均较治疗前降低(P0.01)。结论舍曲林联合归因训练可明显缓解脑卒中后抑郁患者的抑郁症状,但归因训练对患者神经功能改善不明显。
[Abstract]:Objective to investigate the effects of sertraline combined with attribution training on post-stroke depression and neurological rehabilitation. Methods 78 patients with post-stroke depression were randomly divided into study group and control group. The study group was given sertraline combined attribution training, the control group was treated with sertraline alone for 8 weeks. Hamilton depression rating scale was used at the end of August. Hamd) and the National Institute of Health stroke scale. NIHSS was used to evaluate the depression symptoms and neurological rehabilitation. Results the time main effect of the total score of HAMD was found by repeated variance analysis. There was significant difference in the main effect of group, time and interaction between group and group. The total score of HAMD in the study group was significantly lower than that in the control group at the end of 8 weeks. [18. 25 卤4. 27 Vs. 20. 81 卤4. 63 VS. 15.94 卤3. 47 Vs. P 18. 12 卤4. 51). 2.12.85 卤3.12vs.cr. 16.54 卤3.70m (10.42 卤3.66v s.n.13.09 卤3.59)]. The difference was statistically significant (P 0.05). The total score of HAMD in the study group and the control group was lower than that before treatment at all time points. The effective rate of the study group was higher than that of the control group after 8 weeks of treatment (evaluated by the HAMD score reduction rate). 77.5s. 52.6). The difference was statistically significant (P 0.05). The time main effect of the total score of NIHSS in the two groups was statistically significant (P 0.01), and the main effect was divided into groups. There was no significant difference in the interaction between time and group. The total score of NIHSS in the study group and the control group was lower than that before treatment (P 0.01). Conclusion Sertraline combined with attribution training can significantly alleviate the depression symptoms in patients with post-stroke depression. However, attribution training did not significantly improve the neurological function of the patients.
【作者单位】：德州市人民医院心理科;德州市人民医院康复科;
【分类号】：R743.3;R749.4
【正文快照】： 脑卒中后抑郁(post-stroke depression,PSD)是脑卒中后常见的并发症,近几年发病率较高[1]。该病不仅阻碍患者的神经功能康复,而且降低患者的生活质量,增加病死率[2]。归因训练是一种从归因方式入手对患者认知、情绪和行为问题进行治疗的认知行为疗法[3]。目前对PSD的治疗很多

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