本文關(guān)鍵詞： 腦卒中后抑郁 歸因訓(xùn)練 舍曲林　出處：《中國(guó)神經(jīng)精神疾病雜志》2017年03期 　論文類型：期刊論文

【摘要】：目的探討舍曲林聯(lián)合歸因訓(xùn)練對(duì)腦卒中后抑郁及神經(jīng)功能康復(fù)的影響。方法共78例腦卒中后抑郁患者,隨機(jī)分為研究組和對(duì)照組,研究組給予舍曲林聯(lián)合歸因訓(xùn)練,對(duì)照組單用舍曲林治療,療程8周。在治療前及治療的第2、4、6、8周末用漢密爾頓抑郁量表(Hamilton depression rating scale,HAMD)和美國(guó)國(guó)立衛(wèi)生研究院卒中量表(National Institute of Health stroke scale,NIHSS)分別評(píng)定抑郁癥狀和神經(jīng)功能康復(fù)情況。結(jié)果經(jīng)重復(fù)測(cè)量方差分析顯示,患者HAMD總分的時(shí)間主效應(yīng)、分組主效應(yīng)以及時(shí)間與分組交互效應(yīng)均有統(tǒng)計(jì)學(xué)意義(P0.05)。其中研究組在2、4、6、8周末HAMD總分均明顯低于對(duì)照組[(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)],差異有統(tǒng)計(jì)學(xué)意義(P0.05);研究組與對(duì)照組HAMD總分在各個(gè)時(shí)點(diǎn)均較治療前降低(P0.01)。治療8周后研究組有效率(以HAMD減分率評(píng)價(jià))高于對(duì)照組(77.5%vs.52.6%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組NIHSS總分的時(shí)間主效應(yīng)有統(tǒng)計(jì)學(xué)意義(P0.01),分組主效應(yīng)、時(shí)間與分組交互效應(yīng)無統(tǒng)計(jì)學(xué)意義(P0.05)。研究組與對(duì)照組NIHSS總分在各個(gè)時(shí)點(diǎn)均較治療前降低(P0.01)。結(jié)論舍曲林聯(lián)合歸因訓(xùn)練可明顯緩解腦卒中后抑郁患者的抑郁癥狀,但歸因訓(xùn)練對(duì)患者神經(jīng)功能改善不明顯。
[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 鹵4. 27 Vs. 20. 81 鹵4. 63 VS. 15.94 鹵3. 47 Vs. P 18. 12 鹵4. 51). 2.12.85 鹵3.12vs.cr. 16.54 鹵3.70m (10.42 鹵3.66v s.n.13.09 鹵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.
【作者單位】： 德州市人民醫(yī)院心理科;德州市人民醫(yī)院康復(fù)科;
【分類號(hào)】：R743.3;R749.4
【正文快照】： 腦卒中后抑郁(post-stroke depression,PSD)是腦卒中后常見的并發(fā)癥,近幾年發(fā)病率較高[1]。該病不僅阻礙患者的神經(jīng)功能康復(fù),而且降低患者的生活質(zhì)量,增加病死率[2]。歸因訓(xùn)練是一種從歸因方式入手對(duì)患者認(rèn)知、情緒和行為問題進(jìn)行治療的認(rèn)知行為療法[3]。目前對(duì)PSD的治療很多

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