早期康复训练配合帕罗西汀治疗老年人卒中后抑郁的临床研究(1)
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[摘要] 目的：探讨早期康复训练配合帕罗西汀治疗老年人卒中后抑郁(PSD)的疗效。方法：前瞻性研究我院2008年1月～2010年12月收治的80例PSD患者，按析因设计分为常规治疗、康复治疗、药物治疗及康复联合药物治疗4组，每组20例分别于治疗前后使用汉密尔顿抑郁量表(HAMD)、神经功能缺损评分(SSS)、Fugl-Meyer运动功能评分(FMA)、Borthel指数(BI)评价患者的抑郁程度、神经功能缺损程度、运动功能及日常生活的活动能力。结果：治疗后，康复联合药物治疗组患者的HAMD、SSS、FMA、BI评分均显著优于常规治疗组、康复治疗组及药物治疗组。结论：早期康复训练配合帕罗西汀治疗能显著改善老年人卒中后抑郁患者的抑郁程度，促进其神经功能恢复，提高运动功能及日常生活活动能力。
[关键词] 康复训练；帕罗西汀；卒中后抑郁
[中图分类号] R74 [文献标识码] A [文章编号] 1673-7210(2011)07(a)-062-03
The clinical study on the paroxetine and early physical therapy on old patients′ poststroke depression
CHEN Jihua
The First People's Hospital of Chenzhou City, Hu′nan Province, Chenzhou 423000, China
[Abstract] Objective: To observe the curative effect of paroxetine and early physical therapy on poststroke depression(PSD) of old patiants. Methods: 80 PSD patients treated in our hospital from January 2008 to December 2010 were divided into four groups according to the reasons, which were conventional therapy group, rehabilitation therapy group, medicine therapy group and rehabilitation combined medicine therapy group. To evaluate the depression degree, neurological deficit, motor function and activities of daily living by HAMD, SSS, FMA, BI scale before and after treatment. Results: The scores of HAMD, SSS, FMA, BI indicated that the patients who were treated by rehabilitation combined medicine therapy expressed better results than that treated by conventional therapy, rehabilitation therapy and medicine therapy. Conclusion: Early physical therapy and paroxetine can significantly reduce the depression degree of poststroke depression of old patients, stimulate nerve function recovery, and improve the motor function and activities of daily living.
[Key words] Rehabilitation training； Paroxetine； Post-stroke depression
脑卒中后抑郁(post-stroke depression，PSD)是脑卒中常见的并发症之一，有研究表明，至少有40%～50%的脑卒中患者在卒中后有抑郁的体验。PSD多以情绪低落、情绪不稳、失眠多梦、躯体不适、能力下降及悲观无价值感为临床表现，严重患者可能会产生轻生的念头，如不及时治疗，部分患者可能导致自杀的后果。近年来，我院一直致力于早期康复训练配合帕罗西汀治疗老年人卒中后抑郁的研究，现将研究结果报道如下：
1 资料与方法
1.1 一般资料
以2008年1月～2010年12月在我院住院治疗，确诊为卒中后抑郁的80例患者为研究对象，其中，男56例，女24例；年龄60～83岁，平均(69.75±7.41)岁；脑出血27例，脑梗死53例；本研究中 ......
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