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目的观察奥沙西泮联合黛力新对脑卒中后抑郁的疗效及预后情况。方法选择绍兴市立医院于2012年10月—2015年1月收治的98例脑卒中住院患者,随机分为观察组和对照组各49例。2组皆进行常规心理治疗,对照组在此基础上用黛力新治疗;观察组在常规治疗基础上予奥沙西泮联合黛力新治疗。2组疗程4周,比较2组疗效、不良反应发生率、治疗前后HAMD评分、临床神经功能缺损(NDS)评分、日常生活能力(BI)评分。结果观察组的总有效率为96.0%,明显高于对照组的81.6%,差异有统计学意义(P<0.05)。2组不良反应差异无统计学意义(20.4%vs.18.4%,P>0.05)。治疗4周后,观察组的HAMD评分显著低于对照组(13.8±2.8vs.17.6±3.2),差异有统计学意义(P<0.05);观察组的NDS评分也显著低于对照组(6.8±2.4 vs.10.7±3.5),差异有统计学意义(P<0.05);观察组的BI评分显著高于对照组(74.9±14.4 vs.61.3±14.2),差异有统计学意义(P<0.05)。结论采用奥沙西泮联合黛力新治疗脑卒中后抑郁症患者疗效稳定,副作用较低,并发症少,并可显著减轻临床神经功能缺损及改善患者生活能力,值得在临床推广应用。
Objective To observe the efficacy and prognosis of oxazepam combined with Deanxit on post-stroke depression. Methods Ninety-nine inpatients with stroke in Shaoxing Municipal Hospital from October 2012 to January 2015 were randomly divided into observation group (49 cases) and control group (49 cases). The two groups were treated by conventional psychotherapy, the control group was treated with Deanxit on the basis of this; the observation group was treated with oxazapam combined with Deanxit on the basis of routine treatment. The two groups were treated for 4 weeks. The curative effect, incidence of adverse reactions, HAMD score, NDS score and daily living ability (BI) score were compared between the two groups. Results The total effective rate in observation group was 96.0%, which was significantly higher than that in control group (81.6%, P <0.05). There was no significant difference in adverse reactions between the two groups (20.4% vs.18.4%, P> 0.05). After 4 weeks of treatment, the HAMD score of the observation group was significantly lower than that of the control group (13.8 ± 2.8 vs.17.6 ± 3.2) (P <0.05), and the NDS score of the observation group was also significantly lower than that of the control group (6.8 ± 2.4 vs.10.7 ± 3.5, respectively), the difference was statistically significant (P <0.05). The BI score in the observation group was significantly higher than that in the control group (74.9 ± 14.4 vs.61.3 ± 14.2, P <0.05 ). Conclusion The combination of oxazepam and dextrine is effective in the treatment of post-stroke depression, with fewer side effects, fewer complications, significant clinical neurological deficits and better life skills, which is worthy of clinical application.