CAJ | 학술논문

目的观察卒中单元中西医结合治疗对脑卒中患者抑郁及认知功能的影响.方法选取脑卒中后抑郁(PSD)患者105例,按照随机数字表法将其分为对照组、常规治疗组、联合治疗组,每组35例.3组均给予卒中单元常规治疗(包括药物治疗、肢体康复训练、语言训练、心理治疗、健康教育等),常规治疗组在上述基础上加用舍曲林(商品名:左洛复)药物治疗,联合治疗组则在卒中单元常规治疗及服用舍曲林基础上,根据中医辨证分型加用中草药方剂.治疗前及治疗第8,24周时采用汉密尔顿抑郁量表(HAMD)对患者的抑郁程度进行评定,利用简易精神状况检查(MMSE)和蒙特利尔认知评估量表(MoCA)评定患者的认知功能.结果治疗前,3组患者HAMD、MMSE、MoCA评分组间比较,差异均无统计学意义(P＞0.05);治疗第8周,常规治疗组和联合治疗组HAMD评分[(14.28±0.64)分、(13.32±0.91)分]与治疗前比较,差异有统计学意义(P＜0.05);治疗第24周,常规治疗组HAMD、MMSE、MoCA评分[(12.65±0.75)分、(23.24 ±0.89)分、(23.36 ±0.88)分]与治疗前比较,差异均有统计学意义(P＜0.05);联合治疗组治疗第24周HAMD、MMSE、MoCA评分[(10.15±0.67)分、(25.21 ±0.92)分、(25.44 ±0.85)分]与治疗前比较,差异亦有统计学意义(P＜0.05);常规治疗组和联合治疗组HAMD、MMSE、MoCA评分与对照组同时间点比较,差异均有统计学意义(P＜0.05),且联合治疗组各指标评分均优于常规治疗组(P＜0.05).结论卒中单元中西医结合治疗可显著改善PSD患者的抑郁程度,提高其认知功能,值得临床进一步应用、推广.
목적 관찰졸중단원중서의결합치료대뇌졸중환자억욱급인지공능적영향.방법 선취뇌졸중후억욱(PSD)환자105례,안조수궤수자표법장기분위대조조、상규치료조、연합치료조,매조35례.3조균급여졸중단원상규치료(포괄약물치료、지체강복훈련、어언훈련、심리치료、건강교육등),상규치료조재상술기출상가용사곡림(상품명:좌락복)약물치료,연합치료조칙재졸중단원상규치료급복용사곡림기출상,근거중의변증분형가용중초약방제.치료전급치료제8,24주시채용한밀이돈억욱량표(HAMD)대환자적억욱정도진행평정,이용간역정신상황검사(MMSE)화몽특리이인지평고량표(MoCA)평정환자적인지공능.결과 치료전,3조환자HAMD、MMSE、MoCA평분조간비교,차이균무통계학의의(P＞0.05);치료제8주,상규치료조화연합치료조HAMD평분[(14.28±0.64)분、(13.32±0.91)분]여치료전비교,차이유통계학의의(P＜0.05);치료제24주,상규치료조HAMD、MMSE、MoCA평분[(12.65±0.75)분、(23.24 ±0.89)분、(23.36 ±0.88)분]여치료전비교,차이균유통계학의의(P＜0.05);연합치료조치료제24주HAMD、MMSE、MoCA평분[(10.15±0.67)분、(25.21 ±0.92)분、(25.44 ±0.85)분]여치료전비교,차이역유통계학의의(P＜0.05);상규치료조화연합치료조HAMD、MMSE、MoCA평분여대조조동시간점비교,차이균유통계학의의(P＜0.05),차연합치료조각지표평분균우우상규치료조(P＜0.05).결론 졸중단원중서의결합치료가현저개선PSD환자적억욱정도,제고기인지공능,치득림상진일보응용、추엄.
Objective To observe the effects of the integrated traditional and western treatments on poststroke depression and cognitive impairment in a stroke unit.Methods A total of 105 patients with post-stoke depression (PSD) admitted to the authors' stroke unit were enrolled and randomized into a control group (n =35),a conventional treatment group (n =35) and an integrated treatment group (n =35).All the patients were treated with routine interventions including medications,rehabilitation training,psychological counseling and health education.Meanwhile,the patients in the conventional treatment group were also treated with anti-depressant sertraline,while those in the integrated treatment group were treated with sertraline and Chinese medicine as addition.The rating scales such as Hamilton depression (HAMD),mini-mental state examination (MMSE),the Montreal cognitive assessment (MOCA) were used to evaluate all patients after 8 weeks and 24 weeks of treatment.Results Before treatment,there was no significant difference among the 3 groups with regard to assessment scores of HAMD,MMSE and MoCA (P ＞ 0.05).After 8 weeks of treatment,the conventional treatment group and the integrated treatment group were significantly improved in terms of HAMD [(14.28-± 0.64) and (13.32 ± 0.91) respectively] (P ＜0.05).The scores of HAMD,MMSE and MOCA of the conventional treatment group and the integrated treatment group were significantly improved after 24 weeks of treatment (P ＜ 0.05),and the integrated treatment group improved to a significantly greater extent when compared with the conventional treatment group Conclusion Integrated traditional and western treatment used in the authors' stroke unit can effectively improve post-stroke depression and cognitive impairment.