小剂量米氮平联合西酞普兰治疗脑卒中后抑郁症的疗效分析

摘要

目的：探讨小剂量米氮平联合西酞普兰治疗脑卒中后抑郁症（PSD）的临床疗效及安全性。方法将我院收治的114例脑卒中后抑郁症患者，将其随机分为对照组和观察组，每组57例。对照组给予西酞普兰，观察组在此基础上给予小剂量的米氮平。治疗6周，观察并比较两组患者的临床疗效。治疗前后采用汉密尔顿抑郁量表（HAMD）、日常生活能力Barthel指数（BI）量表、临床神经功能缺损评分（SSS）以及不良反应症状量表（TESS）评定疗效及治疗出现的不良反应。结果6周后，两组治疗PSD均有效，观察组的基本治愈率为29.82%，对照组的基本治愈率为21.05%，两组患者间的基本治愈率的差异具有统计学意义（P＜0.05），观察组总有效率（92.98%）明显高于对照组（80.71%），差异有显著性（P＜0.01）。观察组HADM和SSS评分明显低于对照组（P＜0.05），BI评分明显高于对照组（P＜0.05），两组患者的TESS评分无显著性差异，但观察组在失眠及头痛或头晕方面明显低于对照组（P＜0.01）。结论西酞普兰联合小剂量米氮平治疗脑卒中后抑郁症的疗效显著，安全性好，利于神经功能康复，能提高患者的生活质量。%Objective To explore the effectiveness and safety of citalopram combined with small dose of mirtazapine for treating post-stroke depression(PSD). Methods 114 patients with post-stroke depression in our hospital were randomly divided into two groups. In the control group, 57 patients were treated with citalopram, and in the observation group, 57 patients received citalopram combined with small dose of mirtazapine.Before treatment and at the end of 6 weeks of treatment, Line Hamilton depression scale(HAMD), daily living skills Barthel index(BI) scale, clinical nerve function defect score(SSS) and adverse reaction symptom scale(TESS) were assessed. Results The treatment for PSD of two groups was effective after 6 weeks. The basic recovery of observation group was 29.82%, the basic recovery of control group was 21.05%.There was significant difference in the basic recovery rate between observation group and the control group(P<0.05). The total effective rate of observation group(92.98%) was significantly higher than the control group(80.71%). The HADM score and SSS score of the observation group were significantly lower than the control group(P<0.05 or 0.01), and BI score was significantly higher than the control group after 6 weeks. There were no significant difference in TESS score between two groups,but the insomnia and headache or dizziness aspects of observation group were significantly lower than the control group(P<0.01). Conclusion Citalopram in combination with small dose of mirtazapine for post-stroke depression has good efficacy and high safety,and can improve recovery of neurological function and activity of daily living of patients .