Objective To investigate the efficacy of escitalopram combined with rational emotive therapy on patients with postpartum depression and to provide theoretical basis for combination treatment of medication and psychotherapy for postpartum depression .Methods Clinical data of 60 patients with postpartum depression hospitalized in Second People 's Hospital of Zhoushan from June 2015 to June 2017 were analyzed retrospectively .Patients were divided into observation group and control group according to different treatment methods .Patients in control group received conventional treatment with escitalopram , while patients in observation group received rational emotive therapy on basis of therapeutic schedule for the control group .Depression was evaluated by Hamilton Depression Scale (HAMD) before treatment and at 1 week ,1 month ,3 months ,and 6 months after treatment ,and clinical efficacy was assessed .Quality of life before and after treatment was investigated by using MOS item short from health survey (SF - 36) .Results Total effective rate in the observation group was 86 .67% ,which was significantly higher than that of 60 .00% in the control group (χ2 = 5 .455 ,P < 0 .05) .There was significant difference in HAMD scores before and after treatment in both groups (F value was 43 .562 and 43 .562 ,respectively ,both P < 0 .05) ,and with extension of treatment ,HAMD scores decreased gradually in both groups .HAMD scores at 1 week ,1 month ,3 and 6 months after treatment in the observation group were significantly lower than those in the control group (t value was 6 .875 ,7 .237 ,7 .875 and 6 .065 ,respectively ,all P < 0 .05) . Intra group comparison showed that social function ,physiological function ,general health ,physical function ,emotional function , mental health ,vigor score ,body pain scores of SF-36 scale after treatment in both groups were significantly higher than those before treatment (t value ranged 4 .265 to 9 .961 ,all P < 0 .05) .However ,comparison between groups showed that scores of social function ,physiological function ,general health ,physical function ,emotional function ,mental health and vigor score in SF-36 scale after treatment in the observation group were significantly higher than those in the control group (t value was 6 .764 ,5 .875 , 7 .452 ,4 .054 ,5 .765 ,6 .986 and 8 .054 ,respectively ,all P < 0 .05) .There was no significant difference in somatic pain score after treatment between two groups ( t = 1 .213 ,P > 0 .05 ) .Conclusion Escitalopram combined with rational emotive therapy can effectively reduce depression of patients with postpartum depression .It has better curative effect and can greatly improve quality of life .%目的 研究艾司西酞普兰片联合理性情绪疗法对产后抑郁症患者的疗效,为产后抑郁症药物联合心理治疗提供理论依据.方法 回顾性分析2015年6月至2017年6月于舟山市第二人民医院60例产后抑郁症患者的临床资料,根据治疗方法不同分为观察组与对照组,对照组患者采用艾司西酞普兰片进行常规药物治疗,观察组在此基础上联合理性情绪疗法,采用汉密顿抑郁量表(HAMD)观察患者治疗前及治疗后1周 、1个月 、3个月 、6个月抑郁情绪,评价临床疗效,并采用健康调查简表(SF-36)调查治疗前后生活质量.结果 观察组治疗总有效率为86.67%,显著高于对照组的60.00%(χ2=5.455,P<0.05).两组患者治疗前后HAMD评分均有显著性差异(F值分别为43.562、39.667,均P<0.05),并随着治疗时间的延长,两组HAMD评分均逐渐下降,但观察组治疗后1周 、1个月 、3个月 、6个月HAMD评分均显著低于对照组(t值分别为6.875、7.237、7.875、6.065,均P<0.05).两组患者治疗后与治疗前的组内比较显示SF-36量表中社会功能 、生理功能 、总体健康 、生理职能 、情感职能 、精神健康 、活力评分 、躯体疼痛评分均显著升高(t=4.265～9.961,均P<0.05),但治疗后组间比较显示观察组量表中社会功能 、生理功能 、总体健康 、生理职能 、情感职能 、精神健康 、活力评分均显著高于对照组(t值分别为6.764、5.875、7.452、4.054、5.765、6.986、8.054,均P<0.05),两组间躯体疼痛评分差异无统计学意义(t=1.213,P>0.05).结论 艾司西酞普兰片联合理性情绪疗法能显著降低产后抑郁症患者抑郁情绪,疗效更优,能显著提升生活质量.
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