目的：探讨度洛西汀合并认知行为治疗（ CBT）对产后抑郁症的疗效。方法：将66例产后抑郁症患者分为研究组和对照组各33例，两组均给予度洛西汀治疗，研究组在此基础上合并CBT，每周1次，疗程8周。于治疗前后进行功能失调性状况评定量表（ DAS）评定，比较两组疗效及认知改善程度。结果：治疗前两组DAS评分差异无统计学意义；治疗8周，研究组DAS总分（ t=4.435）、脆弱性（ t=4.303）、完美化（t=4.206）、依赖性（t=4.753）及自主性态度（t=3.304）评分较治疗前明显下降（P均<0.01）；对照组DAS各项评分与治疗前比较差异无统计学意义（ P>0.05）。两组间比较，治疗后研究组DAS总分（t=2.759）、脆弱性（t =3.325）、完美化（t=4.105）、依赖性（t=4.743）、自主性态度（t=2.021）因子分较对照组显著降低（P<0.05或P<0.01）。结论：度洛西汀单用或合并CBT对产后抑郁症均有明显疗效；但CBT能明显改善患者功能失调性认知损害。%Objective:To explore the therapeutic efficacy of duloxetine combined with cognitive-behav-ioral therapy( CBT)in the treatment of postpartum depression. Method:Sixty-six patients with postpartum depression were assigned into two groups,the study group( duloxetine combined with CBT group,33 patients) and the control group( duloxetine alone group,33 patients),both group were given duloxetine,the study group also received CBT once a week,both for 8 weeks. The therapeutic efficacy was evaluated with the dysfunctional attitudes scales( DAS)before and after treatment. Resuits:There were no significant statistical differences on DAS scores between the two groups at baseline. After the treatment of 8 weeks,the total score of DAS( t =4. 435),scores of factors of vulnerability(t=4. 303),perfection(t=4. 206),dependence(t=4. 753),inde-pendent attitude(t=3. 304)in study group were significantly lower than those before the treatment(all P<0. 01). The total score,scores of every factor of DAS in control group showed no significantly differences before and after treatment(P>0. 05). The total score of DAS(t=2. 759),scores of factors of vulnerability(t=3. 325),perfection(t=4. 105),dependence(t=4. 743),independent attitude(t=2. 021)of DAS in study group significantly decreased more than those in control group after treatment(P <0. 05 or P <0. 01). Conciusion:Duloxetine alone and combined with CBT both have significant therapeutic efficacy in improving the symptoms of postpartum depression,but CBT can significantly improve the cognition of dysfunctional atti-tudes.
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