丙戊酸镁缓释片联合帕罗西汀治疗老年脑卒中后抑郁患者的临床疗效观察

摘要

Objective To observe the clinical effect of magnesium valproate sustained release tablets combined with paroxetine in treating elderly patients with poststroke depression. Methods A total of 68 elderly patients with poststroke depression were selected in the First Bethune Hospital of Jilin University from May 2013 to April 2015,and they were randomly divided into control group and observation group,each of 34 cases. Patients of control group received paroxetine,while patients of observation group received magnesium valproate sustained release tablets combined with paroxetine;both groups continuously treated for 8 weeks. White blood cell count,blood platelet count,creatinine,ALT and AST before and after treatment,HAMD score,NIHSS score and TESS score before treatment,after 1 week,2 weeks,4 weeks and 8 weeks of treatment,clinical effect and incidence of adverse reactions were compared between the two groups. Results No statistically significant differences of white blood cell count,blood platelet count,creatinine,ALT or AST was found between the two groups before treatment or after treatment(P ﹥ 0. 05). No statistically significant differences of HAMD score was found between the two groups(P ﹥ 0. 05), while HAMD score of observation group was statistically significantly lower than that of control group after 1 week,2 weeks,4 weeks,8 weeks of treatment,respectively(P ﹤ 0. 05);no statistically significant differences of NIHSS score was found between the two groups before treatment or after 1 week,2 weeks of treatment(P ﹥ 0. 05),while NIHSS score of observation group was statistically significantly lower than that of control group after 4 weeks,8 weeks of treatment( P ﹤ 0. 05);no statistically significant differences of TESS score was found between the two groups before treatment or after 1 week,2 weeks,4 weeks,8 weeks of treatment(P ﹥ 0. 05). The clinical effect of observation group was statistically significantly better than that of control group,the incidence of adverse reactions of observation group was statistically significantly lower than that of control group(P ﹤0. 05). Conclusion Magnesium valproate sustained release tablets combined with paroxetine has certain clinical effect in treating elderly patients with poststroke depression,can effectively relive the depressive symptoms and improve the neurological function,and is safe.%目的：观察丙戊酸镁缓释片联合帕罗西汀治疗老年脑卒中后抑郁患者的临床疗效。方法选取2013年5月—2015年4月吉林大学白求恩第一医院收治的老年脑卒中后抑郁患者68例，随机分为对照组与观察组，每组34例。对照组患者予以帕罗西汀治疗，观察组患者在对照组基础上予以丙戊酸镁缓释片治疗；两组患者均连续治疗8周。比较两组患者治疗前后白细胞计数、血小板计数、肌酐水平、丙氨酸氨基转移酶（ALT）水平、天冬氨酸氨基转移酶（AST）水平，治疗前及治疗1、2、4、8周汉密尔顿抑郁量表（ HAMD）评分、美国国立卫生研究院卒中量表（NIHSS）评分、副反应量表（TESS）评分，临床疗效及不良反应发生情况。结果治疗前后两组患者白细胞计数、血小板计数、肌酐水平、ALT 水平、AST 水平比较，差异无统计学意义（ P ﹥0.05）。治疗前两组患者 HAMD 评分比较，差异无统计学意义（P ﹥0.05）；治疗1、2、4、8周观察组患者 HAMD 评分低于对照组（P ﹤0.05）；治疗前及治疗1、2周两组患者 NIHSS 评分比较，差异无统计学意义（P ﹥0.05）；治疗4、8周观察组患者 NIHSS 评分低于对照组（P ﹤0.05）；治疗前及治疗1、2、4、8周两组患者 TESS 评分比较，差异无统计学意义（P ﹥0.05）。观察组患者临床疗效优于对照组，不良反应发生率低于对照组（P ﹤0.05）。结论丙戊酸镁缓释片联合帕罗西汀治疗老年脑卒中后抑郁患者的临床疗效确切，可有效改善患者抑郁症状及神经功能，且安全性较高。