艾司西酞普兰联合米氮平治疗脑卒中后抑郁的疗效观察

Feifei Chen, Xu-hong Wu
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摘要

目的探讨艾司西酞普兰联合米氮平治疗脑卒中后抑郁症的临床疗效。方法随机选取2017年1月至2018年12月太原钢铁集团总医院收治的90例脑卒中后抑郁患者作为研究对象。采用随机数字表法将患者分为研究组和对照组,每组45例。研究组在常规治疗的基础上给予艾司西酞普兰和米氮平治疗,对照组在常规治疗的基础上给予米氮平治疗。采用汉密尔顿抑郁量表(HAMD)评价两组患者治疗前后的抑郁程度,采用世界卫生组织生活质量100量表(WHOQOL-100)评价两组患者治疗前后的生活质量变化。结果治疗前两组HAMD比较,差异均无统计学意义(P>0.05);治疗后研究组HAMD评分下降优于对照组(P<0.05), WHOQOL-100评分升高优于对照组(P<0.05);两组治疗期间,研究组患者口干、便秘、排尿困难等不良反应的发生率均显著低于对照组(P<0.05)。结论临床医生应及时使用HAMD识别疑似脑卒中后抑郁患者的病情。一旦确诊,建议艾司西酞普兰联合米氮平进行抗抑郁治疗,有利于保证患者的治疗效果和安全性,提高患者的生活质量。关键词:卒中;抑郁症;酞;米氮平
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Effect of escitalopram combined with mirtazapine in the treatment of post-stroke depression
Objective To explore the clinical effect of escitalopram combined with mirtazapine in the treatment of post-stroke depression. Methods A total of 90 patients with post-stroke depression admitted to General Hospital of Taiyuan Iron and Steel Group from January 2017 to December 2018 were randomly selected as the study objects. The patients were divided into study group and control group by random number table method, with 45 cases in each group. Study group was treated with escitalopram and mirtazapine on the basis of routine treatment, and control group was treated with mirtazapine on the basis of routine treatment. Hamilton Depression Scale (HAMD) was used to evaluate the depression of the two groups before and after treatment, and the World Health Organization Quality of life 100 (WHOQOL-100) was used to evaluate the changes of the quality of life of the two groups before and after treatment. Results There was no significant difference in HAMD between the two groups before treatment(P>0.05); and the decrease of HAMD score in study group after treatment was better than that in control group (P 0.05), and the increase of WHOQOL-100 score in study group after treatment was better than that in control group (P<0.05); during the treatment of the two groups, the incidence of adverse reactions such as dry mouth, constipation and dysuria in study group was significantly lower than that in control group (P<0.05). Conclusions Clinicians should use HAMD in time to identify the condition of patients with depression after suspected stroke. Once confirmed, esmcitalopram combined with mirtazapine should be recommended to carry out antidepressant treatment, which is conducive to ensuring the treatment effect and safety of patients and improving their quality of life. Key words: Stroke; Depression; Escitalopram; Mirtazapine
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