摘要
目的:从国外脑卒中后抑郁障碍治疗发展的现状出发,探讨脑卒中后抑郁障碍治疗的有效性和存在的问题。资料来源:应用计算机检索Medline2000-01/2006-01期间与脑卒中后抑郁障碍和治疗相关的文献,检索词“stroke,depression,therapy”,并限定语言种类为英文。资料选择:就检索到548篇文献进行筛选,选择以脑卒中后抑郁障碍治疗为主要内容文献43篇,其中研究内容相似的,以近5年发表在权威杂志者优先。排除重复性研究。资料提炼:筛选到42篇相关文献,包括679例脑卒中后抑郁障碍患者。其中17篇与脑卒中后抑郁障碍药物治疗相关,7篇与心理治疗相关,13篇与其他治疗相关。资料综合:脑卒中后抑郁障碍的发生与心理、社会、康复等多种因素相关,治疗抑郁障碍的抗抑郁药物有选择性5-羟色胺再摄取抑制剂、三环类、单胺氧化酶抑制剂和去甲肾上腺素能和特异性5-羟色胺能抗抑郁剂等;讲解脑血管病康复知识、根据心理问题等综合干预和认知行为治疗、电惊厥治疗以及加强社会家庭支持等均可以用于脑卒中后抑郁障碍的治疗,从而有效减少或避免抑郁障碍的发生。结论:药物、心理、电惊厥治疗和社会家庭支持可以有效治疗脑卒中患者抑郁障碍情绪,有利于脑卒中后抑郁障碍患者康复,但能否改善脑卒中患者神经功能缺损程度有待进一步研究。
OBJECTIVE： To probe into the effectiveness and significance of treatment for post-stroke depression based on its temporal status. DATA SOURCES： A computer-based search of Medline was conducted to collect English articles related to post-stroke depression and therapy published between January 2000 and January 2006 by using the key words of ＂stroke, depression, therapy＂.
STUDY SELECTION： 548 retrieved articles were screened, and 34 articles about treatment for post-stroke depression were collected. Articles with similar contents published in the past five years in authoritative journals were enrolled preferentially. Repetitive studies were excluded.
DATA EXTRACTION： Totally 679 eases of post-stroke depression were involved in 42 related articles, of which 17 articles were associated with drug therapy, 7 articles associated with psychological treatment and other 13 articles associated with other therapies.
DATA SYNTHESIS： Occurrence of post-stroke depression was associated with factors of psychology, society factors and rehabilitation etc., and the antidepressants were selective serotonin re-uptake inhibitors （SSRIs）, tricyclic antidepressants （TCAs）, monoamine oxidase inhibitor （MAOI）, noradrenergic, specific serotonerglc antidepressant （NaSSA） and so on. Explanation of knowledge about cerebral vascular disease, synthetic therapy by psychoanalysis and psychotherapy, electroconvulsive therapy as well as reinforcement of family supporting all could be adopted for treatment of post-stroke depression, and accordingly reduce or avoid the occurrence of depression.
CONCLUSION： Antidepressant and psychotherapy, electroconvulsive therapy as well as supporting from family and society are effective in the treatment of post-stroke depression, which are good to the rehabilitation of patients with post-stroke depression. However, more word must be done on whether they can ameliorate the neurological impairment of patients with stoke.
出处
《中国临床康复》
CSCD
北大核心
2006年第38期129-132,共4页
Chinese Journal of Clinical Rehabilitation
