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文拉法辛联合认知行为干预治疗帕金森症合并抑郁、认知功能障碍的临床疗效

2015-07-18聂利珞

中国医药科学 2015年6期
关键词:帕金森症抑郁

聂利珞

[摘要] 目的 探讨文拉法辛联合认知行为疗法治疗帕金森症合并抑郁、认知功能障碍的临床疗效。 方法 选择58例帕金森症合并抑郁患者,根据治疗方法分为联合组和对照组。对照组给予文拉法辛胶囊口服治疗,联合组在此基础上给予认知行为疗法,比较两组患者的临床疗效。 结果 两组组内比较,治疗后焦虑、抑郁评分显著下降(P<0.01),治疗后两组组间比较,联合组评分显著低于对照组(P<0.01)。联合组在干预后认知功能总分、视空间与执行能力、命名能力、语言能力、延迟回忆以及定向力评分显著高于对照组(P<0.01)。 结论 文拉法辛联合认知行为干预治疗帕金森症合并抑郁、认知功能障碍,具有较好的临床疗效,能够显著改善患者焦虑、抑郁、认知功能障碍等情况。

[关键词]文拉法辛;认知行为干预;帕金森症;抑郁

[中图分类号] R749 [文献标识码] B [文章编号] 2095-0616(2015)06-165-04

Clinical efficacy of venlafaxine combined with cognitive behavioral intervention for Parkinson's disease with depression and cognitive dysfunction

NIE Liluo

Department of Neurology, Hengyang Center Hospital, Hunan Province, Hengyang 421001, China

[Abstract] Objective To discuss clinical efficacy of venlafaxine combined with cognitive behavioral intervention for Parkinson's disease with depression and cognitive dysfunction. Methods 58 cases of Parkinson's disease with depression and cognitive dysfunction were selected, and they were divided into combination group and control group according to treatment methods. Control group was treated by venlafaxine treatment. Combination group was treated by venlafaxine combined with cognitive behavioral intervention treatment. Clinical efficacy of two groups were compared. Results After treatment, HAMA and HAMD scores of two groups decreased apparently(P<0.01). HAMA and HAMD scores of combination group after treatment were lower than those of control group(P<0.01). Cognitive function scores, depending on space and ability to execute, naming ability, language ability, delayed recall and disorientation ratings of combination group after treatment were higher than those of control group(P<0.01). Conclusion Venlafaxine combined with cognitive behavioral intervention for Parkinson's disease with depression and cognitive dysfunction shows better clinical efficacy, relieves depression and anxiety, and improves cognitive function.

[Key words] Venlafaxine; Cognitive behavioral intervention; Parkinson's disease; Depression

帕金森病(Parkinson's disease,PD)主要表现为运动功能障碍,包括静止性震颤、肌强直、运动迟缓、姿势步态异常等,是中老年常见的慢性神经系统疾病。在我国,55 岁以上人群 PD的患病率高达1.07%,而随着年龄的增加,患病率逐渐增加。随着我国经济的发展,社会老龄化问题越来越突出,PD的发病率也呈上升的趋势。帕金森病除了运动障碍等临床表现外,患者还多伴非运动症状,包括抑郁、焦虑、认知功能障碍、失眠、便秘、自主神经紊乱、精神异常等多种非运动症状[1-2]。而帕金森病伴有抑郁、认知功能障碍在临床上最为常见,并且病情随着病程的延长而呈加重的趋势。目前临床上的治疗主要以改善帕金森病运动功能障碍为主,对非运动障碍症状的治疗较少。本研究对58例帕金森病患者的临床资料进行分析,评价联合文拉法辛和认知行为疗法对帕金森病合并抑郁患者的临床疗效。现将结果报道如下。

1 资料与方法

1.1 一般资料

选择我科2012年1月~2013年12月在我院诊断治疗的帕金森病合并抑郁、认知功能障碍的患者58例为研究对象,纳入标准:(1)符合帕金森病的诊断标准;(2)HAMD评分>8 分,且MoCA 评分<26 分;(3)未进行抗抑郁治疗;(4)有一定的文endprint

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