2021 年第 3 期 第 16 卷

草酸艾司西酞普兰联合氯硝西泮治疗脑卒中后抑郁的效果及对患者神经功能的影响

Therapeutic efficacy of escitalopram oxalate combined with clonazepam on patients with depression after cerebral apoplexy and its effect on nerve function

作者：田密聂伟曾进

英文作者：Tian Mi Nie Wei Zeng Jin

单位：湖南中医药高等专科学校附属第一医院神经内科，湖南省株洲市412000

英文单位：Department of Neurology the First Affiliated Hospital of Hunan Traditional Chinese Medicine College Hunan Province Zhuzhou 412000 China

关键词：脑卒中后抑郁；草酸艾司西酞普兰；氯硝西泮；神经功能

英文关键词：

• 摘要：

• 目的 探讨草酸艾司西酞普兰联合氯硝西泮治疗脑卒中后抑郁的效果及对患者神经功能的影响。方法 选取2017年10月至2020年2月湖南中医药高等专科学校附属第一医院收治的90例脑卒中后抑郁患者作为研究对象，采用随机数字表法分为观察组（45例）和对照组（45例）。对照组口服草酸艾司西酞普兰片治疗；观察组在上述治疗基础上加用氯硝西泮片治疗。比较2组治疗前和治疗2个月后抑郁情况［汉密尔顿抑郁量表17项(HAMD-17)评分］、认知功能［采用威斯康星卡片分类测验（WCST）进行评价］和神经功能因子S100B蛋白、神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)水平。观察2组不良反应发生情况。结果 2组治疗后HAMD-17评分均较治疗前显著降低，且观察组显著低于对照组［（13±4）分比（17±5）分］，差异均有统计学意义（均P＜0.05）。2组治疗后WCST评价中完成分类数、正确应答数评分均明显高于治疗前，且观察组高于对照组，差异均有统计学意义（均P＜0.05）。2组治疗后S100B、NSE、MBP水平均较治疗前显著降低，且观察组低于对照组，差异均有统计学意义（均P＜0.05）。2组不良反应发生率比较差异无统计学意义（P＞0.05）。结论 草酸艾司西酞普兰联合氯硝西泮治疗脑卒中后抑郁，有助于改善抑郁情况、认知功能和神经功能，且不良反应较少。

• Objective To investigate the therapeutic efficacy of escitalopram oxalate combined with clonazepam on patients with depression after cerebral apoplexy and its effect on nerve function. Methods From October 2017 to February 2020, 90 patients with depression after cerebral apoplexy admitted to the First Affiliated Hospital of Hunan  Traditional Chinese Medicine College were selected. They were randomly divided into observation group (45 cases) and control group (45 cases). The control group was treated with escitalopram oxalate tablets, and the observation group was treated with clonazepam tablets on the basis of the above treatment. The depression ［17-Item Hamilton Depression Scale(HAMD-17) score］, cognitive function ［evaluated by Wsiconsin card sorting test(WCST)］, neurofunctional factor S100B protein, neuron specific enolase (NSE) and myelin basic protein(MBP) levels were compared between the two groups before and after 2 months of treatment. The incidence of adverse reactions was observed. Results The HAMD-17 scores of the two groups after treatment were significantly lower than those before treatment, and that of the observation group was significantly lower than that of the control group ［(13±4) vs (17±5)］(all P＜0.05). The number of categories completed and correct responses score in WCST evaluation of the two groups after treatment were significantly higher than those before treatment, and those of the observation group were higher than those of the control group(all P＜0.05). After treatment, the levels of S100B protein, NSE and MBP in the two groups were significantly lower than those before treatment, and those of the observation group was lower than those of the control group(all P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). Conclusion Escitalopram oxalate combined with clonazepam in the treatment of depression after cerebral apoplexy is helpful to improve depression, cognitive function and neurological function, with less adverse reactions.