聶利珞

[摘要] 目的 探討文拉法辛聯(lián)合認(rèn)知行為療法治療帕金森癥合并抑郁、認(rèn)知功能障礙的臨床療效。 方法 選擇58例帕金森癥合并抑郁患者，根據(jù)治療方法分為聯(lián)合組和對(duì)照組。對(duì)照組給予文拉法辛膠囊口服治療，聯(lián)合組在此基礎(chǔ)上給予認(rèn)知行為療法，比較兩組患者的臨床療效。 結(jié)果 兩組組內(nèi)比較，治療后焦慮、抑郁評(píng)分顯著下降（P<0.01），治療后兩組組間比較，聯(lián)合組評(píng)分顯著低于對(duì)照組（P<0.01）。聯(lián)合組在干預(yù)后認(rèn)知功能總分、視空間與執(zhí)行能力、命名能力、語言能力、延遲回憶以及定向力評(píng)分顯著高于對(duì)照組（P<0.01）。 結(jié)論 文拉法辛聯(lián)合認(rèn)知行為干預(yù)治療帕金森癥合并抑郁、認(rèn)知功能障礙，具有較好的臨床療效，能夠顯著改善患者焦慮、抑郁、認(rèn)知功能障礙等情況。

[關(guān)鍵詞]文拉法辛；認(rèn)知行為干預(yù)；帕金森癥；抑郁

[中圖分類號(hào)] R749 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 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?。≒arkinson's disease，PD）主要表現(xiàn)為運(yùn)動(dòng)功能障礙，包括靜止性震顫、肌強(qiáng)直、運(yùn)動(dòng)遲緩、姿勢(shì)步態(tài)異常等，是中老年常見的慢性神經(jīng)系統(tǒng)疾病。在我國，55 歲以上人群 PD的患病率高達(dá)1.07%，而隨著年齡的增加，患病率逐漸增加。隨著我國經(jīng)濟(jì)的發(fā)展，社會(huì)老齡化問題越來越突出，PD的發(fā)病率也呈上升的趨勢(shì)。帕金森病除了運(yùn)動(dòng)障礙等臨床表現(xiàn)外，患者還多伴非運(yùn)動(dòng)癥狀，包括抑郁、焦慮、認(rèn)知功能障礙、失眠、便秘、自主神經(jīng)紊亂、精神異常等多種非運(yùn)動(dòng)癥狀[1-2]。而帕金森病伴有抑郁、認(rèn)知功能障礙在臨床上最為常見，并且病情隨著病程的延長而呈加重的趨勢(shì)。目前臨床上的治療主要以改善帕金森病運(yùn)動(dòng)功能障礙為主，對(duì)非運(yùn)動(dòng)障礙癥狀的治療較少。本研究對(duì)58例帕金森病患者的臨床資料進(jìn)行分析，評(píng)價(jià)聯(lián)合文拉法辛和認(rèn)知行為療法對(duì)帕金森病合并抑郁患者的臨床療效?，F(xiàn)將結(jié)果報(bào)道如下。

1 資料與方法

1.1 一般資料

選擇我科2012年1月～2013年12月在我院診斷治療的帕金森病合并抑郁、認(rèn)知功能障礙的患者58例為研究對(duì)象，納入標(biāo)準(zhǔn)：（1）符合帕金森病的診斷標(biāo)準(zhǔn)；（2）HAMD評(píng)分>8 分，且MoCA 評(píng)分<26 分；（3）未進(jìn)行抗抑郁治療；（4）有一定的文endprint