目的探讨帕罗西汀联合阿普唑仑治疗老年脑卒中后焦虑和抑郁的效果。方法选取我院2014年6月至2016年6月收治的198例老年卒中后焦虑和抑郁的病人。采用随机数字表法将198例病人分为观察组和对照组,每组99例。所有病人均给予神经内科常规治疗及运动康复训练,同时口服盐酸帕罗西汀20 mg/d。观察组在此基础上口服阿普唑仑0.4 mg/d。2组均连续服用3月。治疗前后采用Zung焦虑自评量表（SAS）和Zung抑郁自评量表（SDS）分别评测病人的焦虑和抑郁状况。采用日常生活能力评定量表（BI）和美国国立卫生院卒中量表（NIHSS）评估病人生活质量。记录2组不良反应发生情况。结果治疗前,2组SDS和SAS评分比较差异均无统计学意义（P〉0.05）;治疗后,2组SDS和SAS评分均显著降低（P〈0.05）,且观察组SDS和SAS评分显著低于对照组（P〈0.05）。治疗前,2组NIHSS评分和BI评分比较差异均无统计学意义（P〉0.05）;治疗后,2组NIHSS评分均显著降低（P〈0.05）,BI评分显著上升（P〈0.05）,且2组间比较差异有统计学意义（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）。结论帕罗西汀联合阿普唑仑治疗老年卒中后焦虑和抑郁效果显著,优于单用帕罗西汀,可显著提高病人生活质量,且不良反应少,值得临床推荐。
Objective To evaluate the efficacy of paroxetine combined with alprazolam in the treatment of post-stroke anxiety and depression in elderly patients. Methods 198 cases of post-stroke anxiety and depression patients treated in our hospital from June 2014 to June 2016 were divided into observation group and control group by random number table method,with 99 cases in each group. All patients were treated with paroxetine hydrochloride 20 mg/d,routine neurological therapy and exercise rehabilitation. The observation group treated with alprazolam 0. 4 mg/d additionally. The treatment period was 3 months. Before and after treatment,the status of anxiety and depression of the patients were evaluated by Zung anxiety self-rating scale（ SAS） and Zung depression self-rating scale（ SDS）. Quality of life was assessed using the daily living ability rating scale（ BI） and the national institute of health stroke scale（ NIHSS）. Adverse events were recorded. Results There were no significant difference in SDS and SAS scores between the two groups before treatment（ P〉0. 05）. After treatment,both SDS and SAS scores were significantly decreased（ P〈0. 05）,and especially significant in the observation group（ P〈0. 05）. There were no significant differences in NIHSS score and BI score between the two groups before treatment（ P〉0. 05）. After treatment,the NIHSS scores of the two groups significantly decreased（ P〈0. 05） and the BI score increased significantly（ P〈0. 05）,and there was significant difference between the two groups（ P〈0. 05）. There was no significant difference in the incidence rate of adverse reactions between the two groups（ P〉0. 05）. Conclusions Paroxetine combined with alprazolam in the treatment of post-stroke anxiety and depression is effective,which can significantly improve the quality of life,with fewer adverse reactions.