认知行为疗法联合心理支持对脑卒中后抑郁患者负性情绪的影响
Effect of Cognitive Behavioral Therapy Combined with Psychological Support on Negative Emotions in Patients with Post-Stroke Depression
摘要: 目的：探究认知行为疗法联合心理支持对脑卒中后抑郁患者负性情绪的影响。方法：采用随机数字表法将广西中医药大学第二附属医院康复医学科2024年8月~2025年8月期间收治的120例脑卒中后抑郁患者分为观察组(60例，认知行为疗法联合心理支持干预)和对照组(60例，常规护理)。观察两组治疗前、后患者的心理弹性、焦虑、抑郁、Barthel指数和生活质量。结果：两组治疗前的心理弹性、焦虑、抑郁、Barthel指数和生活质量比较差异无统计学意义(P > 0.05)；治疗后两组心理弹性、Barthel指数、生活质量均高于治疗前，且观察组更高，焦虑和抑郁均低于治疗前，且观察组更低(P < 0.05)。结论：认知行为疗法结合心理支持能够有效提升脑卒中后抑郁患者的心理弹性，有助于缓解其焦虑、抑郁情绪，并改善生活质量。
Abstract: Objective: To investigate the effect of cognitive behavioral therapy (CBT) combined with psychological support on negative emotions in patients with post-stroke depression (PSD). Methods: A total of 120 patients with post-stroke depression admitted to the Rehabilitation Medicine Department of the Second Affiliated Hospital of Guangxi University of Chinese from August 2024 to August 2025 were randomly allocated using a random number table method into a control group (n = 60, received routine nursing care) and an observation group (n = 60, received cognitive behavioral therapy combined with psychological support intervention). Psychological resilience, anxiety, depression, Barthel index, and quality of life were assessed before and after treatment in both groups. Results: There were no significant differences in psychological resilience, anxiety, depression, Barthel index, or quality of life between the two groups before treatment (P > 0.05). After treatment, both groups showed higher psychological resilience, Barthel index, and quality of life and lower anxiety and depression than before treatment, with the observation group demonstrating greater improvement in all outcomes (P < 0.05). Conclusion: Cognitive behavioral therapy combined with psychological support can effectively enhance psychological resilience, alleviate anxiety and depression, and improve the quality of life in patients with post-stroke depression.
文章引用：谭小歆, 李金灵, 周彩红, 冯燕妮, 吴敏娜, 周丽莎, 马凯芬, 廖洪全. 认知行为疗法联合心理支持对脑卒中后抑郁患者负性情绪的影响[J]. 护理学, 2026, 15(10): 117-124. https://doi.org/10.12677/ns.2026.1510333

参考文献

[1] Yoshimura, Y., Bise, T., Shimazu, S., Tanoue, M., Tomioka, Y., Araki, M., et al. (2019) Effects of a Leucine-Enriched Amino Acid Supplement on Muscle Mass, Muscle Strength, and Physical Function in Post-Stroke Patients with Sarcopenia: A Randomized Controlled Trial. Nutrition, 58, 1-6.
https://doi.org/10.1016/j.nut.2018.05.028
[2] Zhou, L., Wang, L., Liu, G. and Cai, E. (2024) Prognosis Prediction Models for Post-Stroke Depression: A Protocol for Systematic Review, Meta-Analysis, and Critical Appraisal. Systematic Reviews, 13, Article No. 138.
https://doi.org/10.1186/s13643-024-02544-x
[3] 李世明, 冯为, 崔凤伟, 等. 中国脑卒中后抑郁患病率meta分析[J]. 实用医学杂志, 2021, 37(16): 2058-2064.
[4] 董又鸣, 萧蕙, 路世龙, 等. 不同方式重复经颅磁刺激联合SSRI对卒中后抑郁患者干预效果的网状Meta分析[J]. 中国循证医学杂志, 2023, 23(8): 887-893.
[5] Zhang, E. and Liao, P. (2019) Brain‐Derived Neurotrophic Factor and Post‐Stroke Depression. Journal of Neuroscience Research, 98, 537-548.
https://doi.org/10.1002/jnr.24510
[6] 李清金, 韩玉惠, 洪春永, 等. 基于抑郁程度、心理痛苦、自理能力分析的脑卒中后抑郁患者自杀倾向的影响因素探讨[J]. 临床误诊误治, 2024, 37(5): 23-28.
[7] 张彩霞, 徐玉丽, 智喜荷, 等. 基于认知-行为的心理护理对青年脑卒中后抑郁的康复效果的影响[J]. 国际精神病学杂志, 2020, 47(3): 606-608, 612.
[8] Kaczkurkin, A.N. and Foa, E.B. (2015) Cognitive-Behavioral Therapy for Anxiety Disorders: An Update on the Empirical Evidence. Dialogues in Clinical Neuroscience, 17, 337-346.
https://doi.org/10.31887/dcns.2015.17.3/akaczkurkin
[9] 樊茜. 基于积极心理学理论的护理干预在抑郁症患者中的应用效果[J]. 航空航天医学杂志, 2024, 35(12): 1508-1510.
[10] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑出血诊治指南(2019) [J]. 中华神经科杂志, 2019, 52(12): 994-1005.
[11] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性卒中诊治指南2023 [J]. 中华神经科杂志, 2024, 57(6): 523-559.
[12] 王少石, 周新雨, 朱春燕. 卒中后抑郁临床实践的中国专家共识[J]. 中国卒中杂志, 2016, 11(8): 685-693.
[13] 倪倩钰, 田俊. 心理弹性量表信度和效度评价及应用[J]. 中国公共卫生, 2013, 29(10): 1524-1527.
[14] 汤毓华, 张明园. 汉密顿焦虑量表(HAMA) [J]. 上海精神医学, 1984, 26(2): 64-65.
[15] 汤毓华, 张明园. 汉密顿抑郁量表(HAMD) [J]. 上海精神医学, 1984, 26(2): 61-64.
[16] 王伊龙, 马建国, 李军涛, 等. 脑卒中生存质量量表中译本信度和效度及敏感度的初步研究[J]. 中华老年心脑血管病杂志, 2003, 5(6): 391-394.
[17] 张丽敏, 张秀贞, 刘传新. 恶性血液肿瘤患者焦虑情绪与生命质量: 心理弹性的中介作用和自我效能感的调节作用[J]. 中华行为医学与脑科学杂志, 2024, 33(12): 1099-1105.
[18] 孟庆顺, 刘琦, 辛凯鹏. 认知行为疗法联合心理支持治疗对老年抑郁症患者生活质量的影响[J]. 心理月刊, 2025, 20(13): 162-164.
[19] 李伟丽, 仇丽霞, 孟效红, 等. 网络认知行为疗法干预方案在脑卒中后焦虑抑郁共病病人中的应用[J]. 护理研究, 2025, 39(6): 986-991.
[20] 钟娟平, 谢琪, 裴菊红, 等. 认知行为疗法在脑卒中情感障碍病人中的应用进展[J]. 护理研究, 2022, 36(3): 433-436.
[21] Lau, W.K.W. (2022) The Role of Resilience in Depression and Anxiety Symptoms: A Three‐Wave Cross‐Lagged Study. Stress and Health, 38, 804-812.
https://doi.org/10.1002/smi.3136
[22] 汪秀勤, 程燕, 宋明香, 等. 快乐感知训练结合情绪释放疗法在卒中后抑郁患者中的应用[J]. 中国护理管理, 2024, 24(11): 1732-1737.

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