| Stroke, cerebrovascular accident (CVA), is the rapid localized and extensive loss of brain function due to disturbance in the blood supply to the brain. Because of the high disease morbidity, mortality and high morbidity characteristics, stroke leaps to the first leading cause of death nationwide. The findings show that patients with ischemic stroke (mainly cerebral infarction) accounts for about70-85%, much higher than the number of patients with hemorrhagic stroke. Visible, cerebral infarction has serious destruction of our national. Clinical statistics show that most of survivers from stroke will suffer sequela. Among them, nearly3/4will lose their labor ability, with40%grave disability. Therefore, the patient’s neurological rehabilitation after stroke has become an urgent task. However, recently foreign researches have suggested that fluoxetine(one of selective serotonin reuptake inhibitor-SSRIs) as a classic antidepressants,while also could promote neuronal plasticity. If20mg of fluoxetine are given to acutes ischemic strokers, with medium and severe motor dysfunction, in oral formulation at an early stage, together with physical therapy, patients’ motor function could get benefits and be cured, with the future exuberating prosperity.ObjectiveThis study mainly associated with severe motor dysfunction in patients with acute cerebral infarction as the research object, in order to explore whether fluoxetine can improve patients’ motor function of hemiplegic limb with acute cerebral.Methods60Patients, with neurological symptoms and located sign(mainly motor dysfunction),who are at the Department of Neurology of Anyang People’s Hospital from January of2012to June of2012, are diagnosed with cerebrovascular disease. All patients accorded with the diagnostic standard by the fourth Cerebravascular Disease Conference in1995and with cores below65in their motor function of their paralytic limbs. All patients are divided into fluoxetine group and control group(each30cases) with sealed, opaque envelopes randomized single, double the number grouping method. Fluoxetine group of30patients,16males and14females, aged45to77years, an average of62.11±8.51years old, onset to enrollment time3～20days, an average of11.48±6.20days; control group of30patients, male17cases, female13cases, aged43to78years, an average of60.35±7.86years old, onset into the group5to18days, an average of13.54±6.58days. The fluoxetine group patients received fluoxetine hydrochloride tablets20mg/day orally, and give acute cerebral infarction conventional medication and physical therapy (including acupuncture and (or) basic rehabilitation training guidance), while the control group use the same therapy the fluoxetine group except fluoxetine hydrochloride tablets oral. Patients’ motor function of their paralytic limbs will be assessed pre-administration and at30and90days after administration, respectively through FMMS, NIHSS, HAMD and MRS. After the end of the90-day observation period, the patient’s baseline data and the scale score results were statistically analyzed using descriptive statistics analysis:baseline data; measurement data were expressed as mean±standard deviation (x±s), all information normality test; between the two groups were compared using t-test; their own before and after the paired test; count data using a non-parametric test of Mann-Whitney U-test (a rank sum test). Analyzed the results of the ratings of patients (mainly exercise score), to determine whether fluoxetine has a role to improve motor function in patients with acute cerebral.Results(1)The two groups of patients with baseline information (such as gender, age, educational level, family relations, economic conditions and past medical history, etc.) no significant difference (P>0.05).(2)Before treatment, the two groups of patients’ FMMS scale score, NIHSS score, HAMD scores were not statistically different (P>0.05). Fluoxetine patients FMMS NIHSS and HAMD scores were17.6±7.4,12.3±4.2and6.7±4.3, while the control group patients FMMS NIHSS and HAMD scores were14.4±5.2,12.7±3.9and6.2±4.7, the scores of the two groups of patients the t-values were0.078,0.063and0.059, suggesting that comparable between patients.(3)30days after administration, fluoxetine group patients FMMS score was36.7±15.7, while the control group patients FMMS score of32.6±14.9, two groups of patients at30days FMMS scores a t-value of0.083, no significant difference(P>0.05);90days after administration, fluoxetine group patients FMMS score (55.7±22.8) was significantly higher than that in the control group (38.1±19.3), two groups of patients the FMMS rated t=3.223, statistically significant difference (P<0.01), suggesting that at90days fluoxetine group recovery of motor function in patients than in the control group was significantly.(4)HAMD score comparison:30days after administration of fluoxetine group patients HAMD score was6.5±4.1, control group patients HAMD score to6.6±3.8, two groups of patients HAMD score t-value is0.051, the difference was not statistically significance (P>0.05);90days after administration of fluoxetine group patients HAMD score was6.4±5.1, HAMD score of9.3±7.9in the control group patients, two groups of patients HAMD score t=0.018, the difference was not statistically significant (P>0.05), prompted two groups of patients had no significant depressive symptoms during the observation period.(5)NIHSS score comParison:30days after administration of fluoxetine group patients NIHSS score was9.7±3.9to9.9±3.7NIHSS score of the control group patients, t-value is0.108, two groups of patients with NIHSS score difference was not statistically significant (P>0.05);90days after administration of fluoxetine group patients NIHSS score to6.1±3.7to7.5±4.4NIHSS score of the control group patients,t-value is0.151, two groups of patients with NIHSS score difference was not statistically significant (P>0.05), suggesting that the two groups of patients with neurological deficit no significant difference in the degree of recovery.(6)Comparison in patients living skills:30days after administration of fluoxetine group patients, severe disability (MRS score at4-5points) in patients before administration of the27cases (90%) was reduced to30days after administration of the20cases (67%), control group of patients with moderate to severe disability in28cases before administration (93%) was reduced to30days after administration of22cases (73%), suggesting that the viability of the two groups of patients improved than before;90days after administration of MRS score than the time of admission was significantly lower specific to the individual Patient’s score of0-2means that treatment is effective, fluoxetine group (8cases, accounting for27%of the total) was significantly higher (2cases, accounting for7%of the total), suggesting that patients with activities of daily living improved with the recovery of motor function in patients.Conclusion1.Fluoxetine significantly improved motor function of patients with acute cerebral infarction with severe paralysis of the limbs,promoting long-term recovery of motor function,and the motor function on the upper lim improved better than the lower limb, may focus on improving the collaborative movement of the limb and fine motor function.2. Fluoxetine can improve activities of daily living in patients with acute cerebral infarction.3. Fluoxetine may improve motor function in patients with its special role in mechanisms rather than antidepressant mechanism. |
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