| Objective:To investigate the effect of acceptance and commitment therapy(ACT)on post-stroke depression(PSD)and its effects on serum Hs-CRP and BDNF.Methods:74 patients with PSD were randomly divided into ACT psychotherapy group and control group,with 37 cases in each group.Both groups were given symptomatic supportive treatment after stroke and the antidepressant Sertraline 50mg/d,and the study group was given ACT treatment on the basis of the above treatment.Both groups were hospitalized for 4 weeks and followed up for 4 weeks after discharge.Before treatment,2weeks,4 weeks,2 weeks after treatment,and 4 weeks after treatment,HAMD,HAMA,PSQI and MBI scales were used to score depression,anxiety,sleep quality and daily living ability of patients in the two groups,respectively.The differences of depression,anxiety,sleep status and daily living ability scores between the two groups were observed.HAMD scores were compared between groups to observe the differences between the two groups.Serum Hs-CRP and BDNF values of the two groups were detected before treatment and 4 weeks after discharge,and the differences of serum Hs-CRP and BDNF between the two groups were compared before and after treatment.Two-factor repeated measure variance analysis was used to analyze the scale scores and serum Hs-CRP and BDNF levels of the two groups.Test level=0.05.Graphpadprism 8.02 was used for drawing.Results:There was no significant difference in the general demographic data(including age,sex,education level,medical insurance type,stroke duration,lesion site,stroke type,first attack or main caregiver)between the two groups before treatment(P > 0.05).Before treatment,there were no significant differences in HAMD,HAMA,PSQI and MBI scores between the two groups(P > 0.05).HAMD scores in 2 groups were significantly decreased before treatment and at each time point of follow-up,with statistical significance(P < 0.05);The HAMD score of the study group was more significantly decreased than that of the control group during treatment and follow-up,and the difference was statistically significant(P <0.05).There were no significant differences in HAMD scores(anxiety/somatization,cognitive disorder,block and sleep disorder)between the two groups before treatment(P > 0.05).After4 weeks of treatment,the difference between the two groups was statistically significant(P <0.05).The HAMA score of the study group and control group was significantly decreased at each time point of treatment(P < 0.05).The HAMA score of the study group was lower than that of the control group since the 4th week of treatment,and the difference was statistically significant(P < 0.05).The HAMA score of the study group was lower than that of the control group at each time point,and the advantage of the study group was still maintained after treatment(P < 0.05).There was no significant difference in PSQI score between the two groups before treatment(P > 0.05),but the score of the study group was lower than that of the control group at each time point of treatment,and the difference was statistically significant(P < 0.05).There was no significant difference in MBI score between the two groups before treatment(P > 0.05),and the total MBI score before treatment and at each time point of treatment was significantly decreased,with statistical significance(P < 0.05).The MBI scores of the two groups at each time point were compared,and there was no statistical significance between the study group and the control group(P>0.05),suggesting that ACT had no significant advantage in improving the daily living ability of PSD patients compared with the control group.There was no significant difference in serum Hs-CRP and BDNF values between the two groups before treatment(P>0.05).Serum Hs-CRP values in the study group and the control group were decreased 4 weeks after treatment,while BDNF values were increased 4 weeks after treatment.After 4 weeks of treatment,serum Hs-CRP in the research group was lower than that in the control group,the difference was statistically significant,and serum BDNF in the research group was higher than that in the control group,the difference was statistically significant(P < 0.05).Conclusion:ACT therapy has significant effect on improving depression anxiety and sleep quality in patients with PSD.In the factor scores of depressive state,anxiety/somatization,cognitive function and sleep factors show faster effect,while the effect on the improvement of daily living ability is not significant.At the same time,ACT can help reduce the serum Hs-CRP value and inflammatory response during treatment.Increase neurotrophic factor and improve cognitive function. |
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