舍曲林联合小剂量抗精神病药物治疗难治性强迫症的临床研究

发布时间：2018-03-13 09:30

本文选题：难治性强迫症　切入点：耶鲁-布朗强迫量表　出处：《郑州大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的探讨难治性强迫症的临床药物治疗方法和临床疗效及副反应。方法采取临床对照研究方法,选入60例符合中国精神障碍分类与诊断标准第三版(CCMD-3)强迫症诊断标准,且至少服用过2种类型不同的抗强迫药物(即：三环类、SSRIs.5-HT及去甲肾上腺素再摄取抑制剂)系统治疗无效的患者,随机分为两组,实验组给予舍曲林合并利培酮治疗,对照组单用舍曲林同时治疗12周。应用耶鲁-布朗强迫量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)评定心理状态及症状严重程度,采用Y-BOCS量表减分率标准评定疗效,应用副反应量表(TESS)评定治疗过程中的不良反应。结果 1、实验组与对照组疗效比较显示：治疗12周后,实验组总有效率83.3%；对照组总有效率66.7%。两组间总有效率比较,χ2=4.2,P0.05,提示舍曲林联合利培酮疗效优于单用舍曲林治疗。 2、实验组与对照组量表评分比较显示：实验组在2周Y-BOCS、HAMA评分与治疗前即具有显著性差异,而对照组在4周才具有显著性差异。两组间在4周末、8周末、12周末Y-BOCS、HAMA评分值比较具有显著性差异(P0.05)。从两组疗前与疗后自身评分值比较看,除对照组在2周末与疗前评分值比较差异无显著性外,其余各周评分值与疗前比较差异均有非常显著性(P0.01)。 3、实验组与对照组不良反应比较显示：两组在乏力困倦、焦虑、恶心、心动过速、便秘的发生率方面差异均无统计学意义(P0.05)。两组TESS评分比较显示：在治疗第2、4、8、12周末,两组TESS评分经统计学分析,差异均无统计学意义(P0.05)。结论 1、舍曲林联合小剂量利培酮与舍曲林单药治疗难治性强迫症比较,疗效更好、起效更快。 2、舍曲林合并小剂量利培酮治疗难治性强迫症同单用舍曲林治疗副反应相当,均有较好的依从性。
[Abstract]:Purpose. Objective: to explore the clinical therapeutic methods, clinical efficacy and side effects of obsessive-compulsive disorder (OCD). Method. A clinical controlled study was conducted to select 60 patients with OCD in accordance with the Chinese Classification and Diagnostic criteria for Mental Disorder (CCMD-3), the third edition of the Chinese criteria for the diagnosis of obsessive-compulsive disorder (OCD). Patients who had taken at least two different types of anti-compulsive drugs (i.e. tricyclic SSRIs.5-HT and norepinephrine reuptake inhibitors) were randomly divided into two groups. The experimental group was treated with sertraline combined with risperidone. The control group was treated with sertraline alone for 12 weeks. Y-BOCSA and Hamilton anxiety scale were used to assess the mental state and severity of symptoms. The efficacy was evaluated by Y-BOCS score reduction standard. Side effects were assessed by TESS. Results. 1. The comparison of the curative effect between the experimental group and the control group showed that the total effective rate of the experimental group was 83.3 after 12 weeks of treatment, and the total effective rate of the control group was 66.7.The comparison of the total effective rate between the two groups indicated that the curative effect of sertraline combined with risperidone was better than that of sertraline alone. 2. The scores of Y-BOCSHama in the experimental group were significantly different from those in the control group before treatment, and the scores of Y-BOCSHama in the experimental group were significantly different from those in the control group before treatment. There was significant difference in Y-BOCSHama score between the two groups at the 4th weekend and the 8th weekend and the 12th weekend, respectively (P 0.05). The comparison between the two groups before and after the treatment showed that there was a significant difference in Y-BOCSA score between the two groups before and after the treatment, and there was no significant difference between the two groups before and after the treatment. Except for the control group, there was no significant difference in the scores between the control group and the control group at the end of the second week and before treatment, but there was a very significant difference between the score values of the other weeks and that of the pre-treatment group (P 0.01). 3. The adverse reactions of the experimental group and the control group showed that there was no significant difference in the incidence of fatigue, anxiety, nausea, tachycardia and constipation between the two groups (P 0.05). The comparison of TESS scores between the two groups showed that: at the end of the 2nd week of treatment, there was no significant difference between the two groups in the incidence of fatigue, anxiety, nausea, tachycardia and constipation. There was no significant difference in TESS score between the two groups (P 0.05). Conclusion. 1. Sertraline combined with low dose risperidone was more effective and effective than sertraline in the treatment of refractory obsessive-compulsive disorder. 2, sertraline combined with low dose risperidone for refractory obsessive-compulsive disorder (OCD) had good compliance with sertraline alone.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.7

【相似文献】