焦虑障碍伴糖调节受损帕罗西汀联合团体心理治疗的随机双盲对照研究

发布时间：2019-04-01 16:28

【摘要】：目的:比较帕罗西汀联合团体心理治疗与单用帕罗西汀治疗焦虑障碍伴糖调节受损患者的疗效。方法:本研究为随机双盲对照研究。选取52例符合国际疾病和相关健康问题统计分类第十版(ICD-10)焦虑障碍(包括惊恐障碍、广泛性焦虑障碍)诊断标准,同时伴有糖调节受损的患者,随机分为两组,每组26例,一组给予帕罗西汀联合团体心理治疗(团体+药物组),另一组单用帕罗西汀治疗(药物组),疗程6个月。采用Zung焦虑自评量表(SAS)评定焦虑症状及改善情况,检测空腹血糖(FPG)、葡萄糖耐量试验(OGTT)后2 h血糖(2hPG)和糖化血红蛋白(HbA1C)、空腹胰岛素(FINS)并计算胰岛素抵抗指数(HOMA-IR)来评价糖代谢和胰岛素抵抗水平,采用药物副反应量表(TESS)评定安全性。结果:治疗6个月后,两组的FPG、2hPG、HbA1C、FINS、HOMA-IR及SAS评分均低于治疗前(均P0.05);团体+药物组较药物组的2hPG、FINS、HOMA-IR、SAS评分降低更明显[(7.5±1.1)vs.(8.3±1.4),(8.3±1.3)vs.(9.9±1.6),(1.9±0.3)vs.(2.3±0.4),(41.2±4.5)vs.(45.3±5.7);均P0.05]。治疗后两组间FPG、HbA1C下降差异无统计学意义(P0.05)。两组TESS评分差异无统计学意义(P0.05)。结论:本研究提示,帕罗西汀联合团体心理治疗较单用帕罗西汀能更有效地降低焦虑障碍伴糖调节受损患者的餐后血糖水平,改善焦虑症状,提高胰岛素敏感性。
[Abstract]:Objective: To compare the curative effect of paroxetine combined group psychotherapy and paroxetine in the treatment of anxiety disorder with sugar regulation in patients with impaired glucose. Methods: The study was a randomized, double-blind, controlled study. 52 patients with international and related health problems (ICD-10) anxiety disorder (including panic disorder and generalized anxiety disorder) were selected, and the patients with impaired glucose regulation were randomly divided into two groups, each group of 26 cases. One group was given paroxetine group psychotherapy (group + drug group) and the other group was treated with paroxetine alone (drug group) for a period of 6 months. The anxiety symptom and the improvement were assessed by the Zung anxiety self-rating scale (SAS), and the blood glucose (2hPG) and the glycosylated hemoglobin (HbA1C) were measured after fasting blood glucose (FPG) and glucose tolerance test (OGTT). The insulin resistance index (HOMA-IR) was calculated and the insulin resistance index (HOMA-IR) was calculated to evaluate the glucose metabolism and the insulin resistance level, and the safety was assessed by the drug side reaction scale (TESS). Results: After 6 months of treatment, the FPG, 2hPG, HbA1C, FINS, HOMA-IR and SAS scores of the two groups were lower than those in the pre-treatment group (P <0.05). The scores of 2 hPG, FINS, HOMA-IR and SAS in the group + drug group were lower (7.5% 1.1) vs. (8.3. 1.4), (8.3% 1.3) vs. (9.9% 1.6). (1.9-0.3) vs. (2.3-0.4), (41.2-4.5) vs. (45.3-5.7); There was no significant difference in the difference of FPG and HbA1C between the two groups after treatment (P0.05). There was no significant difference between the two groups (P0.05). Conclusion: Paroxetine in combination with paroxetine can reduce the postprandial blood glucose level of patients with impaired anxiety disorder with sugar, improve the anxiety symptoms and improve the insulin sensitivity.
【作者单位】：四川大学华西医院心理卫生中心;重庆医科大学附属第一医院;四川大学华西医院内分泌科;川北医学院附属医院;
【基金】：国家科技支撑计划课题-心身疾病常见心理问题的识别与干预(2009BAI77B06)
【分类号】：R749.720.5

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