阿立哌唑作为增效剂治疗难治性强迫症的临床观察  

Aripiprazole as an adjunctive treatment for refractory Obsessive-compulsive disorder

作　　者：王玉[1] 刘盈[1] 汤艳清[1] 

机构地区：[1]中国医科大学医学心理与精神卫生系,沈阳110001

出　　处：《中国行为医学科学》2006年第9期800-801,共2页Chinese Journal of Behavioral Medical Science

摘　　要：目的探讨阿立哌唑作为增效剂治疗难治性强迫症的疗效和耐受性。方法对31例难治性强迫症患者在原SRI类药物治疗的基础上联合阿立哌唑治疗并以28例继续应用SRI类药物治疗的难治性强迫症患者为对照。阿立哌唑起始量为第1周5mg/d,第2周为10mg/d,第3周为15mg/d口服,之后可根据个体的疗效和耐受情况调整剂量,最大剂量不超过20mg/d,疗程8周;采用Yale-Brown强迫量表、汉密尔顿焦虑量表、总体评定量表及副反应评定量表分别在治疗前、治疗第4周末及治疗第8周末各评定1次,并进行对比分析。结果治疗第8周末,研究组Yale-Brown强迫量表[(12.00±5.32)分]、汉密尔顿焦虑量表[(13.75±3.27)分]、大体评定量表总分[(48.75±11.73)分]与治疗前[分别为(29.80±5.44)分,(23.50±3.61)分,(26.95±10.61)分]比较差异均有显著性(P<0.01);Yale-Brown强迫量表减分率判定痊愈率16%,有效率48%,无效36%;不良反应程度较轻微,患者均可耐受并与对照组在各项量表评分上差异具有显著性。结论小剂量阿立哌唑可作为常规抗抑郁剂的增效剂治疗难治性强迫症。Objective To explore the therapeutic effects and tolerance of aripiprazole as augmentation treatment in the patients with refractory obsessive-compulsive disorder （ROCD） . Methods 31 patients with the ROCD were treated with aripiprazole based upon preceding SSRI antidepressants . It＇s beginning dosage was 5mg/ d and gradually increased , and top dosage was 20mg/d for 8 weeks. Assessments included the Yale-Brown Obsessive Compulsive Scale （YBOCS） , Hamilton Rating Scale for Anxiety （HAMA） , Global Assessment Scale （ GAS） and Treatment Emergent Symptoms Scale （TESS） before treatment and at the end of the 4th and 8th week of the study , respectively. Results At the end of the 8th week of the study , the total scores of the YBOCS （ 12. 00 ± 5.32） , HAMA （ 13.75 ± 3.27 ） and GAS （48.75 ± 11.73 ） had significant difference compared with pretreatmen （ as follows ：29.80 ± 5.44,23.50 ± 3.61,26.95 ± 10.61 ） （ P 〈 0.01 ） ; According to the score-reducing rate of the YBOCS ： recovery rate was 16%, effective rate 48 % and ineffective rate 36 % ; side effects were milder and tolerable. Conclusion Small dose aripiprazole as synergist of SSRI antidepressants in the treatment of patients with refractory obsessive-compulsive disorder has promising prospect.

关 键 词：阿立哌唑 增效剂 难治性强迫症 

分 类 号：R749.7[医药卫生—神经病学与精神病学]