舍曲林合并森田疗法治疗躯体形式障碍的对照研究  

Comparative study of morita therapy combined with sertraline in the treatment of somatoform disorders

作　　者：吴超[1] 杜凌阳 虞洪[1] 孙轻骑[1] 傅正闯 

机构地区：[1]浙江萧山医院精神卫生中心,311200

出　　处：《上海精神医学》2010年第2期91-94,共4页Shanghai Archives of Psychiatry

摘　　要：目的研究舍曲林与森田疗法联合治疗与单用舍曲林治疗躯体形式障碍的临床疗效。方法将58例躯体形式障碍的患者,分别给予森田疗法与舍曲林联合治疗(联合治疗组30例)和单用舍曲林药物治疗(单药治疗组28例)。采用汉密顿焦虑量表(HAMA)、大体评定量表(GAS)评定疗效,采用治疗时出现的症状量表(TESS)评定不良反应。比较2组疗效、不良反应发生率及1.5年内的复发率。结果联合治疗组在治疗后4、8、12周的HAMA总分和躯体性焦虑因子分明显低于药物组,其减分率明显高于药物组。治疗8周后联合治疗组GAS评分及有效率明显高于单药治疗组,用药剂量少于单药治疗组(t=2.13,P=0.04)。联合治疗组治疗有效率为83.3%(25/30),显著高于单药治疗组为57.1%(16/28),(χ2=4.79,P=0.030)。联合治疗组1.5年内的复发率(20%)显著低于单药治疗组(46.4%),(χ2=4.592,P=0.033)。联合治疗组不良反应发生率为26.7%,单药治疗组为25%,2组比较无统计学差异。结论舍曲林与森田疗法联合治疗躯体形式障碍有效,并可减少用药剂量和复发。Objective： To study the clinical effects of morita therapy （MT） combined with sertraline and sertraline single in the treatment of somatoform disorders, Methods： 58 patients with somatoform disorders were randomized to two groups. One group （ MT combined group N = 30） was treated with MT combined with sertraline. The other group （ drug group N = 28） was treated with sertraline solely. The efficacy and safety were assessed with HAMA, GAS and TESS. The effective rate, side effect rate and relapse rate in 1.5 year were compared between the two groups. Results： HAMA total score and HAMA - SOM factor score were significantly lower in MT combined group than in drug group at the end of week 4, 8 and 12 of treatment. GAS total score and effective rate were significantly higher in MT combined group at the end of week 8 andl2 of treatment. Does of drug were lower in MT combined group than in drug group（ t = 2. 13 ,P =0.04）. The effective rate was 83.3% （25/30） in MT combined group and 57.1% （16/28） in drug group （χ^2 =4.79 ,P =0.030）. Relapse rate by 1..5 year was 20% in MT combined group, significantly lower than in drug group （46.4%）, （χ^2 =4.592 ,P = 0.033）. Side effect rate was 26.7% in MT combined group and 25% in drug group. There was no difference between the two groups. Conclusion：Sertraline combined with morita therapy was more effective than sertraline monotherapy in the treatment of somatoform disorders and it can reduce doses of drug required as well as decrease relapse rate.

关 键 词：舍曲林 森田疗法 躯体形式障碍 

分 类 号：R749.7[医药卫生—神经病学与精神病学]