穴位刺激调控法联合小剂量氯米帕明片治疗强迫症81例随机双盲临床研究  

A Randomized Double-Blind Study on Acupuncture Point Regulatory-Control Combined with Clomipramine for Obsessive-Compulsive Disorders

作　　者：冯斌[1] 朱锐明 徐方忠[1] 刘兰英[1] 陈炯[1] 吕洋洋[3] 王佩蓉[1] 

机构地区：[1]浙江省立同德医院,杭州市古翠路234号310012 [2]浙江省义乌市中医医院 [3]浙江中医药大学

出　　处：《中医杂志》2013年第9期762-765,共4页Journal of Traditional Chinese Medicine

基　　金：2008年度中医药行业科研专项项目(200807030);浙江省中医药科技计划项目(2007GA023)

摘　　要：目的观察穴位刺激调控法合并小剂量氯米帕明片治疗强迫症的临床疗效。方法将160例强迫症患者随机分为研究组81例和对照组79例,两组均先经过药物清洗期2周后开始双盲治疗。研究组给予穴位刺激加行为疗法治疗,每日1次,每次30min,每周5次,并服用每片12.5mg剂型的氯米帕明片;对照组服用每片25mg剂型的氯米帕明片并接受模拟穴位刺激调控法治疗。两组服药方法均为第1天1片,以后每隔1天增加1片,第11天增加至6片,两组均治疗12周。治疗前后采用Y-Brown强迫症量表(Y-BOCS)、汉密尔顿抑郁量表(HAMD)、简明精神病量表(BPRS)、副反应量表(TESS)评定临床疗效和不良反应。结果研究组痊愈率为48.15%,对照组为30.38%;研究组总有效率为95.10%,对照组为87.30%,两组比较差异均有统计学意义(P<0.05)。两组患者治疗后第2、4、6、8、12周Y-BOCS评分总分与治疗前比较差异均有统计学意义(P<0.05或P<0.01);治疗后第4、6、8、12周Y-BOCS评分总分与对照组比较差异均有统计学意义(P<0.05或P<0.01)。两组治疗12周后Y-BOCS强迫思维和强迫行为评分、HAMD、BPRS量表评分与治疗前比较差异均有统计学意义(P<0.01);两组治疗后Y-BOCS强迫思维和强迫行为、HAMD评分差异均有统计学意义(P<0.05),而BPRS评分差异无统计学意义(P>0.05)。结论穴位刺激调控法合并小剂量氯米帕明片治疗强迫症临床疗效肯定,且不良反应少。Objective To observe the therapeutic effect of acupuncture point regulatory-control （APRC） combined with low- dose clomipramine for obsessive-compulsive disorders （OCD）. Methods Totally 160 OCD patients were randomized into the study group and control group, with 81 and 79 in each. Both groups were given the double-blind treatment after 2-week wash- out period. The study group was given 30min APRC and behavioral therapy once.daily, 5 times weekly and given clomipramine （12.5mg/tablet） orally. The control group was given elomipramine （25mg/tablet） orally and analog APRC. The medication method in both groups was： 1 tablet daily since the 1st day, then 1 tablet added every other day and increased to 6 tablets on the llth day. Finally, the dose of clomipramine was 75 mg/d in the study group and 150 mg/d in the control group. Both groups were treated for 12 weeks. The therapeutic effect and adverse reactions were evaluated with Yale-Brown Obsessive- Compulsive Scale （Y-BOCS）, Hamilton Depression Scale （HAMD）, Brief Psychiatric Rating Scale （BPRS） and Treatment E- mergent Symptom Scale （TESS）. Results The cure rate in the study group and control group was 48.15% and 30.38% re- spectively, with a significant difference between groups （P〈0.05）. The total effective rate of the study group and the control group was 95. % and 87.30% respectively, with significant difference between groups（P〈0.05）. There were significant differences in the Y-BOCS scores between before and after treatment in both groups in the 2nd, 4th, 6th, 8th and 12th week of treatment （P〈0.05 or P〈0.01）, especially in the study group in the 4th, 6th, 8th and 12th week of treatment （P〈0.05 or P〈0.01）. There were significant differences in the obsessions score and compulsions score of Y-BOCS, HAMD scores and BPRS scores between before and after treatment in both groups after 12 weeks of treatment （P〈0.01）, especially in the obses- sions score and compulsions score of Y-BOCS and HAMD scores

关 键 词：氯米帕明 穴位刺激调控法 强迫症 Y—Brown强迫症量表 汉密尔顿抑郁量表 简明精神病量表 副反应量表 

分 类 号：R749.7[医药卫生—神经病学与精神病学]