新型与传统抗强迫药物治疗强迫症2年效果随访对照研究  

A control-study of two years' follow-up on the effects between atypical and traditional anti-obsessive-compulsive drugs in treatment of obsessive-compulsive disorder

作　　者：丘春柳[1] 

机构地区：[1]汕头大学医学院第一附属医院精神心理科,广东汕头515031

出　　处：《临床和实验医学杂志》2015年第15期1259-1262,共4页Journal of Clinical and Experimental Medicine

基　　金：汕头市重点科技计划项目[(2011)46号]

摘　　要：目的对比分析新型抗强迫药物艾司西酞普兰与传统抗强迫药物氯米帕明治疗强迫症的效果,并对强迫症状和社会功能情况进行2年随访。方法 92例资料完整的强迫症患者按随机分组原则,研究组48例以艾司西酞普兰治疗,对照组44例以氯米帕明治疗。于治疗前、治疗1周末、2周末、4周末、6周末、8周末各时点分别调查两组患者的强迫症状,比较两组症状检出率和副作用发生率;每半年随访一次,调查强迫症状检出率并以社会功能缺陷筛选量表(SDSS)评估社会功能。结果研究组治疗4周末的强迫观念检出率显著低于对照组(P<0.05),6周末的强迫行为检出率显著低于对照组(P<0.05),但8周末两组之间的强迫症状检出率差异无统计学意义(P>0.05)。研究组患者不良反应总发生率(12.5%)显著低于对照组(43.2%,P<0.05)。随访期间研究组强迫思想的检出率、SDSS总分均显著低于对照组(P<0.05或P<0.01),1年半和2年随访均显示就业率研究组均显著高于对照组(P<0.05或P<0.01)。结论新型抗强迫药物艾司西酞普兰与传统抗强迫药物氯米帕明对强迫症的近期效果相当,不良反应发生率低于传统药物。远期在预防强迫症状复发和改善患者的社会功能方面显著优于传统药物。艾司西酞普兰是临床上治疗强迫症较优的选择。Objective To compare the efficacy of atypical anti- obsessive- compulsive drug escitalopram and traditional drug clomipramine in treatment of patients with obsessive- compulsive disorder and to observe the improvement in obsessive- compulsive symptoms and social function during follow- up period for 2 years. Methods The complete clinical data of 92 patients with obsessive- compulsive disorder were randomly divided into 2 groups,48 cases of them treated with escitalopram,a new generation anti- obsessive- compulsive drug,were allocated into study group and 44 cases were treated with traditional drug clomipramine as control group,the observation had been carried out for 8 weeks. Their obsessive- compulsive symptoms were observed before and after treatment for 1,2,4,6 and 8 weeks. The rates of improvement in symptoms and side- effects were observed and compared between these two groups. The Social Disability Screening Schedule（ SDSS） had been applied for this study,and obsessive- compulsive symptoms of patients were studied and followed- up every half a year. Results The rate of appearing obsessive symptoms during treatment for 4 weeks had been significantly lowered（ P〈0. 05） and the rate of appearing compulsive symptoms after treatment for 6 weeks was also significantly lowered（ P〈0. 05） in study group in comparison with those of control group. But,the difference in rates of obsessive- compulsive symptoms after treatment for 8 weeks showed no statistical significance between these two groups（ P〉0. 05）. The total rate of side- effects in study group（ 12. 5%） was significantly lowered than that of control group（ 43. 2%,P〈0. 05）. During the follow- up period,the obsessive rate and total scores of patients in study group showed significantly lower than those of control group（ P〈0. 05 or P〈0. 01）.The employment rates during follow- up for one and a half year and two years showed significantly higher in patients of study group than those of control group（ P〈0. 05 or P〈0. 01）

关 键 词：强迫症 艾司西酞普兰 氯米帕明 对照研究 

分 类 号：R749.7[医药卫生—神经病学与精神病学]