抗抑郁药物联合星状神经节阻滞治疗躯体形式障碍临床评价  

Clinical evaluation of antidepressants combined with stellate ganglion block in the treatment of somatoform disorders

作　　者：史继红[1,2] 张敬悬[3] 

机构地区：[1]山东大学医学院,山东济南250012 [2]山东省济宁市第一人民医院 [3]山东省精神卫生中心

出　　处：《精神医学杂志》2015年第5期354-357,共4页Journal of Psychiatry

基　　金：山东省济宁市医药卫生科技项目(编号:2012jnjc12)

摘　　要：目的探讨抗抑郁药物联合星状神经节阻滞(SGB)治疗躯体形式障碍(SFD)的临床疗效。方法将101例SFD患者随机分为研究组(抗抑郁药物联合SGB治疗,49例)和对照组(仅用抗抑郁药物治疗,52例),共治疗12周。在治疗期间每周采用视觉模拟量表(VAS)自评躯体不适的改善程度;分别采用症状自评量表(SCL-90)和健康状况调查问卷简表(SF-36)在治疗前、治疗后第12周末及治疗结束后第3、6个月末随访评估躯体症状和生活质量状况。结果自治疗后第2周末起,研究组VAS评分均高于对照组(P<0.05)。两组治疗后第12周末及治疗结束后第3、6个月末随访时SCL-90躯体化、抑郁和焦虑评分均较治疗前降低(P<0.05);研究组治疗后第12周末及治疗结束后第3、6个月末随访时SCL-90躯体化和抑郁评分均低于对照组(P<0.05)。两组治疗后第12周末及治疗结束后第3、6个月末随访时SF-36 PCS和MCS评分均较治疗前增加(P<0.05)。结论抗抑郁药物联合SGB治疗SFD优于单用抗抑郁药物。Objective To explore the clinical effect of antidepressants combined with stellate ganglion block （ SGB） in the treatmentofsomatoformdisorders（SFD）.Methods 101patientswithsomatoformdisorderswererandomlydividedintostudy group （49 cases） treated with antidepressants combined with SGB for 12 weeks and control group （52 cases） treated with antidepressants monotherapy for 12 weeks.Improvement of physical discomfort was assessed with visual analogue scale （ VAS） weekly during treatment.Somatic symptoms and health-related quality of life were assessed with symptom checklist 90 （ SCL-90） and short form-36 health survey （SF-36） at baseline, the end of the 12th week of treatment and at 3-month, 6-month follow-up respectively.Results Since the end of the 2nd week, scores of VAS in study group were significantly higher than those in control group （P〈0.05）.Factor scores of somatization, depression and anxiety in SCL-90 in both groups decreased significantly at the end of the 12th week of treatment and at 3-month, 6-month follow-up compared with the baseline （P〈0.05）, and factor scores of somatization and depression in SCL-90 in study group were significantly lower than those in control group at the end of the 12 th week of treatment and at 3-month, 6-month follow-up （P〈0.05）.Scores of physical component summary （PCS） and mental component summary （ MCS） in SF-36 in both groups increased significantly at the end of the 12 th week of treatment and at 3-month, 6-month follow-up compared with the baseline （P〈0.05）.Conclusion The combination of antidepressants and SGB is more effective than antidepressants monotherapy in the treatment of SFD.

关 键 词：抗抑郁药 星状神经节阻滞 躯体形式障碍 

分 类 号：R749.7[医药卫生—神经病学与精神病学]