低频重复经颅磁刺激联合氟伏沙明治疗难治性强迫症的疗效观察  

Observation of efficacy of low-frequency repetitive transcranial magnetic stimulation combined with fluvoxamine in treatment of patients with refractory obsessive-compulsive disorder

作　　者：文飞[1] 吴文涛[1] 龚梅恩[1] 汤姿英[1] 姚建玲[1] WEN Fei;WU Wen-tao;GONG Mei-en(Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院,510260

出　　处：《中国实用医药》2022年第11期83-85,共3页China Practical Medicine

基　　金：广州市卫计委一般引导项目资助(项目编号:20181A011064)。

摘　　要：目的观察低频重复经颅磁刺激(LF-rTMS)联合氟伏沙明治疗难治性强迫症的疗效。方法40例难治性强迫症患者,随机分为对照组和研究组,每组20例。研究组服用氟伏沙明合并LFr TMS治疗,对照组单用氟伏沙明治疗。比较两组患者治疗前后的耶鲁-布朗强迫量表(Y-BOCS)评分、临床疗效、副反应情况。结果治疗前及治疗后2、4、6、8周,研究组患者的Y-BOCS评分分别为(28.25±4.38)、(22.23±4.56)、(17.13±4.35)、(16.33±4.91)、(15.24±4.22)分,对照组患者的Y-BOCS评分分别为(27.18±4.23)、(24.01±4.73)、(23.65±5.34)、(22.32±4.25)、(18.34±4.21)分。治疗后2、4、6、8周,两组患者的Y-BOCS评分均低于治疗前,且研究组患者治疗后4、6、8周Y-BOCS评分均低于对照组,差异均具有统计学意义(P<0.05)。研究组中痊愈3例(15%),显著进步5例(25%),好转3例(15%),无效9例(45%),总有效率为55%;对照组中痊愈1例(5%),显著进步4例(20%),好转3例(15%),总有效率为40%。研究组治疗总有效率略高于对照组,但差异无统计学意义(P>0.05)。研究组患者副反应量表(TESS)评分为(4.83±3.80)分,与对照组的(4.01±3.65)分比较,差异无统计学意义(P>0.05)。结论LF-rTMS联合氟伏沙明治疗难治性强迫症患者的疗效优于单纯氟伏沙明治疗,且安全性相当。Objective To observe the efficacy of low-frequency repetitive transcranial magnetic stimulation(LF-rTMS) combined with fluvoxamine in treatment of patients with refractory obsessive-compulsive disorder. Methods A total of 40 patients with refractory obsessive-compulsive disorder were randomly divided into control group and research group, with 20 cases in each group. The research group was treated with fluvoxamine combined with LF-rTMS, and the control group was treated with fluvoxamine alone. The Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) score before and after treatment, clinical efficacy and side effects were compared between the two groups. Results Before treatment and 2, 4, 6, and 8 weeks after treatment, the Y-BOCS scores in the research group were(28.25±4.38),(22.23±4.56),(17.13±4.35),(16.33±4.91), and(15.24±4.22) points, and those of the control group were(27.18±4.23),(24.01±4.73),(23.65±5.34),(22.32±4.25), and(18.34±4.21) points. At 2, 4, 6 and 8 weeks after treatment, the Y-BOCS scores of the two groups were lower than those of this group before treatment, and the Y-BOCS scores at 4, 6, and 8 weeks after treatment of the research group were lower than those of the control group. All the differences were statistically significant(P<0.05). In the research group, 3 cases(15%) were cured, 5 cases(25%) were significantly improved, 3 cases(15%) improved,9 cases(45%) were ineffective, with a total effective rate of 55%;in the control group, 1 case(5%) was cured,4 cases(20%) were significantly improved, and 3 cases(15%) were improved, with a total effective rate of 40%.The total effective rate of the research group was slightly higher than that of the control group, but the difference was not statistically significant(P>0.05). The treatment emergent symptom scale(TESS) score(4.83±3.80) points in the research group was not statistically significant compared with(4.01±3.65) points in the control group(P>0.05). Conclusion LF-rTMS combined with fluvoxamine is more effective than fluvoxamine in the tr

关 键 词：低频重复经颅磁刺激 氟伏沙明 难治性强迫症 

分 类 号：R749.7[医药卫生—神经病学与精神病学]