舍曲林联合契约学习法治疗强迫症的临床研究  

Clinical Study of Sertraline Combined with Contract Learning in the Treatment of Patients with Obsessive-Compulsive Disorder

作　　者：乔健 于晓光 王晨 王辉[2] QIAO Jian;YU Xiaoguang;WANG Chen;WANG Hui(Dept.of Psychiatry,Qinhuangdao Jiulongshan Hospital,Hebei Qinhuangdao 066000,China;Dept.of Pharmacy,Qinhuangdao Jiulongshan Hospital,Hebei Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市九龙山医院精神科,河北秦皇岛066000 [2]秦皇岛市九龙山医院药剂科,河北秦皇岛066000

出　　处：《中国医院用药评价与分析》2022年第6期708-710,718,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省2020年度医学科学研究课题计划项目(No.20201323)。

摘　　要：目的:探讨舍曲林联合契约学习法在强迫症患者治疗和康复中的效果。方法:成立舍曲林联合契约学习法治疗康复工作小组。根据随机数表法将2019年9月至2020年3月该院收治的强迫症患者60例分为观察组和对照组,每组30例。对照组患者接受舍曲林联合院内日常康复训练,观察组患者在对照组的基础上联合契约学习法。比较两组患者的治疗效果和不良反应;采用Yale-Brown强迫量表(Y-BOCS)和汉密尔顿抑郁量表(HAMD)评估康复效果,采用药物副反应量表(TESS)评估安全性。结果:治疗第1、2和4周,两组患者有效率的差异无统计学意义(P>0.05);治疗第6周末,观察组患者的有效率为76.67%(23/30),明显高于对照组的50.00%(15/30),差异有统计学意义(P<0.05)。与对照组相比,观察组患者的Y-BOCS评分、HAMD评分在出院时和出院后第1、6个月明显降低,差异均有统计学意义(P<0.05)。出院时和出院后1、6个月,两组患者TESS评分的差异均无统计学意义(P>0.05)。结论:舍曲林联合契约学习法对强迫症患者的治疗效果明显优于舍曲林联合医院日常康复护理,且安全性好。OBJECTIVE:To probe into the clinical efficacy and rehabilitation of sertraline combined with contract learning in the treatment of patients with obsessive-compulsive disorder.METHODS:The working group for the treatment and rehabilitation of sertraline combined with contract learning method was established.Totally 60 patients with obsessive-compulsive disorder admitted into the hospital from Sept.2019 to Mar.2020 were extracted to be divided into the observation group and the control group via the random number table,with 30 cases in each group.The control group received sertraline combined with daily rehabilitation training in the hospital,while the observation group was given the contract learning method on the basis of the control group.Clinical effects and adverse drug reactions of two groups were compared.The Yale-Brown obsessive-compulsive scale(Y-BOCS)and Hamilton depression scale(HAMD)were used to evaluate the rehabilitation effect.The treatment emergent symptom scale(TESS)was used to evaluate the safety of two groups.RESULTS:At the 1st,2nd and 4th week of treatment,there was no significant difference in the effective rate between two groups(P>0.05).At the end of the 6th week of treatment,the effective rate of the observation group was 76.67%(23/30),significantly higher than 50.00%(15/30)of the control group,with statistically significant difference(P<0.05).Compared with the control group,the Y-BOCS score and HAMD score of the observation group decreased significantly at the time of discharge and at the 1st and 6th months after discharge,with statistically significant difference(P<0.05).There was no significant difference in the TESS scores between two groups at the time of discharge and at the 1st and 6th months after discharge(P>0.05).CONCLUSIONS:Sertraline combined with contract learning method is more effective than sertraline combined with daily hospital rehabilitation care for patients with obsessive-compulsive disorder and has higher safety.

关 键 词：强迫症 舍曲林 契约学习法 YALE-BROWN强迫量表 汉密顿抑郁量表 副反应量表 

分 类 号：R971[医药卫生—药品]