CBT联合rTMS治疗老年躯体化障碍疗效分析  

Efficacy analysis of CBT combined with rTMS in adjuvant treatment of somatization disorder in elderly patients

作　　者：李艺华[1] 万菲[1] 徐黎明[1] 张新风 Li Yihua;Wan Fei;Xu Liming;Zhang Xinfeng(First author's address Jingzhou Mental Health Center,Jingzhou 434000,Hubei,China)

机构地区：[1]荆州市精神卫生中心,湖北荆州434000 [2]长江大学精神卫生研究所,湖北荆州434000

出　　处：《临床心身疾病杂志》2022年第5期68-71,89,共5页Journal of Clinical Psychosomatic Diseases

基　　金：荆州市医疗卫生科技发展计划项目(编号20183836)。

摘　　要：目的探讨度洛西汀、认知行为疗法联合重复经颅磁刺激治疗老年躯体化障碍患者的临床疗效。方法将72例老年躯体化障碍患者按治疗方法分为研究组38例与对照组34例。两组均给予度洛西汀、认知行为疗法治疗,研究组在此基础上联合重复经颅磁刺激治疗。比较两组临床疗效,治疗前及治疗第1周、2周、4周末采用躯体形式症状筛查量表评定两组躯体化症状数量蹜减少躯体化严重程度,采用汉密顿焦虑量表及汉密顿抑郁量表评定两组焦虑、抑郁症状,比较两组不良反应发生率。结果研究组治疗总有效率显著高于对照组(P<0.01)。治疗1周末起两组躯体形式症状筛查量表躯体化严重程度,减少躯体化症状数量维度评分均较治疗前显著持续降低(P<0.05或0.01),治疗2周及4周末研究组显著低于对照组(P<0.05或0.01)。治疗2周末起两组汉密顿焦虑量表及汉密顿抑郁量表评分均较治疗前显著降低(P<0.01),研究组显著低于对照组(P<0.05或0.01)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论度洛西汀、认知行为疗法联合重复经颅磁刺激治疗老年躯体化障碍疗效显著,能显著改善患者躯体化严重程度,减少躯体化症状数量,缓解焦虑、抑郁情绪,安全性高,值得临床推广。Objective To investigate the clinical efficacy of duloxetine,cognitive behavioral therapy(CBT)combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of somatization disorder in elderly patients.Methods A total of 72 elderly patients with somatization disorder were divided into study group(38 cases)and control group(34 cases)according to the treatment method.Both groups were treated with duloxetine and CBT,and the study group was treated with rTMS on this basis.The clinical efficacy of the two groups was compared.Before treatment and at the 1st,2nd,and 4th week of treatment,the screening for somatoform symptoms-7(SOMS-7)was used to evaluate the number and severity of somatization symptoms in the two groups,the Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were used to evaluate anxiety and depression symptoms in the two groups.The incidence of adverse reactions was compared between the two groups.Results The total effective rate of the study group was significantly higher than that of the control group(P<0.01).From the end of the first week of treatment,the scores of somatization severity and the number of somatization symptoms of SOMS-7 in the two groups were significantly lower than those before treatment(P<0.05 or 0.01).After 2 weeks and 4 weeks of treatment,the study group was significantly lower than the control group(P<0.05 or 0.01).From the end of the second week of treatment,the HAMA and HAMD scores of the two[JP+4]groups were significantly lowerthan those before treatment(P<0.01),the study group was significantly lower than the control group(P<0.05 or 0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Duloxetine,CBT combined with rTMS is effective in the treatment of somatization disorder in elderly patients,which can significantly improve the severity of somatization,reduce the number of somatization symptoms,relieve anxiety and depression,and has high safety,which is worthy of clinical promo

关 键 词：老年 躯体化障碍 度洛西汀 认知行为疗法 重复经颅磁刺激 

分 类 号：R749.2[医药卫生—神经病学与精神病学]