正念认知疗法联合度洛西汀治疗躯体形式障碍患者焦虑症状的随机对照试验  

A randomized controlled trial of mindfulness-based cognitive therapy combined with duloxetine for anxiety symptoms of patients with somatoform disorder

作　　者：李媛媛[1] 王策 丁晓超 狄亚琴[1] 于雪竹[1] 刘杰[1] LI Yuanyuan;WANG Ce;DING Xiaochao;DI Yaqin;YU Xuezhu;LIU Jie(Hebei Provincial Mental Health Center,Hebei Key Laboratory of Major Mental and Behavioral Disorders,the Sixth Clinical Medical College of Hebei University,Baoding 071000,Hebei Province,China)

机构地区：[1]河北省精神卫生中心,河北省重大精神与行为障碍疾病研究重点实验室,河北大学第六临床医学院,河北保定071000

出　　处：《中国心理卫生杂志》2023年第7期558-563,共6页Chinese Mental Health Journal

基　　金：2021年度河北省医学科学研究院课题计划(20210184)。

摘　　要：目的:评价正念认知疗法联合度洛西汀对躯体形式障碍患者焦虑症状的疗效。方法:选用符合疾病和健康相关问题的国际统计分类第十次修订本诊断标准的躯体形式障碍患者80例,随机分为正念认知疗法联合度洛西汀治疗组(n=38)和度洛西汀单药治疗组(n=42)。治疗周期为8周,分别在治疗前、治疗后2周、4周、6周、8周采用汉密顿焦虑量表(HAMA)评估患者焦虑症状改善的效果。结果:联合治疗组33例完成5次评估,脱落5例;单药治疗组39例完成5次评估,脱落3例。重复测量方差分析结果显示,联合治疗组HAMA量表总分低于单药治疗组(F=4.20,P <0.05);联合治疗组躯体性焦虑因子总分均值明显低于单药治疗组(F=5.75,P<0.05);广义估计方程结果显示,联合治疗组的有效率明显高于单药治疗组(OR=6.01,95%CI:2.09~17.32)。结论:正念认知疗法联合度洛西汀对缓解躯体形式障碍患者焦虑症状的疗效优于度洛西汀单药治疗。Objective:To evaluate the efficacy of combination therapy of mindfulness-based cognitive therapy(MBCT)and duloxetine for anxiety symptoms of patients with somatoform disorder.Methods:This was an 8-week randomized control study.Totally 80 patients with somatoform disorder who met the diagnostic criteria of the Inter-national Statistical Classification of Diseases and Health Related Problems,Tenth Revision(ICD-10)were recrui-ted.All patients were randomly divided into the MBCT and duloxetine treatment group(n=38)and the duloxetine group(n=42).The Hamilton Anxiety Scale(HAMA)was administered to evaluate efficiency of the therapies.Results:In the combined treatment group,33 cases completed 5 evaluations and 5 cases dropped out.And in the duoxetine group,39 cases completed 5 evaluations and 3 cases dropped out.ANOVA for repeated measure-ment results showed that the mean HAMA score were significantly lower in the combined treatment group than in the duloxetine group,and the differences were statistically significant(F=4.20,P<0.05).The mean score of so-matic anxiety factor in the combined treatment group was significantly lower than that in the duloretine group,and the differences were statistically significant(F=5.75,P<0.05).The results of the GEE showed that the combined treatment group had better clinical effects than that of the duloretine group(OR=6.01,95%CI:2.09-17.32)Conclusion:It suggects that MBCT combined with duloxetine is more effective than duloxetine monotherapy in relieving anxiety symptoms in patients with somatoform disorder.

关 键 词：正念认知疗法 度洛西汀 躯体形式障碍 焦虑症状 随机对照试验 

分 类 号：R749.059[医药卫生—神经病学与精神病学] R749.2[医药卫生—临床医学]