强迫症创新性系统化综合治疗疗效分析  

作　　者：黄悦琦 马丽沙 王昀瓒 朱丞 

机构地区：[1]浙江大学医学院附属精神卫生中心(杭州市第七人民医院),310063

出　　处：《浙江临床医学》2024年第10期1487-1489,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2022KY993)。

摘　　要：目的探讨低成本、系统的综合治疗模式快速有效改善患者强迫症的严重程度。方法选取诊断强迫症患者89例,分为药物治疗组64例和综合治疗组25例。药物治疗组接受常规药物治疗;综合治疗组接受经颅直流电治疗(tDCS)+药物治疗+心理治疗综合组,均治疗2周。治疗前后均采用耶鲁布朗强迫症状量表(Y-BOCS)、24项汉密尔顿抑郁量表(HAMD-24)及汉密尔顿焦虑量表(HAMA)进行评定。结果治疗2周后,两组患者Y-BOCS总分及因子分均较治疗前降低(P<0.05),综合治疗组Y-BOCS总分(Z=-3.112,P=0.002)及因子分[思维分(Z=-2.13,P=0.033),行为分(Z=-3.334,P=0.001)]、HAMD总分(Z=-2.819,P=0.005)、HAMA总分(Z=-2.002,P=0.045)均低于药物治疗组,Y-BOCS减分率高于药物治疗组(Z=-3.658,P<0.001)。2周后,综合治疗组有效率高于药物治疗组(Z=11.063,P<0.001)。两组HAMD、HAMA总分均较治疗前降低(P<0.05)。结论系统的tDCS综合治疗模式可短期内显著改善患者强迫症严重程度。Objective To explore a low-cost and systematic comprehensive treatment model to rapidly and effectively improve the severity of patients with obsessive-compulsive disorder(OCD).Methods 89 patients diagnosed with OCD were selected and divided into a medication treatment group of 64 cases and a comprehensive treatment group of 25 cases.They underwent a two-week transcranial direct current therapy(tDCS)+medication treatment+psychological treatment comprehensive group.Both before and after treatment were evaluated using the Yale-Brown Obsessive-Compulsive Scale(Y-BOCS),the 24 item Hamilton Depression Scale(HAMD-24),and the Hamilton Anxiety Scale(HAMA).Results After 2 weeks of treatment,the total score and factor score of Y-BOCS in both groups of patients decreased compared to before treatment(P<0.05).The comprehensive treatment group had a lower Y-BOCS total score(Z=-3.112,P=0.002)and factor score(thinking score Z=-2.13,P=0.033)(behavior score Z=-3.334,P=0.001),HAMD total score(Z=-2.819,P=0.005),and HAMA total score(Z=-2.002,P=0.045)than the drug treatment group,and the Y-BOCS reduction rate was higher than that of the drug treatment group(Z=-3.658,P<0.001).After 2 weeks,the effective rate of the comprehensive treatment group was higher than that of the drug treatment group(Z=11.063,P<0.001).The total scores of HAMD and HAMA in both groups decreased compared to before treatment(P<0.05).Conclusion The comprehensive treatment mode of tDCS can significantly improve the severity of OCD in patients in the short term.

关 键 词：强迫性障碍 综合治疗模式 认知行为治疗 经颅直流电刺激 

分 类 号：R749.7[医药卫生—神经病学与精神病学]