1例惊恐障碍患者的随访观察  

Follow up observation of a patient with panic disorder

作　　者：周雪 ZHOU Xue(Department of Psychology,Tianjin Occupational Disease Precaution and Therapeutic Hospital,Tianjin 300011,China)

机构地区：[1]天津市职业病防治院心理科,天津300011

出　　处：《中国城乡企业卫生》2024年第9期78-81,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的随访1例惊恐障碍(PD)患者药物和心理治疗效果,旨在为此类患者的临床治疗提供理论基础。方法选择2010年4月在天津市职业病防治院心理科住院治疗的1例患者,分别予以美时玉50 mg,每晚1次、左洛复50 mg,1次/d、劳拉西泮0.5 mg,3次/d、佐匹克隆7.5 mg,每晚1次等药物治疗,服药6个月后停药。同时在住院期间给予心理治疗(1次/周,1 h/次)。分别在患者出院后3、6、12个月进行门诊随访,出院后3、5、11年进行电话随访,记录其负面情绪、临床症状等方面的治疗效果。结果患者通过药物治疗、心理治疗相结合的方法,消除了紧张、恐惧和忧心忡忡等负面情绪,临床症状基本消失,住院期间未有惊恐发作出现。后期随访通过认知行为治疗改善患者认知,帮助患者调整情绪,改变自己的应对模式,综合治疗的效果颇佳;经过10余年对该患者进行随访观察,现患者已经基本脱离药物,回归正常的生活。结论药物联合心理治疗在PD患者治疗中应用效果较好,能够很好地解决患者躯体和心理遇到的问题,使患者摆脱疾病的困扰,重新回归到正常的社会生活中。Objective To follow up the effect of drug and psychotherapy on a patient with panic disorder(PD),in order to provide a theoretical basis for the clinical treatment of such patients.Methods One patient who was hospitalized in the Department of Psychology in Tianjin Occupational Disease Precaution and Therapeutic Hospital in April 2010 was treated with mesiyu 50 mg/qn,Zoloft 50 mg/qd,lorazepam 0.5 mg/tid,zopiclone 7.5 mg/qn and other drugs respectively,and the drug was stopped after 6 months.At the same time,psychotherapy was given during hospitalization(once a week,1 hour each time).The patients were followed up in the outpatient department at 3 months,6 months and 12 months after discharge,and were followed up by telephone at 3 years,5 years and 11 years after discharge.The treatment effects of negative emotions,clinical symptoms and other aspects were recorded.Results Through the combination of drug treatment and psychotherapy,the patient eliminated the negative emotions such as tension,fear and anxiety,and the clinical symptoms basically disappeared,and there was no panic attack during hospitalization.In the later follow-up,cognitive behavioral therapy could improve patients'cognition,help patients adjust their emotions and change their coping mode,and the effect of comprehensive treatment was quite good;after more than ten years of follow-up observation of the patient,the patient had been basically separated from drugs and returned to normal life.Conclusion The application effect of drug combined with psychotherapy in the treatment of PD patients was good,which could well solve the physical and psychological problems of patients,make patients get rid of the trouble of disease,and return to normal social life.

关 键 词：惊恐障碍 心理治疗 认知行为治疗 

分 类 号：R749[医药卫生—神经病学与精神病学]