中国行为医学科学
中國行為醫學科學
중국행위의학과학
2008年
7期
628-630
,共3页
刘同洲%王善信%王斌%张建军%王旸
劉同洲%王善信%王斌%張建軍%王旸
류동주%왕선신%왕빈%장건군%왕양
无抽搐电痉挛治疗%难治性强迫症
無抽搐電痙攣治療%難治性彊迫癥
무추휵전경련치료%난치성강박증
Modified electric eonvulsive therapy%Refractory obsessive compulsive disorder
目的 探讨无抽搐电痉挛治疗难治性强迫症的疗效及安全性.方法 采用入院顺序分层随机法,将79例难治性强迫症患者随机分为研究组(无抽搐电痉挛治疗合并抗强迫药物)和对照组(抗强迫药物治疗),共观察4周,在治疗前及治疗第1周末、第2周末、第4周末采用Yale-Brown强迫量表、汉密尔顿焦虑量表、副反应量表评定疗效及不良反应.结果 治疗第1周末,研究组Yale-Brown强迫量表[(22.47±3.09)分]及汉密尔顿焦虑量表评分[(19.59±3.51)分]较治疗前[分别为(27.07±1.34)分、(24.99±3.76)分]均有显著性降低(t=6.10,7.69,P<0.05),而对照组均无显著性改善(t=1.32,1.78,P0.05).治疗第1周末、第2周末及第4周末,研究组的Yale-Brown强迫量表[分别为(22.47±3.09)分、(14.93±2.92)分、(10.93±4.23)分]及汉密尔顿焦虑量表评分[分别为(19.59±3.51)分、(16.60±2.97)分、(11.40±2.68)分]均显著低于对照组的Yale-Brown强迫量表[分别为(26.33±4.49)分、(21.40±3.58)分、(19.60±4.26)分]及汉密尔顿焦虑量表评分[分别为(24.38±3.34)分、(20.78±4.05)分、(19.79±3.08)分],均差异有显著性(t=4.36,21.30,P<0.05).在治疗第1周末、第2周末及第4周末,研究组[分别为35.90%、58.97%、74.36%]和对照组[分别为0.00%、17.50%、32.50%]的治疗有效率差异有显著性(X2=13.90～14.42,P<0.05).研究组未出现严重不良反应.结论 无抽搐电痉挛治疗是治疗难治性强迫症快速、有效、安全的首选方法之一.
目的 探討無抽搐電痙攣治療難治性彊迫癥的療效及安全性.方法 採用入院順序分層隨機法,將79例難治性彊迫癥患者隨機分為研究組(無抽搐電痙攣治療閤併抗彊迫藥物)和對照組(抗彊迫藥物治療),共觀察4週,在治療前及治療第1週末、第2週末、第4週末採用Yale-Brown彊迫量錶、漢密爾頓焦慮量錶、副反應量錶評定療效及不良反應.結果 治療第1週末,研究組Yale-Brown彊迫量錶[(22.47±3.09)分]及漢密爾頓焦慮量錶評分[(19.59±3.51)分]較治療前[分彆為(27.07±1.34)分、(24.99±3.76)分]均有顯著性降低(t=6.10,7.69,P<0.05),而對照組均無顯著性改善(t=1.32,1.78,P0.05).治療第1週末、第2週末及第4週末,研究組的Yale-Brown彊迫量錶[分彆為(22.47±3.09)分、(14.93±2.92)分、(10.93±4.23)分]及漢密爾頓焦慮量錶評分[分彆為(19.59±3.51)分、(16.60±2.97)分、(11.40±2.68)分]均顯著低于對照組的Yale-Brown彊迫量錶[分彆為(26.33±4.49)分、(21.40±3.58)分、(19.60±4.26)分]及漢密爾頓焦慮量錶評分[分彆為(24.38±3.34)分、(20.78±4.05)分、(19.79±3.08)分],均差異有顯著性(t=4.36,21.30,P<0.05).在治療第1週末、第2週末及第4週末,研究組[分彆為35.90%、58.97%、74.36%]和對照組[分彆為0.00%、17.50%、32.50%]的治療有效率差異有顯著性(X2=13.90～14.42,P<0.05).研究組未齣現嚴重不良反應.結論 無抽搐電痙攣治療是治療難治性彊迫癥快速、有效、安全的首選方法之一.
목적 탐토무추휵전경련치료난치성강박증적료효급안전성.방법 채용입원순서분층수궤법,장79례난치성강박증환자수궤분위연구조(무추휵전경련치료합병항강박약물)화대조조(항강박약물치료),공관찰4주,재치료전급치료제1주말、제2주말、제4주말채용Yale-Brown강박량표、한밀이돈초필량표、부반응량표평정료효급불량반응.결과 치료제1주말,연구조Yale-Brown강박량표[(22.47±3.09)분]급한밀이돈초필량표평분[(19.59±3.51)분]교치료전[분별위(27.07±1.34)분、(24.99±3.76)분]균유현저성강저(t=6.10,7.69,P<0.05),이대조조균무현저성개선(t=1.32,1.78,P0.05).치료제1주말、제2주말급제4주말,연구조적Yale-Brown강박량표[분별위(22.47±3.09)분、(14.93±2.92)분、(10.93±4.23)분]급한밀이돈초필량표평분[분별위(19.59±3.51)분、(16.60±2.97)분、(11.40±2.68)분]균현저저우대조조적Yale-Brown강박량표[분별위(26.33±4.49)분、(21.40±3.58)분、(19.60±4.26)분]급한밀이돈초필량표평분[분별위(24.38±3.34)분、(20.78±4.05)분、(19.79±3.08)분],균차이유현저성(t=4.36,21.30,P<0.05).재치료제1주말、제2주말급제4주말,연구조[분별위35.90%、58.97%、74.36%]화대조조[분별위0.00%、17.50%、32.50%]적치료유효솔차이유현저성(X2=13.90～14.42,P<0.05).연구조미출현엄중불량반응.결론 무추휵전경련치료시치료난치성강박증쾌속、유효、안전적수선방법지일.
Objective To explore the efficacy and side effects of modified electroeonvulsive therapy (MECT) in treatment of refractory obsessive compulsive disorder. Methods A total of 79 patients with refractory obsessive compulsive disorder were randomly divided into study group with MECT and control group with antide-pressants for treatment of 4 weeks. They were assessed and analysed eontrastively using Yale-Brown Obsessive Compulsive Scale (YBOCS), Hamilton Axiety Scale (HAMA) and Treatment Emergent Side Effect Scale (TESS). Results In the 1st weekend,the total scores of YBOCS (22.47±3.09)and HAMA (19.59±3.51)in study group were significantly decreased than those before treatment(as follows: 27.07±1.34,24.99±3.76)( t =6.10～7.69, P<0.05) and there was no difference in control group(t= 1.32～1.78, P0.05). In the lst,2nd and 4th weekend, the total scores of YBOCS (as follows : 22.47±3.09,14.93±2.92,10.93±4.23) and HAMA (as follows: 19.59±3.51,16.60±2.97,11.40±2.68) in study group were significantly lower than the total scores of YBOCS (as follows: 26.33±4.49,21.40±3.58,19.60±4.26) and HAMA (as follows: 24.38± 3.34,20.78±4.05, 19.79±3.08) in control group(t=4.36±21.30, P < 0.05). In the 1st,2nd and 4th weekend,the effective rates had significant differencesn between study group (as follows: 35.90,58.97,74.36%) and control group(as follows : 0.00%, 17.50,32.50%) (X2= 13.90～14.42, P < 0.05). No severe side effect was found in study group. Conclusion MECT is effective in treating refractory obsessive compulsive disorder without severe side effects.
