实用医院临床杂志
實用醫院臨床雜誌
실용의원림상잡지
PRACTICAL JOURNAL OF CLINICAL MEDICINE
2014年
5期
110-113
,共4页
惊恐障碍%防御方式%防御方式问卷%药物治疗
驚恐障礙%防禦方式%防禦方式問捲%藥物治療
량공장애%방어방식%방어방식문권%약물치료
Panic disorder%Defense mechanisms%Defense Style Questionnaire%Pharmacotherapy
目的：探讨惊恐障碍（ panic disorder ，PD）患者药物治疗的效果及其与防御方式变化的相关性。方法选取49例PD患者作为PD组，予帕罗西丁或文拉法辛治疗16周，采用临床疗效总评量表、汉密尔顿焦虑量表（ HAMA）评估治疗效果，采用防御方式问卷评估治疗前后防御方式的变化。同期健康人群40人作为对照。结果①PD患者不成熟防御机制总分、中间防御机制总分明显高于对照组（ P＜0.01），成熟防御机制总分明显低于对照组（ P＜0.001）；② PD组治疗后缓解23例（57.5％），不成熟防御机制总分、中间防御机制总分均较治疗前明显下降（ P＜0.001）；无缓解的患者治疗前后各防御因子无明显变化（ P＞0.05）；③HAMA得分、发病年龄、病情严重程度、不成熟防御机制得分是PD药物治疗效果的影响因素，年轻发病、HAMA得分高、病情重、不成熟防御机制得分高与治疗效果欠佳相关。结论 PD患者多使用不成熟防御机制、中间防御机制，使用成熟防御机制减少；药物治疗效果欠佳与HAMA得分、发病年龄、病情严重程度、不成熟防御机制相关。在对PD患者进行治疗时，要针对每个个体的不同情况采取适当的治疗措施。
目的：探討驚恐障礙（ panic disorder ，PD）患者藥物治療的效果及其與防禦方式變化的相關性。方法選取49例PD患者作為PD組，予帕囉西丁或文拉法辛治療16週，採用臨床療效總評量錶、漢密爾頓焦慮量錶（ HAMA）評估治療效果，採用防禦方式問捲評估治療前後防禦方式的變化。同期健康人群40人作為對照。結果①PD患者不成熟防禦機製總分、中間防禦機製總分明顯高于對照組（ P＜0.01），成熟防禦機製總分明顯低于對照組（ P＜0.001）；② PD組治療後緩解23例（57.5％），不成熟防禦機製總分、中間防禦機製總分均較治療前明顯下降（ P＜0.001）；無緩解的患者治療前後各防禦因子無明顯變化（ P＞0.05）；③HAMA得分、髮病年齡、病情嚴重程度、不成熟防禦機製得分是PD藥物治療效果的影響因素，年輕髮病、HAMA得分高、病情重、不成熟防禦機製得分高與治療效果欠佳相關。結論 PD患者多使用不成熟防禦機製、中間防禦機製，使用成熟防禦機製減少；藥物治療效果欠佳與HAMA得分、髮病年齡、病情嚴重程度、不成熟防禦機製相關。在對PD患者進行治療時，要針對每箇箇體的不同情況採取適噹的治療措施。
목적：탐토량공장애（ panic disorder ，PD）환자약물치료적효과급기여방어방식변화적상관성。방법선취49례PD환자작위PD조，여파라서정혹문랍법신치료16주，채용림상료효총평량표、한밀이돈초필량표（ HAMA）평고치료효과，채용방어방식문권평고치료전후방어방식적변화。동기건강인군40인작위대조。결과①PD환자불성숙방어궤제총분、중간방어궤제총분명현고우대조조（ P＜0.01），성숙방어궤제총분명현저우대조조（ P＜0.001）；② PD조치료후완해23례（57.5％），불성숙방어궤제총분、중간방어궤제총분균교치료전명현하강（ P＜0.001）；무완해적환자치료전후각방어인자무명현변화（ P＞0.05）；③HAMA득분、발병년령、병정엄중정도、불성숙방어궤제득분시PD약물치료효과적영향인소，년경발병、HAMA득분고、병정중、불성숙방어궤제득분고여치료효과흠가상관。결론 PD환자다사용불성숙방어궤제、중간방어궤제，사용성숙방어궤제감소；약물치료효과흠가여HAMA득분、발병년령、병정엄중정도、불성숙방어궤제상관。재대PD환자진행치료시，요침대매개개체적불동정황채취괄당적치료조시。
Objective To explore the correlation between effect of pharmacotherapy and defense mechanisms in adult patients with panic disorder ( PD).Methods Forty patients with PD were treated with venlafaxin or paroxetine for 16 weeks.The defense mechanisms were evaluated by a Defense Style Questionnaire (DSQ) at the beginning of the study and after 16 weeks of treatment.The effects were evaluated by clinical global impression-disease severity (CGI-SI) and Hamilton Anxiety (HAMA).At the same time, 40 healthy people were used as controls .Results ①The total scores of immature and neurotic defense mechanisms in the PD patients were significantly higher than that in the controls ( P<0.01 ) while total scores of mature defense mechanisms were lower than that in the controls (P<0.001).②Full remission was observed in 23 patients (57.5%).The total scores of immature and neurotic defense mechanisms in these patients were significantly reduced when compared to before treatment (P<0.001).However, no changes were found in the PD patients without remission .③The HAMA score , age of onset ,severity of PD and scores of immature defenses were fac-tors influencing PD drug effect .Conclusion PD patients use more immature and neurotic defenses and less mature defenses .Poor drug treatment is associated with high HAMA score , age of onset ,severity of PD and immature defenses .These findings could lead to the de-velopment of specific psychotherapeutic interventions .
