CAJ | 학술논문

目的：对比分析新型抗强迫药物艾司西酞普兰与传统抗强迫药物氯米帕明治疗强迫症的效果，并对强迫症状和社会功能情况进行2年随访。方法92例资料完整的强迫症患者按随机分组原则，研究组48例以艾司西酞普兰治疗，对照组44例以氯米帕明治疗。于治疗前、治疗1周末、2周末、4周末、6周末、8周末各时点分别调查两组患者的强迫症状，比较两组症状检出率和副作用发生率；每半年随访一次，调查强迫症状检出率并以社会功能缺陷筛选量表（SDSS）评估社会功能。结果研究组治疗4周末的强迫观念检出率显著低于对照组（ P ﹤0.05），6周末的强迫行为检出率显著低于对照组（ P ﹤0.05），但8周末两组之间的强迫症状检出率差异无统计学意义（ P ﹥0.05）。研究组患者不良反应总发生率（12.5%）显著低于对照组（43.2%，P ﹤0.05）。随访期间研究组强迫思想的检出率、SDSS 总分均显著低于对照组（ P﹤0.05或 P ﹤0.01），1年半和2年随访均显示就业率研究组均显著高于对照组（ P ﹤0.05或 P ﹤0.01）。结论新型抗强迫药物艾司西酞普兰与传统抗强迫药物氯米帕明对强迫症的近期效果相当，不良反应发生率低于传统药物。远期在预防强迫症状复发和改善患者的社会功能方面显著优于传统药物。艾司西酞普兰是临床上治疗强迫症较优的选择。
목적：대비분석신형항강박약물애사서태보란여전통항강박약물록미파명치료강박증적효과，병대강박증상화사회공능정황진행2년수방。방법92례자료완정적강박증환자안수궤분조원칙，연구조48례이애사서태보란치료，대조조44례이록미파명치료。우치료전、치료1주말、2주말、4주말、6주말、8주말각시점분별조사량조환자적강박증상，비교량조증상검출솔화부작용발생솔；매반년수방일차，조사강박증상검출솔병이사회공능결함사선량표（SDSS）평고사회공능。결과연구조치료4주말적강박관념검출솔현저저우대조조（ P ﹤0.05），6주말적강박행위검출솔현저저우대조조（ P ﹤0.05），단8주말량조지간적강박증상검출솔차이무통계학의의（ P ﹥0.05）。연구조환자불량반응총발생솔（12.5%）현저저우대조조（43.2%，P ﹤0.05）。수방기간연구조강박사상적검출솔、SDSS 총분균현저저우대조조（ P﹤0.05혹 P ﹤0.01），1년반화2년수방균현시취업솔연구조균현저고우대조조（ P ﹤0.05혹 P ﹤0.01）。결론신형항강박약물애사서태보란여전통항강박약물록미파명대강박증적근기효과상당，불량반응발생솔저우전통약물。원기재예방강박증상복발화개선환자적사회공능방면현저우우전통약물。애사서태보란시림상상치료강박증교우적선택。
Objective To compare the efficacy of atypical anti - obsessive - compulsive drug escitalopram and traditional drug clomipra-mine in treatment of patients with obsessive - compulsive disorder and to observe the improvement in obsessive - compulsive symptoms and social function during follow - up period for 2 years. Methods The complete clinical data of 92 patients with obsessive - compulsive disorder were ran-domly divided into 2 groups,48 cases of them treated with escitalopram,a new generation anti - obsessive - compulsive drug,were allocated into study group and 44 cases were treated with traditional drug clomipramine as control group,the observation had been carried out for 8 weeks. Their obsessive - compulsive symptoms were observed before and after treatment for 1,2,4,6 and 8 weeks. The rates of improvement in symptoms and side - effects were observed and compared between these two groups. The Social Disability Screening Schedule(SDSS)had been applied for this study,and obsessive - compulsive symptoms of patients were studied and followed - up every half a year. Results The rate of appearing obsessive symptoms during treatment for 4 weeks had been significantly lowered( P ﹤ 0. 05)and the rate of appearing compulsive symptoms after treatment for 6 weeks was also significantly lowered( P ﹤ 0. 05)in study group in comparison with those of control group. But,the difference in rates of ob-sessive - compulsive symptoms after treatment for 8 weeks showed no statistical significance between these two groups( P ﹥ 0. 05). The total rate of side - effects in study group(12. 5% )was significantly lowered than that of control group(43. 2% ,P ﹤ 0. 05). During the follow - up peri-od,the obsessive rate and total scores of patients in study group showed significantly lower than those of control group( P ﹤ 0. 05 or P ﹤ 0. 01). The employment rates during follow - up for one and a half year and two years showed significantly higher in patients of study group than those of control group( P ﹤ 0. 05 or P ﹤ 0. 01). Conclusion Escitalopram,a new anti - obsessive - compulsive drug,is as effective as traditional drug clomipramine in short - term treatment of patients with obsessive - compulsive disorder,and it has fewer side - effects than traditional drug. In comparison with traditional drug(clomipramine),escitalopram shows better long - term efficacy in prevention of relapse of obsessive - compulsive symptoms and improvement in social function. Escitalopram is the first choice for treatment of patients with obsessive - compulsive disorder.