CAJ | 학술논문

目的：比较舍曲林单用或合并重复经颅磁刺激（rTMS）治疗难治性强迫症患者的临床疗效。方法：将60例强迫症患者随机分成研究组（舍曲林＋ rTMS）和对照组（舍曲林＋ rTMS 伪刺激），疗程8周。治疗前及治疗2、4、6、8周后进行耶鲁布朗强迫症状量表（Y-BOCS）评定，治疗2、4、6、8周后进行治疗中出现的症状量表（TESS）评定，治疗前后进行世界卫生组织生活质量测定量表（ WHOQOL-100）评定。结果：治疗4周末起两组 Y-BOCS 评分较治疗前显著降低（P 均﹤0.01）；且研究组评分较对照组下降更显著（t ＝3.536、2.367、2.519；P ﹤0.05或 P ﹤0.01）。治疗8周末研究组总有效率（92.9%）显著高于对照组（67.8%）（P ﹤0.05）。在治疗第8周末，研究组 WHOQOL-100中社会关系、独立性、心理及生理评分显著高于对照组（P ﹤0.05或 P ﹤0.01）；治疗第4周末研究组 TESS 评分显著高于对照组（P ﹤0.01）。结论：舍曲林联合 rTMS 对难治性强迫症患者的疗效及生活质量影响均优于单用舍曲林。
목적：비교사곡림단용혹합병중복경로자자격（rTMS）치료난치성강박증환자적림상료효。방법：장60례강박증환자수궤분성연구조（사곡림＋ rTMS）화대조조（사곡림＋ rTMS 위자격），료정8주。치료전급치료2、4、6、8주후진행야로포랑강박증상량표（Y-BOCS）평정，치료2、4、6、8주후진행치료중출현적증상량표（TESS）평정，치료전후진행세계위생조직생활질량측정량표（ WHOQOL-100）평정。결과：치료4주말기량조 Y-BOCS 평분교치료전현저강저（P 균﹤0.01）；차연구조평분교대조조하강경현저（t ＝3.536、2.367、2.519；P ﹤0.05혹 P ﹤0.01）。치료8주말연구조총유효솔（92.9%）현저고우대조조（67.8%）（P ﹤0.05）。재치료제8주말，연구조 WHOQOL-100중사회관계、독립성、심리급생리평분현저고우대조조（P ﹤0.05혹 P ﹤0.01）；치료제4주말연구조 TESS 평분현저고우대조조（P ﹤0.01）。결론：사곡림연합 rTMS 대난치성강박증환자적료효급생활질량영향균우우단용사곡림。
Objective:To compare the clinical curative effect of sertraline alone or combined repetitive transcranial magnetic stimulation(rTMS)in patients with refractory obsessive- compulsive disorder(rOCD). Method:Sixty rOCD patients were randomly divided into study group(treated with sertraline + rTMS)and the control group(treated with sertraline + false stimulation of rTMS),and treated for 8 weeks. The patients were assessed by Yale brown obsessional-compulsive scale( Y-BOCS)before treatment and 2,4,6,8 weeks after treatment,treatment emergent symptoms scale(TESS)at 2,4,6,8 weeks after treatment,and the World Health Organization quality of life scale(WHOQOL-100)before and after treatment. Results:Since the end of the 4th week after treatment,the Y-BOCS scores of the two groups were significantly reduced than before treatment (all P ﹤ 0. 01);and those in the study group were more obvious than the control group( t = 3. 536,2. 367, 2. 519;P ﹤ 0. 05 or P ﹤ 0. 05). The end of the 8th week after treatment,the total effective rate of the study group (92. 9% )was significant higher than the control group(67. 8% )(P ﹤ 0. 05);and the scores of social rela-tions,independence,psychological and physiological of WHOQOL-100 in the study group were significant high-er than the control group(P ﹤ 0. 05 or P ﹤ 0. 01). The score of TESS in the study group was significantly higher than the control group just in the end of 4th week(P ﹤ 0. 01). Conclusion:For rOCD patients,sertraline combined rTMS has better curative effect and influence on the quality of life than sertraline alone.