改良电抽搐治疗难治性强迫症疗效观察_0.docVIP

改良电抽搐治疗难治性强迫症疗效观察 作者：张迎黎 梁炜 张红梅 李战文 张建宏 【关键词】 强迫症；改良电抽搐；氯丙咪嗪；疗效比较 　　【摘要】 目的 探讨改良电抽搐 治疗 难治性强迫症的疗效与安全性。 方法 将59例难治性强迫症患者随机分为两组， 研究 组(24例)：无改良电抽搐治疗禁忌症，在给予75～150mgd-1氯丙咪嗪治疗的同时，联合改良电抽搐治疗，3次W-1，共治疗10次；对照组（35例）：常规氯丙咪嗪(150～300mgd-1)治疗，疗程6w；两组在治疗前及治疗第1、2、4、6w末采用YaleBrown强迫评定量表、临床疗效总评量表评定临床疗效，采用副反应评定量表评定不良反应；YBOCS减分率≥75％为痊愈，50～74％为显著进步，25～49％为进步，25％为无效。结果 研究组总有效率79.1%，对照组总有效率42.8％，两组差异极显著（χ2＝14.505，P0.01）；治疗6w末强迫评定量表评分，两组差异显著（P0.05）；研究组副反应评定量表总分显著低于对照组（P0.05）。 结论 改良电抽搐治疗难治性强迫症有效，不良反应较轻。 　　【关键词】 强迫症；改良电抽搐；氯丙咪嗪；疗效比较 　　Curative effects of modified electric convulsive therapy in refractory obsessivecompulsive disorder. 　　【Abstract】 Objective To explore the curative effect and safety of modified electric convulsive therapy (MECT) in patents with refractory obsessivecompulsive disorder (OCD). Methods 59 patients with OCD were randomly divided into: research group(n=24,without contraindication of MECT) treated with clomipramine 75~150mg/d combined with MECT 3 times/w totaling 10 times, and control group(n=35) with clomipramine 150~300mg/d for 6 weeks. The efficacy were assessed by YaleBrown Obsessive Compulsive Scale(YBOCS) and Clinical Global Impression(CGI), and the side efects by Treatment Emergent Symptoms Scale (TESS) before treatment and at the ends of 1st,2nd 4th and 6th week. Criterion of curative effect: scorereducing rate of YBOCS ≥75% was recovery, 50~74% marked improvement, 25~49% improvement and 25% ineffectiveness. Results The total effective rates were 79.1% in research group and 42.8% in the control group respectively, the difference was best significant(χ2 =14.505,P0.01); after 6 week treatment, there was significant difference in scores of the YBOCS(P0.05);the total score of the TESS was significantly lower in research group than in control group(P0.05). Conclusion The MECT is effective and has fewer side effects in the treatment of refractory OCD. 　　【Keywords】 Obsessivecompulsive disorder；MECT；clomipramine; comparison of curative effect 　　强迫症是一种慢性的疾病过程。调查显示［