西酞普兰及氯米帕明治疗难治性强迫症对照探究.docVIP

西酞普兰及氯米帕明治疗难治性强迫症对照探究【摘要】 目的：探讨西酞普兰与氯米帕明治疗难治性强迫症的疗效和不良反应。方法：对难治性强迫症64例，随机分为两组，分别用西酞普兰与氯米帕明治疗8周。采用强迫症量表(Y-BOCS)和副反应量表(TESS)评价疗效及不良反应。结果：两组治疗后各周Y-BOCS评分均较治疗前下降(P 0.05)；两药的总体疗效相仿。西酞普兰不良反应小。结论：西酞普兰治疗难治性强迫症郁疗效与氯米帕明相当，安全性高，不良反应轻微，依从性好。西酞普兰尤适用于难治性强迫症。 【关键词】 西酞普兰；氯米帕明；难治性强迫症 Comparative study of citalopram and clomipramine in treatment of patients with refractory obsessive-compulsive disorder Jiang Chong-Rong 【Abstract】 Objective: To compare the efficacy and side effects of citalopram and clomipramine in the treatment of patients with refractory obsessive-compulsive disorder (OCD).Method: Sixty-four patients were randomly divided into two groups treated with citalopram and clomipramine respectively for 8 weeks. The efficacy and side effects were monitored with clinical evaluation, Yale-Brown obsessive compulsive scale (Y-BOCS) and treatment emergent symptoms scale (TESS).Results:The scores of Y-BOCS decreased more markedly after the treatment than those before the treatment in two groups; There were no significant differences after the treatment in 4th, 6th, 8th weekend. Citalopram and clomipramine were effective to refractory OCD, but citalopram had less side effects. Conclusion: Although citalopram has similar efficacy with clomipramine in the treatment of the patients with refractory obsessive-compulsive disorder (OCD), but the former is safer with slighter side reaction and better compliance. Citalopram is a more suitable drug for patients with refractory obsessive-compulsive disorder (OCD). 【Key words】 citalopram;clomipramine; refractory obsessive-compulsive disorder 【中图分类号】 R917 【文献标识码】 Ｂ 【文章编号】 1007-8231（2011） 07-0300-02 难治性强迫症约占强迫症的20～30%,症状严重而迁延。我们进行了西酞普兰与氯米帕明治疗难治性强迫症的研究，现将结果报告如下。 1对象和方法 1.1对象 为2008年09月至2010年10月住我院精神科患者。符合中国精神障碍分类与诊断标准第3版强迫症诊断标准；曾经过≥2种SSRI（或一种为氯米帕明）足量、足疗程（≥6周）治疗，强迫症状无明显好转；强迫症量表（Y－BOCS）≥16分，排除器质性疾病。共64例，随机分为两组。西酞普兰组32例，男13例，女19例；平均年龄(41.3±12.7)岁，平均病程(6.2士3.4)年。氯米帕明组32例，男17例，女15例；平均年龄(41.2±13.5)岁，平均病程(6.4±3.6)年。两组以上各项差异均