帕罗西汀合并小剂量奎硫平治疗强迫症临床观察.docVIP

帕罗西汀合并小剂量奎硫平治疗强迫症临床观察 　　摘 要 目的：观察帕罗西汀合并小剂量奎硫平治疗强迫症的临床疗效和不良反应。方法：将符合入组条件的80例强迫症患者随机分为两组，研究组服用帕罗西汀和奎硫平治疗，对照组单用帕罗西汀治疗，共观察8周，于治疗前，治疗后1、2、4、6、8周末应用Y-BOCS、HAMD、HAMA量表评定疗效，不良反应量表（TESS）记录治疗过程中的不良反应，并随访1年，观察其1年内的复发率。结果：两组治疗后Y-BOCS、HAMD、HAMA评分均明显下降（P＜0.05），Y-BOCS、HAMA在第6、8周末的评分显示两组间有明显差异（P＜0.05）；8周末研究组有效率为83.78%，高于对照组的有效率72.97%（P＜0.05）；两组不良反应评分及1年内的复发率比较无明显差异（P＞0.05）。结论：帕罗西汀联合小剂量奎硫平治疗强迫症起效快，可提高疗效，并能迅速改善睡眠障碍和焦虑症状，不会明显增加不良反应，对复发率无明显影响。 　　关键词 帕罗西汀 奎硫平 强迫症 　　 　　AbstractObjective:To study the clinical effect of paroxetine with small-dose quetiapine in the treatment of obsessive-compulsive disorder.Methods:80 hospitalized patients who met the criteria of CCMD-3 for obsessive-compulsive disorder were assigned to study group and control group,study group were given paroxetine combining quetiapine control group given paroxetine only for the treatment of 8 weeks.The efficacy and side effects were evaluated with Y-BOCS、HAMD、HAMA and TESS at the end of 1nd、2th、4th、6th and 8th.The relapse of one year was observed by follow up.Results:After treatment,scores of Y-BOCS、HAMD and HAMA of both groups were significantly lower than pre-treatment（P＜0.05）.There were significant differences in the scores of Y-BOCS and HAMA between two groups at the end of 6th and 8th （P＜0.05）.The effective rate of study group（83.78%） were higher than control group（72.97%,P＜0.05）.There were no significantly difference in TESS and the relapse of one year between two groups（P＞0.05）.Conclusion:Paroxetine with small-dose quetiapine could improve the efficacy compared with paroxetine in the treatment of obsessive-compulsive disorder,and could improve sleep orexis and the feeling discomfort.But quetiapine had no distinct effect no relapse. 　　KeyWordsParoxetine;Quetiapine;Obsessive-compulsive disorder 　　强迫症（OCD）是精神科常见的慢性精神障碍，是以无法控制的强迫思维，强迫怀疑或强迫动作为特征的神经症，它的症状明显影响患者的日常生活能力，且病程迁延，常导致严重的功能损害。患者常有一定的性格基础，在社会心理因素影响下发病，治疗难度大。传统的三环类抗抑郁剂氯丙咪嗪是公认的治疗强迫症的一线药物，但不良反应较大，新一代抗抑郁剂5-羟色胺再摄取抑制剂对强迫症有效，据报道与氯丙咪嗪疗效相当，不良反应更小［1］，但总体疗效也不十分满意。有研究