低频重复经颅磁刺激联合氟伏沙明控制维持期强迫症患者症状的疗效观察
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摘要
目的探讨低频重复经颅磁刺激(r TMS)联合氟伏沙明控制维持期强迫症患者症状的效果。方法将95例维持期强迫症患者随机分为研究组(49例)和对照组(46例),研究组患者接受r TMS联合氟伏沙明系统治疗,对照组患者接受伪刺激联合氟伏沙明系统治疗,共3个月。于基线及治疗终点采用耶鲁布朗强迫症状量表(Y-BOCS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评定疗效。结果治疗后研究组Y-BOCS、SDS、SAS评分均低于对照组(P<0.05)。治疗后两组患者均未出现明显不良反应及异常实验室检查结果。结论相对于单用氟伏沙明,低频r TMS联合氟伏沙明对维持期强迫症患者的临床症状有更好疗效。
Objective To explore the effect of slow frequency repetitive Transcranial Magnetic Stimulation(rTMS) combined with fluvoxamine on clinical symptoms of patients with obsessive-compulsive disorder(OCD) in maintenance stage. Methods95 patients with OCD in maintenance stage were randomly divided into study group(n = 49) treated with low frequency r TMS combined with fluvoxamine and control group( n = 46) treated with sham r TMS combined with fluvoxamine for 3 months. All patients were assessed with Yale-Brown Obsessive Compulsive Scale(Y-BOCS),Self-rating Depression Scale(SDS) and Selfrating Anxiety Scale(SAS) at baseline and at the endpoint to evaluate the efficacy. Results Scores of Y-BOCS,SDS and SAS at endpoint were significantly lower in study group than those in control group(P< 0. 05). There were no serious side effects or abnormal results of laboratory examination in both groups. Conclusion Low frequency r TMS combined with fluvoxamine has better efficacy than fluvoxamine monotherapy in improving clinical symptoms of patients with OCD in maintenance stage.
Objective To explore the effect of slow frequency repetitive Transcranial Magnetic Stimulation(rTMS) combined with fluvoxamine on clinical symptoms of patients with obsessive-compulsive disorder(OCD) in maintenance stage. Methods95 patients with OCD in maintenance stage were randomly divided into study group(n = 49) treated with low frequency r TMS combined with fluvoxamine and control group( n = 46) treated with sham r TMS combined with fluvoxamine for 3 months. All patients were assessed with Yale-Brown Obsessive Compulsive Scale(Y-BOCS),Self-rating Depression Scale(SDS) and Selfrating Anxiety Scale(SAS) at baseline and at the endpoint to evaluate the efficacy. Results Scores of Y-BOCS,SDS and SAS at endpoint were significantly lower in study group than those in control group(P< 0. 05). There were no serious side effects or abnormal results of laboratory examination in both groups. Conclusion Low frequency r TMS combined with fluvoxamine has better efficacy than fluvoxamine monotherapy in improving clinical symptoms of patients with OCD in maintenance stage.
引文
[1]郭艳红,成媛媛,张伯全,等.强迫症患者自知力及对选择性5-羟色胺再摄取抑制剂的治疗反应性[J].精神医学杂志,2012,25(4):265-267
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[12]薛芬,彭正午,张华,等.重复经颅磁刺激结合帕罗西汀治疗躯体形式障碍疗效观察[J].精神医学杂志,2012,25(6):414-416
[13]崔爱军,郑玉英,石永存,等.高频重复经颅磁刺激合并艾司西酞普兰治疗老年难治性抑郁症对照研究[J].精神医学杂志,2014,27(4):300-302
[14]张勇,李恒芬,杨世昌,等.中学生强迫症的认知倾向、D型人格与家庭环境的关系[J].实用儿科临床杂志,2006,21(24):1713-1729
[15]刘英,刘蔚,杨世昌.强迫症患者疾病严重程度与家庭功能的相关研究[J].精神医学杂志,2014,27(5):356-358
[16]张传波,葛茂宏,张玉芹,等.重复经颅磁刺激治疗首发抑郁症快速起效作用的临床研究[J].精神医学杂志,2013,26(1):50-51
[17]刘增训,孙丰霞,刘书奎,等.低频重复经颅磁刺激改善老年期慢性酒精中毒患者认知功能的效果[J].中国老年学杂志,2014,34(2):298-299
[2]王旸,尚金钊,陈鑫.心理健康教育[M].吉林:吉林大学出版社,2011:125-127
[3]展西友.艾司西酞普兰和帕罗西汀改善强迫症患者症状的对照研究[J].精神医学杂志,2012,25(5):362-364
[4]汲送花,季加翠,张海英.综合心理护理对改善强迫症患者症状的效果分析[J].精神医学杂志,2010,23(5):381-382
[5]Howland RH,Shutt LS,Berman SR,et al.The emerging use of technology for the treatment of depression and other neuropsychiatric disorders[J].Ann Clin Psychiatry,2011,23(1):48-62
[6]刘同洲,王善信,王斌,等.无抽搐电痉挛治疗难治性强迫症的对照研究[J].中国行为医学杂志,2008,17(7):628-630
[7]Cordes J,Falkai P,Guse B,et al.Repetitve transcranial magnetic stimulation for the treatment of negative symptoms in residual schizophrenia:rationale and design of a shamcontrolled,randomized multicenter study[J].Eur Arch Psychiatry Clin Neurosci,2009,259(2):189-197
[8]Poulet E,Haesebaert F,Saoud M,et al.Treatment of schizophrenic patients and r TMS[J].Psychiatr Danub,2010,22(Suppl 1):143-146
[9]Preston G,Anderson E,Silva C,et al.Effects of 10 Hz r TMS on the neural effeciency of working memory[J].J Cogn Neurosci,2010,22(3):447-456
[10]李子青,薛芬,陈冠婕,等.不同刺激参数r TMS对慢性不可预见应激大鼠行为的作用及大脑BDNF水平的影响[J].精神医学杂志,2014,27(2):123-127
[11]Vercammen A,Knegtering H,Bruggeman R,et al.Effects of bilateral repetitive transcranial magnetic stimulation on treatment resistant auditory-verbal hallucination in schizophrenia:a randomized controlled trial[J].Schizophr Res,2009,114(1-3):172-179
[12]薛芬,彭正午,张华,等.重复经颅磁刺激结合帕罗西汀治疗躯体形式障碍疗效观察[J].精神医学杂志,2012,25(6):414-416
[13]崔爱军,郑玉英,石永存,等.高频重复经颅磁刺激合并艾司西酞普兰治疗老年难治性抑郁症对照研究[J].精神医学杂志,2014,27(4):300-302
[14]张勇,李恒芬,杨世昌,等.中学生强迫症的认知倾向、D型人格与家庭环境的关系[J].实用儿科临床杂志,2006,21(24):1713-1729
[15]刘英,刘蔚,杨世昌.强迫症患者疾病严重程度与家庭功能的相关研究[J].精神医学杂志,2014,27(5):356-358
[16]张传波,葛茂宏,张玉芹,等.重复经颅磁刺激治疗首发抑郁症快速起效作用的临床研究[J].精神医学杂志,2013,26(1):50-51
[17]刘增训,孙丰霞,刘书奎,等.低频重复经颅磁刺激改善老年期慢性酒精中毒患者认知功能的效果[J].中国老年学杂志,2014,34(2):298-299