暴露与反应预防疗法与阿立哌唑对强迫症增效作用临床对照研究

A controlled clinical study of the efficacy of exposure and response prevention therapy vs Aripiprazole for Augmenting effect in obsessive-compulsive disorder

目的评价暴露与反应预防疗法与阿立哌唑对强迫症的增效作用。方法将符合CCMD-3强迫症诊断标准,使用足量氟西汀治疗12周,Y-BOCS>16分的62例患者随机分为2组,每组各31例,2组在继续使用氟西汀治疗的同时分别给予每周1次,为期16周,每周1次的暴露与反应预防疗法治疗和为期16周的阿立哌唑治疗,使用Y-BOCS、SAS、SDS及总体幸福感量表(GWB)在治疗前后进行评价。结果暴露与反应预防疗法组总有效率为74.0%,阿立哌唑组总有效率38%(P<0.01),暴露与反应预防疗法组强迫因子总分、强迫思维因子分、强迫行为因子分及SAS、SDS评分较阿立哌唑组明显降低(P<0.01),GWB评分较阿立哌唑组明显升高(P<0.01)。结论作为增效策略,暴露与反应预防疗法优于阿立哌唑,且副作用低。

Objective To assess the efficacy of exposure and response prevention therapy（ ERP） vs Aripiprazole for Augmenting effect in obsessive-compulsive disorder. Methods Sixty-two OCD patients（ based on CCMD-3 criteria） who were treated fluoxetine for 12 weeks,and remained at least moderately symptomatic（ Y-BOCS score 16） were randomly divided into the study group（ 31） and control group（ 31）. Each group was treated with fluoxetine（ 40 ~80 mg,qd）. At the same time,study group received 16 sessions ERP over 16 weeks. Control group received Aripiprazole over 16 weeks（ 5 ~ 15 mg,qd）. Clinical assessments were conducted by Y-BOCS,SAS,SDS and GWB before and after treatment. Results The clinical effective rate of study group was 74%. The clinical effective rate of control group was 38%（ P〈0. 01）. The scores of Y-BOCS,SAS,SDS was lower and GWB was higher in study group than control group at the end of the treatment（ P〈0. 01）. Conclusion As Augmenting strategies EX/RP is superior than Aripiprazole and less negative adverse effect.