强迫症含强迫思想和强迫行为者二重辨证施治在开放式心理病房的研究

An investigation on double-therapy treatment based on differentiation of syndromes on obsession with obsessive thoughts and compulsive behavior in open wards

目的 :探讨二重辨证施治对强迫症含强迫思想和强迫行为者的疗效 ,及其在开放式心理病房的适应情况。 方法:将 5 2例强迫症含强迫思想和强迫行为者按随机的原则在开放式心理病房分为研究组 (2 7例 )和对照组 (2 5例 )。研究组用二重辨证施治 ,对照组用认知疗法结合氯丙咪嗪、氟西汀等。研究时间共 5个月 ,头 2个月为积极治疗期 ,后 3个月为自由治疗期。采用临床疗效评定标准 ,耶鲁布朗强迫症量表 (Y -BOCS) ,x2 检验 ,t检验。 结果 :研究组和对照组 ,积极治疗期末痊愈差异有统计学意义 (x2 =19.94,P <0 .0 0 5 ) ,自由治疗期末痊愈差异有更大的统计学意义 (x2 =2 6.64 ,P <0 .0 0 5 )。耶鲁布朗强迫症量表 (Y -BOCS)总分 ,两组治疗前差异无统计学意义 (t =0 .75 6,P >0 .2 ) ;积极治疗期末 ,两组差异有统计学意义 (t=10 .3 2 4,P <0 .0 0 1) :自由治疗期末 ,两组差异有更大的统计学意义 (t=12 .66,P <0 .0 0 1)。 结论 :二重辨证施治对强迫症含强迫思想和强迫行为者有普遍卓越的痊愈功效和痊愈巩固功效 ,应积极推广。

Objective: To study the significance of double-therapy treatment based on differentiation of syndromes on obsession with obsessive thoughts and compulsive behavior and its suitability in open wards. Methods: 52 cases were divided into experimental team (27) and blank team (25) freely in open wards. The experimental team was treated by double-therapy treatment based on differentiation of syndromes, while blank team was treated by cognitive therapy with chlorimipramine and fluoxetine etc. The treatment lasted five months, in which positive therapy lasted two months and free therapy lasted next three months. The therapeutic effect was evaluated by Y-BOCS, and the data was analyzed by x 2-check and t-check. Results: More significant difference was seen between two teams in free therapy five months later ( x 2=26.64, P <0.005) while difference ( x 2=19.94, P <0.005) in positive therapy two months. Significance also appeared after two months therapy (t=10.324, P <0.001) and extreme significance after five months (t=12.66, P <0.001). Conclusions: Double-therapy treatment based on differentiation of syndromes has a satisfied curative effect and prognosis on obsession with obsessive thoughts and compulsive behavior and should be advocated. Open wards in paidocheu can be used as a platform also.