不同干预、治疗方式对网络成瘾临床疗效的对照研究

A comparative study on the clinical effect to internet addiction with different intervention methods and therapy

目的探讨心理治疗、行为治疗、家庭治疗、药物治疗和综合干预在网络成瘾戒治和病情转归中的作用。方法对150例网络成瘾患者以随机数字表法进行分组，分为心理治疗组、行为治疗组、家庭治疗组、药物治疗组和综合干预治疗组，并分别于入组前及干预治疗16周后进行网络成瘾和总体表现量表评定。结果各组治疗后网络成瘾测评分均明显低于治疗前[心理治疗组（72．13±14．55）分，（37．57±13．71）分，行为治疗组（69．57±15．06）分，（32．95±8．75）分，家庭治疗组（74．56±16．31）分，（35．84±13．03）分，药物治疗组（72．96±18．30）分，（21．19±1．88）分，综合治疗组（78．80±13．82）分，（16．92±2．04）分]（均P〈0．01）；除药物治疗组，各研究组总体表现测评分治疗前后增分均差异有显著性（P〈0．05，〈0．01）；以网络成瘾减分值为因变量的多元逐步回归分析，在α=0．05的水准下，进入回归方程的依次是综合干预、药物治疗、上网史，标化回归系数依次为0．454，0．301，-0．139；在以总体表现测评增分值为因变量的多元逐步回归分析中，在α=0．05的水准下，进入回归方程的依次是综合干预、家庭治疗、上网史，标化回归系数依次为0．444，0．256，-0．140。结论心理、行为、家庭、药物、综合之各种治疗方法戒治网络成瘾均有效，对总体行为表现的改善除药物治疗外其他各种治疗方法均有效，无论是网络成瘾戒治还是总体行为表现的改善均以综合干预疗效最佳；上网史与疗效呈负相关。

Objective To discuss the effect and discipline during the treatment of internet addiction and turnover of pathogenetic condition by using psychotherapy, behavior therapy, family therapy, and comprehensive intervention. Methods 150 internet addiction patients were divided with random number table into psychotherapy group, behavioral therapy group, family therapy group, pharmacotherapy group and comprehensive intervention therapy group. Assessments and evaluations were taken before the grouping and 16 weeks after treatment respectively. Results For each therapy group, the points after the treatment were obviously lower than before [ psychotherapy group ：72.13 ± 14.552 vs 37.57 ± 13. 711 ; behavior therapy group ： 69.57 ± 15. 065 vs 32.95 ± 8. 755 ; family therapy group ： 74.56±16.310 vs 35.84 ± 13. 034 ; medication group ： 72.96 ± 18. 308 vs 21.19 ± 1. 882 ; comprehensive therapy group：78.80 ± 13. 829 vs 16.92 ± 2. 040; All P 〈 0.01 ]. By using comparison among groups, obvious differences of evaluation deduction were observed in following groups ： psycho-comprehensive, behavior-comprehensive,family-eomprehensive,psycho-medication,behavior-medication family-medication,and medication-comprehensive. T-value one by one,5.471,5. 782,4. 730 （P 〈 0.01 ）, 3. 956, 3. 784 （P 〈 0.01 ）, 2. 786 （P 〈 0.01 ） , 1. 740（P 〈 0.05 ）. Except for the medication group, the general performance scores before and after the treatments for each group have obvious difference. By using comparison among groups, obvious differences of general performance were observed in following groups：family-comprehensive, behavior-comprehensive, medicationcomprehensive, psycho-comprehensive, psycho-family, family-medication, behavior-medication, and psycho-medication. T-value one by one,8. 878, 6. 734, 4. 715,4. 305 （P〈 0.01 ）, 3. 864（P〈0.01 ）, 2. 863, 2. 553, 2. 016 （P 〈 0.05 ）. In the multiple regression analysis by using deduction value as the dependent variable and α= 0.05, the order for entering the regression equation was as follows ： comprehensive intervention, medication, on-line history. The coefficient of regression one by one ： 0. 454, 0. 301, and - 0.139. In the multiple regression analysis by using general performance scores as the dependent variable and α= 0.05, the order for entering the regression equation was as follows ：comprehensive intervention, family therapy, and on-line history. The coefficient of regression one by one ：0.444, 0. 256, - 0. 140. Conclusion To treat Internet addiction, psychotherapy, behavior therapy, medication, family therapy, and comprehensive therapy are all effective. Except for the medication group, all other methods have positive effect on the improvement of general performance. Comprehensive intervention guarantees the optimal effectiveness for both the Internet addiction treatment and the improvement of general performance. Online history has a negative correlation with effectiveness.