利培酮合并氯丙咪嗪治疗难治性强迫症临床分析

Clinical analysis of Risperidone and Clomipramine in the treatment of refractory obsessive-compulsive disorders

目的比较利培酮合并氯丙咪嗪对难治性强迫症的临床疗效及不良反应。方法用前瞻性、随机单盲法,将28例难治性强迫症患者随机分为利培酮合并氯丙咪嗪组和氯丙咪嗪组(n=14),疗程10周。在疗前,疗后2、4、6、8、10周末用Yale-Brown强迫量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、副反应量表(TESS)和临床疗效评定标准评定疗效及不良反应。结果利培酮合并氯丙咪嗪组起效快,第2周末各分值与治疗前比较,差异有显著性(P<0.05)。两组从第4周末始各分值与治疗前比较,差异均有极显著性(P<0.01)。第4、6、8、10周两组间各分值比较,差异均有显著性(P<0.05)。利培酮合并氯丙咪嗪组总体疗效优于氯丙咪嗪组,两组有效率差异有显著性(P<0.05),两组不良反应差异无显著性(P>0.05)。结论利培酮合并氯丙咪嗪治疗难治性强迫症较单用氯丙咪嗪好,且起效快,值得临床应用。

Objective To compare the efficacy and side effects of Risperidone and Clomipramine in the treatment of refractory obsessive-compulsive disorders （OCD）. Methods Twenty-eight patients were randomized to Risperidone and Clomipramine and Clomipramine group and Clomipramine group（n= 14）according to foresight and singer-blind for 10 weeks. The effieacy was mea- sured with Y--BOCS,HAMA and HAMD and the side effects were determined by TESS before and after the second, fourth,six- th,eighth and tenth week. Results Risperidone and Clomipramine group took effeet quiekly. At the end of the second week, there was marked difference between after and before treatment（P^0. 05）. But the two group took effect obviously at the end of the fourth week （P〈0. 01）.＇And there was marked difference in the fourth, sixth, eighth and tenth week between the two groups （P〈0. 05）. Risperidone and Clomipramine group was more efficient than the Clomipramine group. There was more obvious dif- ferenee between effeetive rate of two groups （P〈0. 05）. There was no marked difference in side effeets between the two groups（P 〉0. 05）. Conclusion It is better to use both Risperldone and Clomipramine than the only use of Clomipramine. The combination of Risperidone and Clomipramine is an effective method in treatment of refractory OCD , which also takes into effect rapidly. The fact that the side effects of both group are nearly same shows that it can be put into clinical application.