创伤后应激障碍与焦虑症共病的认知行为治疗与药物治疗的对照研究

Comparative Study between Cognitive Behavior Therapy and Drug Therapy For Patiens With the Combidity of Post-trauma Stress Disorder(PTSD) and Anxiety

目的比较认知行为治疗、抗焦虑药及二者联合治疗创伤后应激障碍与焦虑症共病的临床疗效、社会功能、生活满意度及生活质量改善情况。方法创伤后应激障碍与焦虑症共病患者92例按随机区组法分为认知行为组、抗焦虑药物组、二者联合治疗组,疗程12周。分别于治疗前和治疗结束时采用汉密尔顿焦虑量表(HAMA)评定临床疗效,功能大体评定量表(GAF)、生活满意度量表(LSR)和生活质量综合评定问卷(GQOLI-74)评定患者的社会功能、生活满意度、生活质量情况。结果治疗后,3组HAMA总分显著低于治疗前,社会功能、生活满意度和生活质量总分显著高于治疗前。认知行为组的不良反应显著低于药物治疗组和联合治疗组。结论认知行为治疗,抗焦虑药物和二者联合治疗创伤后应激障碍与焦虑症共病均有显著疗效,安全性好,联合治疗显出一定优势。3种治疗方法对患者的社会功能、生活满意度、生活质量均有明显改善。

Objective To compare the clinical efficacy, social function, life satisfaction and quality of life improvement between cognitive behavior therapy and drug therapy and both combined on patients with the combidity of PTSD and anxiety. Methods A total of 92 patients with the combidity of PTSD and anxiety were divided into cognitive behavior therapy group, drug therapy group and cognitive behavior therapy plus drug therapy group by random block design for 12 weeks . Hamiltion anxiety scale （HAMA）was used to evaluate the clinical efficacy, and global assessment function （GAF） ,life satisfaction rating scale （SLR）, and general quality of life in ventory-74 （GQOLI-74） were used to evaluate the patients social function,life satisfaction and quality of life . Results Compared with pre-treatment, the total scores of HAMA were lower significantiy and the scores of GAF, LSR and GQOLI-74 creased markedly after 12 weeks for each group. Patients in cognitive behavior therapy group had much less adverse effects than patients in drug therapy group as well as patients in combined treatment group. Conclusion Congitive behavior thera- py, drug treatment and both combined treatment are efficacious and safe in treating patients with the cobidity of PTSD and anxiety. Combined treatment shows superiority to two other therapies. The three therapies can significantly improve the patients＇ social function and quality of life.