躯体化障碍的临床特征、治疗及临床转归的研究

A study of clinical feature,treatment and clinical turnover on Somatization disorder

目的探讨综合医院中躯体化障碍患者的临床特点、治疗与症状转归情况。方法对符合CCMD-3躯体化障碍诊断标准的155例患者用自编调查表对患者一般资料进行调查。应用躯体形式障碍症状筛查量表(SOMS-7)评定临床症状,抑郁自评量表(SDS)和焦虑自评量表(SAS)评价情绪状况。给予小剂量SSRI类或SNRI类抗抑郁药物治疗。对其中47例患者进行8周随访观察其主要症状缓解情况和容易残留的症状。结果躯体化障碍患者女性多于男性,症状复杂可累及多个系统,最常见的症状为疲劳(73.55%)、心悸(72.90%)、头痛(70.32%)、睡眠障碍(69.67%)、头昏(66.45%)等,普遍伴有抑郁症状(72.26%)或焦虑症状(59.35%)。给予抗抑郁药治疗8周,症状明显减少,焦虑、抑郁明显缓解;8周末常见症状完全缓解率在70%以上,其中头痛完全缓解率为86.67%,头昏不易缓解,残留率为27.70%,但程度较前有明显减轻。结论躯体化障碍患者存在比较敏感的症状,如疲劳,心悸,头痛,睡眠障碍和头昏等;小剂量SSRI类或者SNRI类抗抑郁药物治疗躯体化障碍有效。

Objective To study the clinical feature of somatization disorder（SD） in general hospital and to explore the treatment and the change of somatization symptoms.Methods The general information of 155 patients with somatization was assessed with self-editing investigate scale.The emotional condition changes were evaluated by self-rating anxiety scale（SAS） and self-rating depression scale（SDS） on baseline and after 8 weeks treatment.47 patients was treated by low dose SSRI or SNRI antidepressants for 8 weeks.Results There are more female patients than male,the somatic symptoms are multi-styles and multi-systems,the frequently symptoms are fatigue（73.55%）,alpitation（72.90%）,headache（70.32%）,dyssomnia（69.67%）,dizziness（66.45%）.Most of SD patients manifested depression（72.26%） and anxiety（59.35%）.After 8weeks treatment,the numbers of symptoms were obviously reduced.Anxiety and depression were obviously relieved.The remission rate of cardinal symptom was exceeds 70% and remission of headache was 86.67%.Dizziness was difficult to be relieved and remission only 27.70%.Conclusion SD has sensitive or cardinal symptoms.Low dose SSRI or SNRI was efficacy for treating SD.