心理干预联合帕罗西汀治疗持续性躯体形式疼痛障碍对照研究

A control study of psychological intervention combined with paroxetine in the treatment ot persistent somatororm pain disorder

目的探讨心理干预联合帕罗西汀治疗持续性躯体形式疼痛障碍的疗效。方法将72例持续性躯体形式疼痛障碍患者随机分为两组，各36例。研究组采取心理干预联合帕罗西汀治疗，对照组单用心理干预治疗，观察12周。采用疼痛视觉模拟评分法评定患者疼痛症状及其疗效，汉密顿抑郁量表评定抑郁情绪状态及其疗效，艾森克人格问卷评定人格特征。结果研究组治疗4周末起，对照组治疗8周末起视觉模拟评分法和汉密顿抑郁量表评分均较治疗前有显著性下降（P〈0.05或0．01）；同期两组比较，治疗4周末起研究组视觉模拟评分和汉密顿抑郁量表评分均较对照组下降更显著（P〈0．05或0．01）；治疗12周末两组疼痛和抑郁症状显效率差异均有显著性（Х^2=9．76、5．53，P〈0．05或0．01）。两组疼痛伴发人格障碍男女患者艾森克人格问卷的内外倾、神经质维度评分与常模比较差异均存在显著性（P〈0.01）。结论持续性躯体形式疼痛障碍与情绪、个性密切相关，心理干预联合帕罗西汀治疗持续性躯体形式疼痛障碍可以显著控制患者疼痛症状，改善不良情绪，显著优于单用心理治疗。

Objective To explore the efficacy of psychological intervention combined with paroxetine in the treatment of persistent sornatoform pain disorder （PSPD）. Methods Seventy-two PSPD patients were randomly divided to two groups of 36 ones each,. Rsearch group received psychological intervention combined with paroxetine and control group did psychological intervention only for 12 weeks. Pain symptom and efficay were assesses with the Pain Visual Analogue Scale （VAS）, depression emotion and efficacy with the Hamilton Depression Scale （HAMD） and personality characteristics with the Eysenck Personality Questionnaire （EPQ）. Results The scores of both the VAS and HAMD since the end of the 4th week in the research and since the end of the 8^th in the control group lowered more significantly compared with pretreatment （P〈0.05 or 0.01） ; contemporary group comparions showed that the scores of both the VAS and HAMD since the end of the 4^th week lowered more significantly in the research than in the control group （P〈0.05 or 0.01）. There were significant differences in obvious effective rates of both pain and depression at the end of the 12^th week （Х^2=9.76,5.53, P〈0.05 or 0.01）. There were significant differences in introversion-extroversion and neuroticism score of the EPQ between pain patients with personality disorder and norm （P〈0.01）. Conclusion PSPD is closely related to the emotion and personality, psychological intervention combined with paroxetine can notably control pain symptom and improve bad emotion, and is better than psychotherapy only.