氟伏沙明联合阿立哌唑治疗难治性强迫症对照研究

A control study of fluvoxamine combined with aripiprazole in the treatment of refractory obsessive-compulsive disorder

目的 探讨氟伏沙明联合阿立哌唑治疗难治性强迫症的临床疗效和安全性.方法 将56例强迫症患者随机分为两组,每组28例,两组均口服氟伏沙明治疗,研究组联合阿立哌唑治疗.观察8周.于治疗前及治疗2周、4周、6周、8周末采用Yale-Brown强迫量表评定临床疗效,副反应量表评定不良反应.结果 治疗4周末起两组Yale-Brown强迫量表评分均较治疗前有显著下降（P＜0.01）,但研究组治疗4周、6周、8周末均较对照组下降更显著（P＜0.05或0.01）.治疗8周末,研究组总有效率为85.7%、对照组为67.8%,研究组疗效优于对照组.治疗4周末研究组副反应量表评分显著高于对照组（P＜0.01）,其他各时段评分两组差异均无显著性（P＞0.05）;两组不良反应均轻微,研究组以神经系统不良反应为主,对照组以植物神经系统反应为主.结论 氟伏沙明联合阿立哌唑能增强抗强迫效应,治疗难治性强迫症起效快,疗效显著,安全性高,依从性好,显著优于单用氟伏沙明治疗.

Objective To explore the efficacy and safety of fluvoxamine combined with aripiprazole in the treatment of refractory obsessive-compulsive disorder （OCD）. Methods Fifty six OCD patients were randomly divided into two groups of 28 ones each, both groups took orally fluvoxamine and research group was plus aripiprazole for 8 weeks. Efficacies were assessed with the Yale-Brown Obsessive Compulsive Scale （Y-BOCS） and adverse reactions with the Treatment Emergent Symptom Scale （TESS） before treat ment and at the end of the 2^nd, 4^th, 6^th and 8^th week. Results Since the end of the 4^th week the Y-BOCS scores of both groups lowered more significantly research than in control group at the end of the 4 compared with pretreatment （P〈0.01）, so did those in 4^th 6^th and 8^th week （P〈0.05 or0.01）. At the end of the 8＇h week, total effective rate was higher in research than in control group （85.7% vs 67.8%）. The TESS score was significantly higher in research than in control group at the end of the 4^th week （P〈0.01） and had significant differences in other periods （P〈0.05） ; adverse reactions of both groups were mild, mainly untoward reactions of nervous system in research and of vegetative nervous system in control group. Conclusion Fluvoxamine combined with aripiprazole could reinforce anti-obsessive effect and has an advantage over single fluvoxamine in taking effect, efficacy, safety and compliance.