帕罗西汀联合认知行为疗法治疗广泛性焦虑障碍的临床研究

Clinical study of paroxetine plus cognitive behavioral therapy in the treatment of generalized anxiety disorder

目的探讨帕罗西汀联合认知行为疗法与单纯帕罗西汀治疗广泛性焦虑障碍患者的疗效和区别。方法以2013年1月-2014年12月间浙江中医药大学附属第二医院临床心理科收治的广泛性焦虑障碍患者为研究对象,采用随机对照研究的方法将符合美国《精神障碍诊断和统计手册（DSM-V）》广泛性焦虑障碍患者60例随机分为帕罗西汀治疗组（A组）30例,认知行为治疗联合帕罗西汀治疗组（B组）30例;在治疗前和治疗第8周末、治疗的第6个月末,应用汉密尔顿焦虑量表（HAMA）、全面功能评估量表（GAF）进行评估,并比较疗效。结果两组HAMA评分治疗后较治疗前降低,GAF评分较治疗前增加,治疗前后差异有统计学意义（P〈0.05）。治疗8周末A组的HAMA高于B组、GAF评分低于B组,差异有统计学意义（P〈0.05）。在治疗的第6个月末随访时,两组的HAMA评分差异无统计学意义（P〉0.05）,但是GAF评分显示B组要高于A组,差异有统计学意义（P〈0.05）。结论帕罗西汀联合认知行为疗法能更好地缓解广泛性焦虑障碍患者的临床症状,对广泛性焦虑障碍患者社会功能恢复更有利。

Objective To investigate the efficacy of and distinction between paroxetine plus cognitive behavior therapy and simple paroxetine in the treatment of generalized anxiety disorder.Methods Patients with generalized anxiety disorders in Department of Clinical Psychology,Second Affiliated Hospital of Zhejiang Medical University from January 2013 to December 2014 were chosen as the study objective.By method of randomized controlled study,60 cases of patients with generalized anxiety disorders who were consistent with the United States ＂Diagnostic and Statistical Mental Disorders Manual（DSM-V）,were randomly divided into the paroxetine treatment group（group A with 30 cases）,and the group with the treatment of cognitive-behavioral therapy combined with paroxetine（group B with 30 cases）.Hamilton anxiety scale（HAMA） and global assessment function Scale（GAF） were used to evaluate and determine efficacy before the treatment,at the end of 8 weeks after treatment,and at the end of 6 months after treatment.Results HAMA scores of the two groups after treatment were lower than those before treatment,and GAF scores of the two groups after treatment were higher than those before treatment,and the differences were statistically significant（P〈0.05）.At the end of 8 weeks after treatment,HAMA scores in group A were higher than those in group B,and GAF scores in group A were lower than those in group B,and the differences were statistically significant（P〈0.05）.At the end of 6 months after treatment,follow-up showed that the difference of HAMA scores between the two groups was not statistically significant（P〉0.05）.but GAF scores in group B were higher than those in group A,and the difference was statistically significant（P〈0.05）.Conclusion Paroxetine plus cognitive behavior therapy can better alleviate the clinical symptoms of patients with generalized anxiety disorder and be more beneficial for the recovery of social function in generalized anxiety disorder patients.