舍曲林治疗青少年网络成瘾的随机、双盲、对照临床研究

Double-blind Randomized Controlled Clinical Trial of Sertraline in Adolescents with Internet Addiction Disorder

目的：评价舍曲林治疗青少年网络成瘾的有效性及安全性。方法：采用随机对照双盲试验，共纳入青少年网络成瘾患者64人，按就诊或入院先后顺序编号。按完全随机法（应用 SPSS 软件随机抽样分组）将纳入患者随机编入研究组（舍曲林治疗组，剂量为50～100mg／d）和对照组（安慰剂治疗组），每组32例，治疗8周。分别于治疗前和治疗8周后评估每周上网时间，采用中文网络成瘾量表修订版（Chinese Internet Addiction Scale － Revised ， CIAS － R）评估成瘾程度，焦虑自评量表（SAS）及抑郁自评量表（SDS）评估焦虑抑郁情绪，副反应反应量表（TESS）评定不良反应。结果：治疗结束后，研究组每周上网时间从治疗前的（34．3＆#177;6．4）小时下降至（9．1＆#177;5．7）小时（t ＝17．45，P ＜0．01），CIAS － R 量表总分及5个维度（强迫性上网行为、网络成瘾耐受性、戒断反应、人际与健康、时间管理分）分值较治疗前均有显著性降低（P ＜0．01），SAS 、SDS 量表总分也较前显著性降低（t ＝5．935，10．226；P ＜0．01）。与对照组相比，治疗结束后研究组每周上网时间、CIAS － R 总分及各维度分、SAS 、SDS 量表分均显著性降低，差异有统计学意义（P ＜0．01）。治疗期间研究组药物不良反应的发生率为18．75％（6／32），主要为胃肠道不适、嗜睡及出汗，未发生严重不良反应。结论：舍曲林治疗青少年网络成瘾能明显减少患者上网时间，改善患者焦虑抑郁情绪，明显减轻患者对网络的成瘾程度，且安全性好，值得进一步深入研究。

Objective ：To evaluate the efficacy and safety of Sertraline in the treatment of adolescents with internet addiction disorder .Methods ：Using randomized ,double - blind controlled clinical trial included 64 adolescents with in‐ternet addiction ,according to the clinic or hospital order number .According to completely random method （applica‐tion of SPSS software random sampling group） ,all 64 patients received 8 weeks treatment with either Sertraline tab‐lets（Sertraline treatment group ,the dose of 50 to 100 mg /d ,n = 32）or placebo（placebo treatment group ,n = 32） .At baseline and the end of 8 weeks ,participants completed Chinese Internet Addiction Scale - Revised（CIAS - R） ,Self- Rating Anxiety Scale（SAS）and Self - rating depression scale（SDS） ,while the adverse reactions were appraised with the Treatment Emergent Side Effect Scale （TESS） .Results ：The time spent online every week decreased from （34 .3 ＆#177; 6 .4）hours to（9 .1 ＆#177; 5 .7）hours after treatment （t = 17 .45 ,P 〈 0 .01）in Sertraline sample .in CIAS - R scale ,the total score and five dimensions （compulsive Internet ,Internet addiction tolerance ,withdrawal reactions ,time manage‐ment ,interpersonal and health points ）scores were significantly lower than those of pre - treatment in the Sertraline sample（P 〈 0 .01） .The scores of SAS and SDS in Sertraline sample were lower significantly than those of the base line（t = 5 .935 ,10 .226 ,P 〈 0 .01） .Compared with the placebo group ,the time online ,the scores of CIAS - R ,including all dimensions ,SAS and SDS were significantly lower in Sertraline sample ,the differences were statistically signifi‐cant（P 〈 0 .01） .The incidence of adverse effects during in Sertraline group was 18 .75% （6/32） ,mainly for gastroin‐testinal discomfort ,sleepiness ,and sweating .There were not serious adverse effects in Sertraline sample .Conclusion ：This study using Sertraline treatment in adolescents with internet addiction can significantly reduce the time spent online ,anxiety and depression .Meanwhile ,it can significantly reduce the level ofnternet addiction ,and has good safe‐ty ,worths being spread .