氟伏沙明联合认知行为疗法在强迫症治疗中的应用价值

Use of Fluvoxamine and cognitive behavioral therapy in treatment of obsessive-compulsive disorder

目的:探讨氟伏沙明联合认知行为疗法在强迫症治疗中的应用价值。方法:将2014年3月至2015年2月广州市惠爱医院收治的120例强迫症患者随机分为观察组(氟伏沙明联合认知行为疗法)和对照组(单用氟伏沙明),每组各60例,疗程共12个月。随访6、12个月,采用Y-BOCS减分率评定标准和自我和谐量表进行评估,对比两组临床疗效、依从性及复发率等指标差异。结果:治疗后6、12个月,观察组痊愈率、有效率均显著优于对照组(P<0.01);两组Y-BOCS评分、自我和谐量表评分均优于治疗前(P<0.05),其中观察组优于对照组(P<0.01);观察组治疗依从性均好于对照组。治疗后12个月,对照组和观察组中出现过复发或恶化者分别为22例(36.7%)和9例(15.0%),两组比较,差异有统计学意义(P<0.01)。结论:氟伏沙明联合认知行为疗法治疗强迫症远期疗效显著,依从性好,复发率低,优于单用氟伏沙明治疗。

Objective：To investigate the use of Fluvoxamine and cognitive behavioral therapy in the treatment of obsessive-compulsive disorder. Methods：A total of 120 patients with obsessive-compulsive disorder, who were hospitalized in Guangzhou Huiai Hospital between March 2014 and February 2015,were randomly divided into the study group （Fluvoxamine and cognitive behavioral therapy）and the control group （monotherapy with Fluvoxamine）,with 60 cases in each group,and a course of treatment for 12 months. All patients were followed up for 6 and 12 months. Yale-Brown Obsessive-Compulsive Scale （Y-BOCS）reduction rate and Self Consistency and Congruence Scale （SCCS ） were used for evaluation. The clinical effect,compliance and recurrence rate in the two groups were compared. Results：At 6 and 12 months after the treatment,the cure rate and effective rate in the study group were significantly better than those in the control group （P〈0.01）.After the treatment,the scores of Y-BOCS and SCCS in the two groups were better than those at baseline （P〈0.05）,in which the study group was better than the control group （P〈0.01）. The treatment compliance in the study group was better than that in the control group. At 12 months after the treatment,there were 22 （36. 7%）and 9 （15.0%）cases of recurrence and exacerbation in the control group and the study group. There was statistically significant difference between the two groups （P〈0. 01 ）. Conclusion：Using Fluvoxamine and cognitive behavioral therapy in the treatment of obsessive-compulsive disorder show significant effect,good compliance and low recurrence rate,which is better than monotherapy with Fluvoxamine.