强迫症规范化治疗的研究进展

Research progress in standardized treatment of obsessive-compulsive disorder

强迫症是临床常见且病因复杂的一种精神疾病,主要特点是反复出现强迫观念和强迫行为。强迫症给患者的心理健康、日常生活等均造成了较大的影响,而对其治疗也是目前临床中的一大难点。在强迫症的规范化治疗中,主要包括药物治疗、心理治疗、物理治疗及手术治疗。药物治疗是强迫症治疗的主要手段,常用的药物包括三环类药物氯米帕明及5-羟色胺再摄取抑制剂。认知行为疗法、正念疗法、森田疗法等心理治疗也是强迫症治疗的重要手段。而重复经颅磁刺激、经颅直流电刺激等物理治疗手段主要是对强迫症的辅助治疗,往往与精神药物联用,以提升临床疗效。对于药物治疗、心理治疗无效的难治性强迫症患者,可采用手术治疗,目前常用的手术方式有扣带前回毁损术、内囊前肢毁损术、迷走神经刺激术和脑深部电刺激等。本文将从强迫症的规范化治疗方法及相关进展进行综述,旨在为强迫症的治疗提供参考。

Obsessive-compulsive disorder is a clinically common and complex mental disease,which is mainly characterized by repeated compulsive concepts and compulsive behavior.Obsessive-compulsive disorder has caused a great impact on patients′mental health and daily life,and its treatment is also a major difficulty in the current clinical practice.In the standardized treatment of obsessive-compulsive disorder,they mainly include drug therapy,psychotherapy,physical therapy,and surgical treatment.Drug therapy is the main means of obsessive-compulsive disorder treatment,and the commonly used drugs include the tricyclic drugs Clopepamine and selective serotonin reuptake inhibitor.Cognitive behavioral therapy,mindfulness therapy,Morita therapy and other psychological treatment are important mean of obsessive-compulsive disorder treatment.And repeated transcranial magnetic stimulation,transcranial direct current stimulation and other physical therapy methods are mainly auxiliary treatment of obsessive-compulsive disorder,often combined with psychotropic drugs,to improve the clinical efficacy.For drug treatment,psychotherapy ineffective refractory obsessive-compulsive disorder patients,surgery can be used.At present,the common surgical methods include anterior buckle band destruction,internal sac anterior limb destruction,vagal nerve stimulation and deep brain electrical stimulation.This article will review the standardized treatment methods and related progress of obsessive-compulsive disorder,in order to provide reference for the treatment of obsessive-compulsive disorder.