茴拉西坦并暴露疗法治疗创伤后应激障碍患者的效果

EFFICACY OF ANIRACETAM COMBINED WITH EXPOSURE THERAPY IN TREATMENT OF POST-TRAUMATIC STRESS DISORDER PATIENTS

目的探讨茴拉西坦并暴露疗法在创伤后应激障碍(post-traumatic stress disorder,PTSD)患者治疗中的临床价值。方法选取30例在青岛市精神卫生中心就诊的PTSD患者,并将其随机分为研究组和对照组各15例,研究组采用暴露疗法联合茴拉西坦治疗,对照组采用暴露疗法和安慰剂治疗,疗程均为12周。分别在治疗前和治疗后第2、4、8、12周末采用PTSD自评量表(PTSD-SS)和汉密尔顿焦虑量表(HAMA)评估患者病情状况。结果重复测量设计的方差分析结果显示,时间、组别及时间与组别交互作用均对患者PTSD-SS总分和HAMA评分具有明显影响(F_(时间)=257.92、817.29,F_(组别)=16.74、23.29,F_(时间*组别)=18.11、3.27,P<0.05)。与治疗前相比,两组患者治疗后PTSD-SS总分和HAMA评分均显著降低(F=114.97~350.64,P<0.05),在治疗后第4、8、12周末,研究组患者的PTSD-SS总分和HAMA评分均明显低于对照组(F=6.84~62.14,P<0.05)。在治疗后第8和第12周末,研究组主观评定及反复重现体验评分均明显低于对照组(F=8.20~65.21,P<0.05),而在警觉性增高方面,两组患者无明显差异(P>0.05)。结论茴拉西坦并暴露疗法较单纯应用暴露疗法可更好地改善PTSD患者的症状和焦虑情绪,临床疗效较好。

Objective To investigate the efficacy of aniracetam combined with exposure therapy in the treatment of posttraumatic stress disorder(PTSD)patients.Methods A total of 30 patients with PTSD who attended Qingdao Mental Health Center were selected and randomly divided into study group and control group,with 15 patients in each group.The patients in the study group were given exposure therapy combined with aniracetam,and those in the control group were given exposure therapy combined with placebo;the course of treatment was 12 weeks for both groups.PTSD Self-rating Scale(PTSD-SS)and Hamilton An-xiety Scale(HAMA)were used to assess disease conditions before treatment and at weeks 2,4,8,and 12 of treatment.Results The repeated measures analysis of variance showed that time,group,and time-group interaction had significant impacts on the total score of PTSD-SS and HAMA score(F_(time)=257.92,817.29,F_(group)=16.74,23.29,F_(time*group)=18.11,3.27,P<0.05).After treatment,both groups had significant reductions in the total score of PTSD-SS and HAMA score(F=114.97-350.64,P<0.05),and at the end of weeks 4,8,and 12,the study group had significantly lower total score of PTSD-SS and HAMA score than the control group(F=6.84-62.14,P<0.05).At the end of weeks 8 and 12,compared with the control group,the study group had significantly lower scores of the dimensions of subjective assessment and repeated recurrence experience(F=8.20-65.21,P<0.05),while there was no significant difference in increased alertness between the two groups(P>0.05).Conclusion Aniracetam combined with exposure therapy has a better clinical effect than exposure therapy alone and can better improve the symptoms and anxious emotion of PTSD patients.