舍曲林联合重复经颅磁刺激治疗青少年强迫症可行性

A feasibility study of sertraline combined with repetitive transcranial magnetic stimulation in the treatment of adolescent obsessive-compulsive disorders

目的:探讨舍曲林联合重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗青少年强迫症(OCD)的可行性。方法:选取我院住院的青少年OCD患者76例为研究对象,随机分为观察组和对照组各38例,两组患者均口服舍曲林,观察组给予rTMS进行治疗,对照组给予rTMS伪刺激。治疗前及治疗4周、8周后采用汉密尔顿焦虑量表(HAMA)评定焦虑症状,Y-BOCS评定强迫症状;研究结束后评定患者临床疗效及不良反应发生情况。结果:观察组治疗4周、8周后HAMA、Y-BOCS评分均低于同期对照组(t=-5.782,-2.593;-13.596,-3.726;P<0.01);研究结束后观察组总有效率为94.74%,显著高于对照组的68.42%(Z=-2.469,P<0.05);观察组不良反应发生率为21.05%,对照组为23.68%(P>0.05)。结论:舍曲林联合rTMS可显著增强青少年OCD患者的抗强迫效应,临床效果满意,安全性高,值得临床推广。

Objective:To explore the feasibility of sertraline combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of adolescent obsessive-compulsive disorders(OCD).Methods:A total of 76 adolescents with OCD who were admitted in our hospital were included in the study and randomized into the observation group and the control group with 38 cases in each group.The patients in the two groups were orally administrated with sertraline.The patients in the observation group were given rTMS,while the patients in the control group were given sham-rTMS.HAMA was used to evaluate the anxiety symptoms before treatment,4 and 8 weeks after treatment.Y-BOCS was used to evaluate the obsessive-compulsive symptoms.After study,the clinical efficacy and the adverse reactions were evaluated.Results:HAMA and Y-BOCS scores 4 and 8 weeks after treatment in the observation group were significantly lower than those in the control group(t=-5.782,-2.593,-13.596,-3.726;P<0.01).The total effective rate in the observation group after treatment(94.74%)was significantly superior to that in the control group(68.42%)(Z=-2.469,P<0.05).The occurrence rate of adverse reactions in the observation group was 21.05%,while that in the control group was 23.68%,and the comparison between the two groups was not statistically significant(P>0.05).Conclusion:The sertraline combined with rTMS in the treatment of adolescent OCD can significantly strengthen the anti-obsession effect,with a satisfactory clinical effect and high safety;Therefore,it deserves to be widely recommended in the clinic.