帕利哌酮联合舍曲林治疗强迫症的对照研究
[摘要] 目的 探讨帕利哌酮联合舍曲林治疗强迫症的疗效。 方法 将符合条件的56例强迫症患者随机分为帕利哌酮联合舍曲林组和单用舍曲林组，各28例，治疗12周。采用耶鲁-布朗强迫量表(Y-BOCS)和副反应量表(TESS)评定疗效和副反应。 结果 治疗结束后两组Y-BOCS评分均显著降低，而合用组更为明显，与舍曲林组比较差异具有统计学意义(13.18±4.16 vs 10.56±3.66，t = 2.40，P < 0.05)。治疗第6周末时，研究组副反应显著高于对照组(3.56±1.64 vs 2.68±1.27，t = 2.18，P < 0.05)，而当治疗第12周末时两组副反应差异无统计学意义(2.83±1.45 vs 2.47±1.22，t = 0.95，P > 0.05)。结论 帕利哌酮可以作为舍曲林增效剂治疗强迫症，增强疗效。
[关键词] 帕利哌酮；舍曲林；强迫症；Y-BOCS评分；TESS评分
[中图分类号] R749.053 [文献标识码] A [文章编号] 1674-4721(2012)07(c)-0023-03
, 百拇医药
A control study of Paliperidone combining with Sertraline in treating obsessive-compulsive disorder
SHI Yanbo YANG Xiushuang ZHANG Xiuli
Jiaozuo Psychiatric Hospital in Henan Province, Jiaozuo 454000, China
[Abstract] Objective To explore the efficacy of Paliperidone combining with Sertraline on patients with obsessive-compulsive disorder (OCD). Methods Fifty six patients with OCD who met the conditions were randomly divided into two groups. One group (n = 28) was treated with Paliperidone combining with Sertraline, the other group (n = 28) was treated with Sertraline only. The efficacy of treatment was measured with Yale-Brown obsessive Compulsive Scale (Y-BOCS) and Treatment Emergent Symptom Scale (TESS). Results After treatment, Y-BOCS score of both groups were significantly reduced, and it was more apparent for the combined treatment group. There was significant difference compared with the Sertraline treated group(13.18±4.16 vs 10.56±3.66, t = 2.40，P < 0.05). At the end of the sixth week, the side effects of study group were significantly higher than control group, while no significant difference of side effects were found between two groups at the end of the twelveth week (2.83±1.45 vs 2.47±1.22, t = 0.95, P > 0.05). Conclusion Paliperidone can be used as a synergist of Sertraline in the treatment of obsessive- compulsive disorder to enhance the efficacy.
, 百拇医药
[Key words] Paliperidone; Sertraline; Obsessive-compulsive disorder; Yale-Brown obsessive Compulsive Scale; Treatment Emergent Symptom Scale
强迫症是一种慢性可致残的焦虑障碍，治疗困难，单一用药效果往往不理想。5-羟色胺回收抑制剂包括氯丙咪嗪和SSRIs类药物都是治疗强迫症的首选药物[1]，但在临床实践中发现即使给予足剂量、足疗程的抗强迫症药物治疗，许多患者仍不能获得满意疗效。目前，非典型精神病药物作为增效剂已成为强迫症的治疗策略之一[2]。利培酮作为DA和5-HT平缓阻滞剂，与舍曲林合用可加强抗强迫治疗效果[3]，而帕利哌酮是利培酮在体内代谢的主要活性产物，作为缓释制剂可能更有其优点。本研究采用非典型抗精神病药物帕利哌酮联合舍曲林联合治疗，以探讨对强迫症治疗效果的影响，现报道如下：
1 资料与方法
, 百拇医药
1.1 一般资料
(1)入组标准：2010年10月～2012年4月来自本院门诊和住院患者，均符合《中国精神障碍分类与诊断标准第3版(CCMD-3)》的强迫症诊断标准；耶鲁-布朗强迫量表(Y-BOCS)评分≥16分；患者同意治疗并签署知情同意书。(2)排除标准：妊娠或哺乳期及计划妊娠者；癫痫、心肌梗死、不稳定型心绞痛、充血性心力衰竭、严重肝硬化、急慢性肾衰竭、严重糖尿病、再生障碍性贫血、闭角型青光眼，其他严重神经系统等躯体疾病或可能干扰试验评估的疾病；符合CCMD-3的酒、药依赖诊断标准。(3)退出标准：因药物不良反应无法耐受；研究者出于对患者利益考虑认为应该退出研究。(4)临床资料：共56例，随机分为两组。研究组28例，男15例，女13例；年龄15～45岁，平均(31.5±11.7)岁，病程5个月～7年，平均(3.8±3.7)年。对照组28例，男14例，女14例，年龄15～45岁，平均(31.8±12.1)岁，病程6个月～7年，平均(3.9±3.6)年，两组以上各项比较差异均无统计学意义(P > 0.05)。, 百拇医药(师艳波 杨秀双 张秀丽)
[关键词] 帕利哌酮；舍曲林；强迫症；Y-BOCS评分；TESS评分
[中图分类号] R749.053 [文献标识码] A [文章编号] 1674-4721(2012)07(c)-0023-03
, 百拇医药
A control study of Paliperidone combining with Sertraline in treating obsessive-compulsive disorder
SHI Yanbo YANG Xiushuang ZHANG Xiuli
Jiaozuo Psychiatric Hospital in Henan Province, Jiaozuo 454000, China
[Abstract] Objective To explore the efficacy of Paliperidone combining with Sertraline on patients with obsessive-compulsive disorder (OCD). Methods Fifty six patients with OCD who met the conditions were randomly divided into two groups. One group (n = 28) was treated with Paliperidone combining with Sertraline, the other group (n = 28) was treated with Sertraline only. The efficacy of treatment was measured with Yale-Brown obsessive Compulsive Scale (Y-BOCS) and Treatment Emergent Symptom Scale (TESS). Results After treatment, Y-BOCS score of both groups were significantly reduced, and it was more apparent for the combined treatment group. There was significant difference compared with the Sertraline treated group(13.18±4.16 vs 10.56±3.66, t = 2.40，P < 0.05). At the end of the sixth week, the side effects of study group were significantly higher than control group, while no significant difference of side effects were found between two groups at the end of the twelveth week (2.83±1.45 vs 2.47±1.22, t = 0.95, P > 0.05). Conclusion Paliperidone can be used as a synergist of Sertraline in the treatment of obsessive- compulsive disorder to enhance the efficacy.
, 百拇医药
[Key words] Paliperidone; Sertraline; Obsessive-compulsive disorder; Yale-Brown obsessive Compulsive Scale; Treatment Emergent Symptom Scale
强迫症是一种慢性可致残的焦虑障碍，治疗困难，单一用药效果往往不理想。5-羟色胺回收抑制剂包括氯丙咪嗪和SSRIs类药物都是治疗强迫症的首选药物[1]，但在临床实践中发现即使给予足剂量、足疗程的抗强迫症药物治疗，许多患者仍不能获得满意疗效。目前，非典型精神病药物作为增效剂已成为强迫症的治疗策略之一[2]。利培酮作为DA和5-HT平缓阻滞剂，与舍曲林合用可加强抗强迫治疗效果[3]，而帕利哌酮是利培酮在体内代谢的主要活性产物，作为缓释制剂可能更有其优点。本研究采用非典型抗精神病药物帕利哌酮联合舍曲林联合治疗，以探讨对强迫症治疗效果的影响，现报道如下：
1 资料与方法
, 百拇医药
1.1 一般资料
(1)入组标准：2010年10月～2012年4月来自本院门诊和住院患者，均符合《中国精神障碍分类与诊断标准第3版(CCMD-3)》的强迫症诊断标准；耶鲁-布朗强迫量表(Y-BOCS)评分≥16分；患者同意治疗并签署知情同意书。(2)排除标准：妊娠或哺乳期及计划妊娠者；癫痫、心肌梗死、不稳定型心绞痛、充血性心力衰竭、严重肝硬化、急慢性肾衰竭、严重糖尿病、再生障碍性贫血、闭角型青光眼，其他严重神经系统等躯体疾病或可能干扰试验评估的疾病；符合CCMD-3的酒、药依赖诊断标准。(3)退出标准：因药物不良反应无法耐受；研究者出于对患者利益考虑认为应该退出研究。(4)临床资料：共56例，随机分为两组。研究组28例，男15例，女13例；年龄15～45岁，平均(31.5±11.7)岁，病程5个月～7年，平均(3.8±3.7)年。对照组28例，男14例，女14例，年龄15～45岁，平均(31.8±12.1)岁，病程6个月～7年，平均(3.9±3.6)年，两组以上各项比较差异均无统计学意义(P > 0.05)。, 百拇医药(师艳波 杨秀双 张秀丽)