奥氮平合用氯米帕明治疗强迫症对照观察

目的：观察奥氮平合用氯米帕明治疗强迫症的疗效与不良反应。方法：将43例强迫症患者随机分为两组，以奥氮平合用氯米帕明及单用氯米帕明治疗，以强迫症量表(Y-BOCS)和副反应量表(TESS)评定疗效与不良反应。结果：奥氮平合用氯米帕明组显效率高于单用组，8周末Y-BOCS评分低于单用组；合用组体重增加数高于单用组。结论：奥氮平合并氯米帕明治疗强迫症安全有效。     

脑波治疗仪治疗强迫症的临床研究

目的:探讨脑波治疗仪治疗强迫症的疗效。方法:将96例强迫症患者随机分为氯米帕明合并脑波治疗组49例和单用氯米帕明组47例。疗程6周。用强迫症量表(Y-BOCS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定疗效。结果:治疗结束时两组Y-BOCS、HAMD、HAMA评分均显著降低,以合并治疗组明显。结论:脑波治疗仪可提高氯米帕明对强迫症的临床疗效。     

氟伏沙明与氯米帕明治疗青少年强迫症的对照研究

目的 比较氟伏沙明与氯米帕明治疗青少年期强迫症的疗效和不良反应.方法 共纳入强迫症患者42例,随机分为氟伏沙明组和氯米帕明组,疗程8周.应用耶鲁-布朗强迫症量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)评定疗效,治疗中需处理的不良反应症状量表(TESS)评价不良反应.结果 氟伏沙明组治疗总有效率86.4％,氯米帕明组治疗总有效率86.4％,两组比较差异无统计学意义(P＞0.05).两组治疗后第4、8周末Y-BOCS评分、HAMA评分与治疗前比较差异有显著统计学意义(P＜0.01).氟伏沙明组与氯米帕明组不良反应发生率差异有统计学意义(P＜0.05).结论 氟伏沙明对于青少年期强迫症状的治疗是安全有效的.     

喹硫平合并氟伏沙明治疗儿童强迫症的临床初步观察

目的 探讨喹硫平合并氟伏沙明治疗儿童强迫症的临床疗效和安全性.方法 将47例儿童强迫症患者根据患儿家庭经济条件分为氯米帕明组(氯米帕明100～150 mg/d单药治疗,9例),氟伏沙明组(氟伏沙明100～150 mg/d单药治疗,13例),喹硫平合并氟伏沙明组(氟伏沙明100～150 mg/d,喹硫平400～600 mg/d,25例).随访8周.采用Yale-Brown强迫症量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)和副反应量表(TESS)评定疗效和不良反应.结果 基线时3组间Y-BOCS、HAMA评分相似.随访第8周时喹硫平合并氟伏沙明组的Y-BOCS评分(12.4±4.7)低于氯米帕明组(15.9±3.8,t=2.654,P=0.021)和氟伏沙明组(16.1±3.9,t=2.576,P=0.037),HAMA评分(6.9±3.8)也低于氯米帕明组(9.9±4.1,t=2.197,P=0.027)和氟伏沙明组(10.1±3.6,t=2.236,P=0.017).结论 喹硫平合并氟伏沙明用于儿童强迫症的治疗有明确的疗效和安全性.     

利培酮与喹硫平联合氯米帕明治疗难治性强迫症的疗效比较

目的比较利培酮和喹硫平分别联合氯米帕明治疗难治性强迫症的疗效。方法将62例难治性强迫症患者随机分为利培酮联合氯米帕明组和喹硫平联合氯米帕明组,于治疗前和治疗后第8、及24周末16分别使用Yale-Brown量表(Y-BOCS)、汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)进行评分,以Y-BOCS减分率评定疗效。结果两组治疗后第8、及24周末各量表评分较疗前均有明显下降,差异具有显16著性(P<0.01);两组同期比较,喹硫平联合氯米帕明组评分明显低于利培酮联合氯米帕明组,差异具有显著性(P<0.01);治疗第24周末喹硫平联合氯米帕明组的显效率明显高于利培酮联合氯米帕明组,差异有显著性(P<0.01)。结论氯米帕明联合利培酮或喹硫平均能有效治疗难治性强迫症,联合喹硫平的疗效优于联合利培酮。     

西酞普兰与氯米帕明治疗强迫症对照研究

目的：比较西酞普兰与氯米帕明治疗强迫症的疗效和不良反应。方法：以西酞普兰和氯米帕明治疗强迫症各30例,疗程8周。应用Yale—Brown强迫症量表（Y—BOCS）、汉密尔顿抑郁量表（HAUD）及汉密尔顿焦虑量表（HAMA）评定疗效。结果：西酞普兰组与氯米帕明组治疗后Y-BOCS、HAMD、HAMA分值均显著下降,两组间差异无显著性。西酞普兰组不良反应明显少于氯米帕明组。结论：西酞普兰治疗强迫症疗效与氯米帕明相仿,不良反应较轻,值得推广。     

西酞普兰治疗强迫症对照研究

目的：评价西酞普兰与氯米帕明治疗强迫症的疗效和不良反应。方法：将符合中国精神障碍分类与诊断标准第3版强迫症诊断标准的46例住院和门诊患者，随机分为两组，分别给予西酞普兰及氯米帕明治疗。疗程8周。用Yale-Brown强迫症量表(Y-BOCS)，汉密顿抑郁量表(HAMD)，临床疗效总评量表的病情严重程度(CGI-SI)和副反应量表(TESS)评定疗效和不良反应。结果：西酞普兰与氯米帕明对强迫症疗效相似，但前者起效更快，不良反应少于后者。结论：西酞普兰是一种安全、有效的新一代抗强迫症药，可以作为治疗强迫症的一线药使用。     

帕罗西汀与氯米帕明治疗难治性强迫症对照研究

目的：观察帕罗西汀和氯米帕明对难治性强迫症的疗效和不良反应。方法：对难治性强迫症患者60例,随机分为两组,分别用帕罗西汀和氯米帕明治疗8周。采用强迫症量表（Y-BOCS）和副反应量表（TESS）评价疗效及不良反应。结果：两药的总体疗效相仿。帕罗西汀对强迫行为疗效较好,不良反应小,尤其是心血管系统及抗胆碱能不良反应少。结论：帕罗西汀尤适用于以强迫行为为主的难治性强迫症患者。     

西酞普兰与氯米帕明治疗强迫症对照观察

目的：探讨西酞普兰对强迫症的疗效及安全性。方法：将36例强迫症患者，平分为西酞普兰组及氯米帕明组。疗程8周。采用Yale-Brown强迫症量表(Y-BOCS)、Marks恐怖强迫量表(MSC-POR)、Hamiltor。抑郁量表(HAMD)及副反应量表(TESS)评定疗效及安全性。结果：西酞普兰组显效率为56％，有效率为83％，与氯米帕明组的61％及89％相当。西酞普兰组不良反应较氯米帕明组少且轻微。结论：西酞普兰与氯米帕明对强迫症均有较好的疗效。     

阿立哌唑与氯米帕明治疗强迫症的疗效对照分析

目的比较阿立哌唑与氯米帕明治疗强迫症的疗效及不良反应。方法将符合CCMD-3诊断标准的强迫症患者62例，随机分成研究组（阿立哌唑组）29例，对照组（氯米帕明组）33例。分别应用临床疗效评定标准、Yale-Brown强迫症量表（Y—BOCS）和Hamilton抑郁量表（HAMD）、自编不良反应出现频率表，分别评定疗效及不良反应。结果研究结束时，两组自身在治疗前后的临床疗效、Y-BOCS量表及Hamilton量表的减分率均显示有显著性差异（P〈0．01）。阿立哌唑组和氯米帕明组的有效率分别为53％和56％，但是两组之间的疗效则无显著性差异（P〉0．05）。两组不良反应格局略有不同。结论结果显示阿立哌唑在治疗强迫症时，其临床疗效与氯米帕明相当，而不良反应虽有所差异，但不影响治疗。     

氯丙咪嗪合并利培酮治疗强迫症的对照研究

目的探讨利培酮对于氯丙咪嗪治疗强迫症的增效作用。方法将70例强迫症随机分为2组,氯丙咪嗪同时合并利培酮和单独使用氯丙咪嗪治疗,治疗8周。采用强迫症量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评定疗效。结果合并利培酮组有31例完成试验,氯丙咪嗪组有32例完成试验。治疗8周后,两组Y-BOCS平均总分有明显下降,合并利培酮组优于氯丙咪嗪组,两组无显著性差异(P<0.05);HAMA、HAMD的评分均显著下降,两组无显著性差异(P>0.05)。结论合并利培酮对于氯丙咪嗪治疗强迫症有增效作用。     

Citalopram for treatment-resistant obsessive-compulsive disorder.

We investigated the comparative efficacy of citalopram vs. citalopram administered with clomipramine, in treatment-resistant obsessive-compulsive disorder (OCD). Sixteen adult outpatients participated in a 90-day, randomized, open-label trial. Eligible patients were aged 18 to 45 years, had moderate to severe DSM-III-R OCD of >/= one year's duration, a baseline Yale-Brown scale (Y-BOCS) score of >/= 25 and no other active axis I diagnosis, and had failed adequate clomipramine and fluoxetine trials. The citalopram-plus-clomipramine group (n = 9) experienced a significantly larger percent decrease in mean Y-BOCS score by day 90 than the citalopram alone group (n = 7). Only one citalopram patient decreased her score by >/= 35%, and two by >/= 25%. All nine citalopram-plus-clomipramine patients experienced decreases of 35%. Side effects were mild to moderate in both groups. We also treated with citalopram six OCD patients who had not tolerated fluoxetine alone and clomipramine alone; three achieved Y-BOCS score decreases of >/= 35% at 90 days. Since citalopram does not significantly affect clomipramine metabolism, the improvement in the combined drug group is unlikely to have resulted from increased plasma clomipramine levels. Double-blind controlled trials are needed of citalopram in OCD, and of combining citalopram with clomipramine in treatment-resistant OCD.     

西酞普兰合并氯丙咪嗪治疗难治性强迫症

目的探讨西酞普兰以及西酞普兰合并氯丙咪嗪治疗难治性强迫症的疗效和不良反应。方法将16例难治性强迫症患者随机分为2组(n=8)，分别给予西酞普兰，西酞普兰合并氯丙咪嗪治疗。采用耶鲁布朗强迫症量表(YBOCS)和副反应量表(TESS)评定疗效和副反应。结果西酞普兰合并氯丙咪嗪组的所有病人的YBOCS减分率均大于35％，有6例出现副反应。西酞普兰组仅有一例患者的YBOCS减分率大于35％，有3例出现副反应。结论西酞普兰合并氯丙咪嗪治疗难治性强迫症的疗效优于单用西酞普兰，但副反应明显多于西酞普兰组。     

Transcutaneous electrical acupoint stimulation as an adjunct therapy for obsessive-compulsive disorder: A randomized controlled study

BackgroundTranscutaneous electrical acupoint stimulation (TEAS) is thought to have potential to treat obsessive-compulsive disorder (OCD).ObjectiveThe purpose of this study was to determine whether adding TEAS to cognitive behavioral therapy (CBT) and clomipramine would improve the efficacy of these conventional treatments in OCD.MethodsIn this randomized controlled trial, 360 OCD patients were assigned to receive TEAS combined with CBT plus clomipramine (Group A, n = 120), TEAS combined with CBT plus placebo (Group B, n = 120), and simulated (placebo) TEAS combined with CBT plus clomipramine (Group C, n = 120) for 12 weeks. The primary outcome was measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).ResultsOCD symptoms in all patients reduced over time, however Groups A and B had a significantly greater reduction in Y-BOCS total score and the subscale for obsession and compulsion between week 2 and week 12 compared to Group C. Groups A and B had similar scores on these measures. Both groups had significantly higher rates of clinical response than Group C (88.3% and 81.7% vs. 67.5%, respectively, p < 0.001); and higher rates of remission (30.0% and 22.5% vs. 9.2%, respectively, p < 0.001). Group B experienced fewer adverse events than the other two groups.ConclusionsTEAS enhances the efficacy of conventional OCD interventions and avoids the adverse effects associated with conventional pharmacological treatment. It can be considered as an effective adjunct intervention for OCD.     

西酞普兰联合认知行为疗法治疗强迫症对照观察

目的：比较西酞普兰联合认知行为治疗与单用西酞普兰治疗强迫症的临床疗效。方法：将Yale-Brown强迫量表（Y-BOCS）评分≥16分的64例强迫症患者随机分为研究组（西酞普兰联合认知行为治疗）和对照组（单用西酞普兰治疗）,每组各32例,疗程6个月。于治疗前及治疗1、2、4和6个月时采用Y-BOCS评定疗效。结果：治疗后研究组和对照组Y-BOCS评分分别为（9.41±3.87）分和（12.37±5.34）分,较治疗前（25.26±5.38）分和（24.23±4.25）分显著下降（P〈0.05或P〈0.01）;以研究组下降更为显著（P〈0.05或P〈0.01）,其中强迫性思维和强迫性行为因子评分在治疗6个月时仍维持降分（P〈0.01）。结论：西酞普兰联合认知行为治疗强迫症较单用西酞普兰疗效更好。     

Anterior cingulotomy for refractory obsessive-compulsive disorder

OBJECTIVE: This study was designed to prospectively investigate the efficacy and cognitive adverse effects of stereotactic bilateral anterior cingulotomy as a treatment for refractory obsessive-compulsive (OCD) patients for 12 months. METHOD: Patients were eligible if they had severe OCD and rigorous treatments had been unsuccessful. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Clinical Global Impression (CGI) and neuropsychological tests were used to assess the efficacy and cognitive changes of cingulotomy before and 12 months after operation. RESULTS: The mean improvement rate of the Y-BOCS scores achieved from baseline was 36.0%. Out of 14 patients six met responder criteria; 35% or higher improvement rate on Y-BOCS and CGI improvement of very much or much better at 12-month follow-up. There was no significant cognitive dysfunction after cingulotomy. CONCLUSION: Anterior cingulotomy shows few cognitive adverse effects, with about half of the OCD patients demonstrating significant symptomatic improvement.     

Olanzapine augmentation of serotonin uptake inhibitors in obsessive-compulsive disorder: an open study.

OBJECTIVE: This study evaluates the clinical response to olanzapine used in association with selective serotonin reuptake inhibitors (SSRIs) or clomipramine in treatment-resistant obsessive-compulsive disorder (OCD). METHODS: We describe the cases of 9 patients with serotonin uptake inhibitor-resistant OCD who were given an open-label adjunctive treatment of olanzapine for a minimum of 6 weeks. The response was assessed by using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Clinical Global Impression Scale (CGI). RESULTS: Six patients showed improvement of symptoms after the augmentation with olanzapine. One patient (treated with clomipramine) discontinued olanzapine due to side effects, and another 2 did not respond. CONCLUSION: Olanzapine augmentation of SSRIs in treating OCD showed a good (two-thirds) response rate, and it could therefore be considered as a treatment option when conventional therapies have failed.