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1.
目的 分别对非器质性失眠症受试者进行药物治疗以及认知行为治疗,比较两组受试者的疗效.方法 将100名非器质性失眠症受试者随机分为两组,一组用乌灵胶囊治疗,另一组用认知行为治疗(CBT),疗程4周,治疗后第1个月(随访期Ⅰ)和第2个月(随访期Ⅱ)进行随访.使用匹兹堡睡眠指数量表(PSQI),通过治疗前后减分情况及有效率进行疗效评价.结果 与治疗前相比,治疗后PSQI总分下降明显,前后比较差异有统计学意义(P〈0.01),两组之间差异无统计学意义(P〉0.05);治疗4周、随访期Ⅰ和随访期Ⅱ的有效率,乌灵胶囊组分别是66.7%、58.4%和60.4%;认知行为组分别是69.2%、71.8%和74.4%,差异无统计学意义(P〉0.05).结论 乌灵胶囊和认知行为疗法对非器质性失眠症疗效相当.  相似文献   

2.
目的:探讨度洛西汀合并认知行为治疗( CBT)对产后抑郁症的疗效。方法:将66例产后抑郁症患者分为研究组和对照组各33例,两组均给予度洛西汀治疗,研究组在此基础上合并CBT,每周1次,疗程8周。于治疗前后进行功能失调性状况评定量表( DAS)评定,比较两组疗效及认知改善程度。结果:治疗前两组DAS评分差异无统计学意义;治疗8周,研究组DAS总分( t=4.435)、脆弱性( t=4.303)、完美化(t=4.206)、依赖性(t=4.753)及自主性态度(t=3.304)评分较治疗前明显下降(P均<0.01);对照组DAS各项评分与治疗前比较差异无统计学意义( P>0.05)。两组间比较,治疗后研究组DAS总分(t=2.759)、脆弱性(t =3.325)、完美化(t=4.105)、依赖性(t=4.743)、自主性态度(t=2.021)因子分较对照组显著降低(P<0.05或P<0.01)。结论:度洛西汀单用或合并CBT对产后抑郁症均有明显疗效;但CBT能明显改善患者功能失调性认知损害。  相似文献   

3.
目的 分析认知行为+家庭治疗对首发青少年抑郁症(MDD)的临床疗效。方法 入组研究对象是2017年1月~2021年1月我院门诊及住院168例首诊青少年MDD患者,随机分为两组(n=84),对比组接受常规药物治疗,观察组在对比组基础上接受认知行为+家庭治疗,对比两组临床疗效、汉密尔顿抑郁量表24项版本(HAMD-24)评分、蒙哥马利-阿斯伯格抑郁量表(MADRS)评分、贝克抑郁量表(BDI)评分、社会支持评定量表(SSRS)评分。结果 观察组临床总有效率(97.62%)高于对比组(83.33%),观察组第四周、第六周、第八周HAMD-24评分、MADRS评分、BDI评分均低于对比组,观察组第四周、第六周、第八周SSRS评分高于对比组(P<0.05)。结论 认知行为+家庭治疗可有效减轻首发青少年MDD患者抑郁症状及心理健康状况,提高社会支持度。  相似文献   

4.
目的:探讨认知行为团体治疗对住院抑郁症患者的疗效。方法:64例住院抑郁症患者随机分为研究组和对照组各32例。两组均给予盐酸舍曲林治疗,研究组同时接受为期8周,每周1次的认知行为团体治疗。两组分别于入组前及治疗8周接受汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)及自动思维问卷(ATQ)的评定;治疗8周后接受团体治疗疗效因子问卷调查。结果:两组HAMD、HAMA及ATQ评分均较治疗前显著降低(P均〈0.01),以研究组HAMD、HAMA及ATQ评分显著低于对照组(t=-2.63,-2.93,-2.81;P〈0.05或P〈0.01)。研究组团体治疗疗效因子中普同性、情绪宣泄、人际学习(获取)、人际学习(付出)、团体凝聚力等因子显著优于对照组(t=11.74,7.18,5.88,6.09,3.39;P均=0.001)。结论:认知行为团体治疗可有效提高住院抑郁症患者的疗效。  相似文献   

5.
目的:探讨舍曲林加认知行为治疗对产后抑郁症的疗效. 方法:78例产后抑郁症患者分为研究组(舍曲林联合认知行为治疗)与对照组(仅舍曲林治疗),两组舍曲林剂量50~100 mg/d,研究组认知行为治疗每周2次,每次50 min.在基线与治疗8周采用汉密顿抑郁量表(HAMD)和自动思维问卷(ATQ)评定. 结果:64例完成研究(研究组34例,对照组30例).治疗8周后,研究组有效率76.5%,对照组有效率73.3%,两组有效率差异无统计学意义(x2=1.58,P>0.05).HAMD评分均有下降,但两组差异无统计学意义(P>0.05).治疗8周后研究组ATQ评分下降比对照组显著(P<0.01). 结论:舍曲林联合认知行为治疗对产后抑郁可能治疗效果更好.  相似文献   

6.
目的探讨药物治疗基础上联合重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对抑郁症患者负性认知及情绪的影响。方法将抑郁症患者60例随机分为研究组(n=30,在氟西汀治疗的基础上联合rTMS)及对照组(n=30,单用氟西汀治疗),在治疗前、治疗2周、4周、6周末,采用汉密尔顿抑郁量表24项版本(Hamilton rating scale for depression,HAMD-24)评估患者抑郁程度,采用自动思维量表(automatic thoughts questionnaire,ATQ)评估患者负性认知情况。结果重复测量方差分析显示,HAMD-24评分的组别×时间交互作用无统计学意义(F=0.455,P=0.586),组别主效应(F=11.754,P=0.001)与时间主效应(F=787.600,P0.001)均有统计学意义,随时间推移,两组HAMD评分降低均有统计学意义(P0.001)。治疗6周末研究组的HAMD减分率高于对照组(77.1%±6.8%vs.72.4%±9.7%,t=2.152,P=0.036)。ATQ评分的组别×时间交互作用有统计学意义(F=6.512,P=0.004),治疗后两组ATQ评分降低均有统计学意义(P0.001),且研究组在治疗2周末、4周末、6周末的评分均低于对照组(P0.05)。结论药物联合rTMS不仅有助于改善抑郁症患者的抑郁情绪,也有利于改善其负性认知。  相似文献   

7.
秦霞 《四川精神卫生》2013,26(4):290-293
目的 观察认知行为治疗对自杀未遂精神分裂症患者的心理健康状况及生命质量改善的效果,为制定提高精神分裂症患者自杀预防水平、降低和防止精神分裂症患者再次自杀的策略提供临床依据.方法 选取符合〈国际疾病分类(第10版)〉(ICD-10)中精神分裂症诊断标准的、自杀未遂的住院患者共130例,按住院号末尾数字随机分配到认知行为治疗组(治疗组,n=66)和对照组(n=64).治疗组给予12周的常规药物治疗,以及每次约50分钟共8次的短程认知行为治疗.对照组只给予常规药物治疗12周.分别于治疗前、治疗12周末采用WHO生存质量简表(WHOQOL-BREF)评估患者的健康状况,生命质量量表(QOLS)评定患者的生命质量,抑郁自评量表(SDS)评定患者的抑郁情绪,社会支持评定量表(SSRS)评定患者的社会支持状况.结果 与治疗前相比,治疗12周末 SDS、WHOQOL-BREF、QOLS总分差异有统计学意义(P<0.01);较治疗前治疗组SSRS总分差异有统计学意义(P<0.05),对照组差异无统计学意义(P>0.05).两组相比,SDS、WHOQOL-BREF、QOLS总分差异有统计学意义(P<0.01),SSRS总分差异无统计学意义(P>0.05).结论 认知行为治疗可能有助于改善自杀未遂精神分裂症患者的生命质量和心理健康状况.  相似文献   

8.
目的:分析比较改良电抽搐治疗(MECT)和抗抑郁剂治疗对抑郁症患者的疗效、血清皮质醇浓度和认知功能的影响。方法:将60例抑郁症患者随机分为MECT治疗组和常规抗抑郁剂治疗组。MECT组30例,每周1、3、5治疗,连续4周,以后每周一次维持治疗,共治疗12周。药物组30例.应用抗抑郁剂盐酸文拉法辛治疗,剂量在150mg~225mg/d之间,共治疗12周。所有入组病例.在入组时、治疗1周、治疗4周、治疗12周分别测汉密尔顿抑郁量表(HAMD)和血清皮质醇浓度。两组在入组时和治疗12周进行威斯康星卡片(WCST)评定,结果:HAMD分比较,在治疗1周、4周两组间有统计学差异(P〈0.05),在第12周末两组间无统计学差异(P〉0.05)。血清皮质醇浓度比较,第1、4周末两组间差异有统计学(P〈0.05),在治疗12周两组间差异无统计学意义(P〉0.05)。WCST评定在入组时两组间差异无统计学(P〉0.05),在第12周末两组内均有统计学差异(P〈0.05),而两组间在治疗12周差异无统计学意义(P〉0.05)。血清皮质醇浓度与汉密尔顿抑郁量表总分,成斯康星卡片分类测验分类测验结果显示的认知功能情况存在相关性.结论:MECT是一种有效的治疗手段,相比较抗抑郁剂而言起效更快,埘认知功能无不良反应,随病情好转对认知功能有改善。血清皮质醇浓度升高程度可能与抑郁症认知功能损害程度相关。  相似文献   

9.
目的 探讨富马酸喹硫平对精神分裂症的抑郁症状的疗效及副作用.方法 随机抽取广州市民政局精神病院男女各二个病区的住院精神分裂症患者作为研究对象,予以测评中文版卡尔加里精神分裂症抑郁量表(CDSS-C),评分≥6分判断合并有抑郁症状,将此类患者共96例随机分为两组,治疗组加用富马酸喹硫平,对照组维持原有治疗方法 不变,观察4周,先后于入组前、用药第2周及第4周以CDSS-C及治疗中出现的症状量表(TESS)进行评定及完善体格检查及实验室检查,记录不良事件的发生,以量表分值的变化来判断治疗效果及药物副反应.结果 (1)喹硫平对精神分裂症患者合并抑郁症状的疗效显著,两组比较有统计学差异(有效率分别为81.2%和33.3%,x2=17.425,P=0.000);(2)研究结束时喹硫平组的CDSS-C评分为(1.64±1.61),对照组为(2.91±2.46),两组比较有统计学意义(t=2.735,P=0.008);研究第2及4周喹硫平组CDSS-C减分值均要明显高于对照组,两组比较有统计学意义(P=0.000及0.001);(3)药物副反应的严重程度及副反应所引起的痛苦评分以及对实验室检查指标的影响两组间无差异.结论 喹硫平能有效缓解精神分裂症的抑郁症状,无明显药物副作用,可在临床推广使用喹硫平治疗精神分裂症的抑郁症状.  相似文献   

10.
认知行为护理疗法在抑郁症治疗中的作用   总被引:4,自引:1,他引:4  
孔媛  张丽 《精神医学杂志》2003,16(2):110-111
目的 从护理角度探讨认知行为疗法在抑郁症治疗中的作用。方法 对 84例抑郁症患者随机分为两组 ,采用单纯药物治疗和联合认知行为治疗 ,以BDI、HAMD、DAS、SDSS量表为评定工具。结果 出院时两组BDI、HAMD、DAS评分较治疗前有明显下降 (P <0 .0 5 ) ,但联合治疗组DAS评分较单纯药物治疗组下降更明显。出院后一年 ,两组BDI、HAMD、DAS评分比较有显著性差异 (P <0 .0 5 ,或P <0 .0 1)。结论 抑郁症状与认知障碍有密切相关 ,认知行为治疗对抑郁症的预后起重要作用 ,在整体护理中认知行为疗法作为精神病患者心理护理的重要手段之一  相似文献   

11.
OBJECTIVE: To assess the efficacy and tolerability of paroxetine in pediatric major depressive disorder. METHOD: Subjects 7 to 17 years old with major depressive disorder received paroxetine (10-50 mg/day) or placebo for 8 weeks from 2000 to 2001. The primary efficacy measure was change from baseline in the Children's Depression Rating Scale-Revised total score at week 8 last observation carried forward). Safety was primarily assessed by spontaneous reporting of adverse events. RESULTS: A total of 206 patients (intent to treat) were randomized to paroxetine (n = 104) or placebo (n = 102). Week 8 Children's Depression Rating Scale-Revised total score adjusted mean changes from baseline for patients receiving paroxetine and placebo were -22.58 (SE 1.47) and -23.38 points (SE 1.60), respectively (0.80, 95% confidence interval -3.09 to 4.69, p = 0.684). Increased cough (5.9% versus 2.9%), dyspepsia (5.9% versus 2.9%), vomiting (5.9% versus 2.0%), and dizziness (5.0% versus 1.0%) occurred in >or=5% of the paroxetine group and at least twice that of the placebo group. Six of 104 (5.8%) paroxetine patients reported serious adverse events compared to 1 placebo patient (1.0%). The incidence of adverse events of suicidal behavior and/or ideation while taking study medication (excluding taper) was 1.92% (2/104) for paroxetine versus 0.98% (1/102) for placebo. CONCLUSIONS: Paroxetine was not shown to be more efficacious than placebo for treating pediatric major depressive disorder.  相似文献   

12.
OBJECTIVE: To evaluate cognitive-behavioral therapy, antidepressant medication alone, and combined CBT and antidepressant medication in the treatment of depressive disorders in adolescents. METHOD: Seventy-three adolescents (ages 12-18 years) with a primary diagnosis of DSM-IV major depressive disorder, dysthymic disorder, or depressive disorder not otherwise specified were randomly allocated to one of three treatments. Treatment outcome measures were administered before and after acute treatment, and at a 6-month follow-up. Depression diagnosis was the primary outcome measure; secondary measures were self- and other report and clinician rating of global functioning. The trial was conducted at three community-based clinics between July 2000 and December 2002. Data analyses used an intent-to-treat strategy. RESULTS: Following acute treatment, all treatment groups demonstrated statistically significant improvement on outcome measures (depressive diagnosis, Reynolds Adolescent Depression Scale, Revised Children's Manifest Anxiety Scale, Suicidal Ideation Questionnaire), and improvement was maintained at follow-up. Combined cognitive-behavioral therapy and antidepressant medication was not found to be superior to either treatment alone. Compared with antidepressant medication alone, participants receiving cognitive-behavioral therapy alone demonstrated a superior acute treatment response (odds ratio = 6.86; 95% confidence interval 1.12-41.82). Although cognitive-behavioral therapy was found to be superior to antidepressant medication alone for the acute treatment of mild to moderate depression among youth, this may have stemmed from the relatively low dose of sertraline used. CONCLUSIONS: All treatments led to a reduction in depression, but the advantages of a combined approach were not evident.  相似文献   

13.
BACKGROUND: Approximately 10% to 16% of women experience a major depressive episode after childbirth. A significant proportion of these women also suffer from comorbid anxiety disorders. The purpose of this study was to evaluate whether the addition of cognitive-behavioral therapy (CBT) to standard antidepressant therapy offers additional benefits in the treatment of post-partum depression with comorbid anxiety disorders. METHOD: Thirty-five women referred to a tertiary care hospital outpatient program with a DSM-IV diagnosis of postpartum depression with comorbid anxiety disorder were randomly assigned to 1 of 2 treatment groups-paroxetine-only monotherapy group (N = 16) or paroxetine plus 12 sessions of CBT combination therapy group (N = 19)-for a 12-week trial. Progress was monitored by a psychiatrist blinded to treatment group, using the Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, Yale-Brown Obsessive Compulsive Scale, Clinical Global Impressions scale, and Edinburgh Postnatal Depression Scale. Data were analyzed using 2-tailed statistical tests at an alpha level of.05. The study was conducted from April 1, 2002, to June 30, 2003. RESULTS: Both treatment groups showed a highly significant improvement (p <.01) in mood and anxiety symptoms. Groups did not differ significantly in week of recovery, dose of paroxetine at remission, or measures of depression, anxiety, and obsessive-compulsive symptoms at outcome. CONCLUSION: Antidepressant monotherapy and combination therapy with antidepressants and CBT were both efficacious in reducing depression and anxiety symptoms. However, in this sample of acutely depressed/anxious postpartum women, there were no additional benefits from combining the 2 treatment modalities. Further research into the efficacy of combination therapy in the treatment of moderate-to-severe depression with comorbid disorders in postpartum women is recommended.  相似文献   

14.
OBJECTIVE: To examine the feasibility and efficacy of a manual-based cognitive-behavioral therapy (CBT) in reducing depressive symptomatology in adolescents with inflammatory bowel disease (IBD). Primary and Secondary Control Enhancement Therapy-Physical Illness (PASCET-PI) modified for youths with IBD was compared to treatment as usual (TAU), plus an information sheet about depression, without therapist contact using assessable patient analysis. METHOD: Following assessment, participants 11 to 17 years old with IBD and mild to moderate subsyndromal depression were randomly assigned to PASCET-PI (n = 22) or comparison treatment (n = 19). Primary outcome measures at baseline (T1) and 12 to 14 weeks posttreatment (T2) were Children's Depression Inventory (child/parent report), Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), Children's Global Assessment Scale, and Perceived Control Scale for Children. RESULTS: The PASCET-PI group showed significantly greater improvement in Children's Depression Inventory (child/parent report), Children's Global Assessment Scale, and Perceived Control Scale for Children posttreatment than the comparison group. CONCLUSIONS: Screening and treatment of depressive symptoms in pediatric settings is feasible. PASCET-PI may be an efficacious intervention for subsyndromal depression in adolescents with IBD, although comparison with a more active treatment is necessary to attribute the improvement to PASCET-PI. Clinical trial registration information: URL: http://clinicaltrials.gov. Unique identifier: NCT00446238.  相似文献   

15.
OBJECTIVE: This study compared the tolerability and efficacy of paroxetine and amitriptyline in the treatment of depression in general practice. METHODS: In this double-blind, multicentre study conducted in the general practice, patients with depression (Montgomery Asberg Depression Rating Scale [MADRS] score > or = 20) who were regarded as requiring antidepressant therapy were randomly assigned to receive paroxetine (20 mg, n = 184) or amitriptyline (50-100 mg, n = 191) once daily for 9 weeks. RESULTS: More patients completed treatment with paroxetine than with amitriptyline (71.1% vs 56.1%, p = 0.009). Depression rating scores (MADRS and Clinical Global Impression [CGI]) were improved with both agents, but at week 9, paroxetine achieved more favourable scores compared with amitriptyline on MADRS (p=0.019), CGI severity of depression (p=0.044), and CGI efficacy index (p = 0.038). CONCLUSIONS: Depressed patients treated in general practice respond more quickly and are more likely to complete the treatment regimen with paroxetine than with amitriptyline.  相似文献   

16.
BACKGROUND: Both cognitive-behavioral therapy and treatment with selective serotonin reuptake inhibitors (SSRIs) have proved to be effective in the treatment of panic disorder. The present study examined the effects of paroxetine added to continued cognitive-behavioral therapy in patients who were unsuccessfully treated with initial cognitive-behavioral therapy alone. METHOD: 161 patients with panic disorder with or without agoraphobia (DSM-IV criteria) underwent a manual-guided cognitive-behavioral therapy of 15 sessions. Forty-three unsuccessfully treated patients from this group were included in a double-blind, placebo-controlled, next-step treatment study consisting of continued cognitive-behavioral therapy plus adjunctive paroxetine at a dose of 40 mg/day or continued cognitive-behavioral therapy plus placebo. RESULTS: Overall, patients in the cognitive-behavioral therapy plus paroxetine condition improved significantly on agoraphobic behavior (p < .05) and anxiety discomfort (p < .01), whereas patients in the cognitive-behavioral therapy plus placebo condition did not. Effect sizes in the cognitive-behavioral therapy plus paroxetine condition ranged from 1.0 to 1.8 and in the cognitive-behavioral therapy plus placebo condition, from 0.4 to 1.0. CONCLUSION: Patients with panic disorder who are unsuccessfully treated with initial cognitive-behavioral therapy may benefit from the addition of an SSRI as a second treatment modality. The importance of timely evaluation of treatment results is emphasized.  相似文献   

17.
帕罗西汀治疗抑郁症的双盲对照研究   总被引:19,自引:0,他引:19  
评估帕罗西汀和阿米替林治疗抑郁症病人的临床疗效。  方法 采用随机、双盲对照的研究方法 ,帕罗西汀组和阿米替林组各 1 6例 ,治疗 6周。  结果 帕罗西汀与阿米替林疗效相似 ,帕罗西汀的植物神经、心血管、神经系统及其它副作用显著少于阿米替林 ;帕罗西汀主要副作用为轻度口干、便秘。  结论 帕罗西汀是一种安全而有效的抗抑郁剂  相似文献   

18.
BACKGROUND: Estrogen has been considered as a potential antidepressant in postmenopausal women. Our goal was to study whether estrogen therapy is effective in treating depressive disorders in older postmenopausal women and to determine whether progestins are associated with a deterioration of mood. METHODS: After 2 weeks of single-blind placebo treatment in 87 patients, 57 were randomly assigned to receive 8 weeks of treatment with estradiol (.1 mg/day; n = 31) or placebo (n = 26). All patients were then treated with medroxyprogesterone 10 mg/day for 2 weeks combined with the study patch. Depressive symptoms were rated with the 21-item Hamilton Depression and Center for Epidemiologic Studies Depression scales. RESULTS: A clinically significant antidepressant effect of estradiol was excluded after 8 weeks of estradiol treatment. The estradiol group and placebo group improved in depressive symptoms at a similar rate based on the Hamilton Depression Scale (40% decreases in depression for estradiol vs. 44% for placebo). No significant increase in depressive symptoms was demonstrated with the use of progestins; however, positive affect decreased slightly with the use of combined estradiol-medroxyprogesterone compared with medroxyprogesterone alone (5.8%, p =.027). CONCLUSIONS: Estradiol cannot be considered as an effective treatment in postmenopausal women with mild to moderate depression.  相似文献   

19.
文拉法辛缓释剂替换治疗门诊抑郁症患者观察   总被引:1,自引:0,他引:1  
目的:了解文拉法辛缓释剂替换选择性5-羟色胺再摄取抑制剂类(SSRIs)疗效欠佳的门诊抑郁症患者的有效性和安全性. 方法:将符合抑郁症诊断标准并经氟西汀,舍曲林,氟伏沙明和西酞普兰4种SSRIs抗抑郁剂之一治疗量治疗6周而疗效不佳的抑郁症患者72例随机分为两组.文拉法辛组34例换用文拉法辛缓释剂,帕罗西汀组38例换用帕罗西汀,疗程6周.换药前均停原用SSRIs药物.以汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、临床疗效总评量表病情严重程度(CGI-SI)分别于入组时、治疗2周末、4周末、6周末评定疾病的严重程度及好转情况;以治疗中出现的症状量表(TESS)评定药物的不良反应. 结果:两组在治疗4周末及6周末时其HAMD、CGI-SI评分差异有显著性,HAMA评分则从治疗2周末起即表现出显著性差异.文拉法辛组疗效优于帕罗西汀组,两组显效率分别为70.6%和52.6%,不良反应发生率无明显差异. 结论:文拉法辛缓释剂替换经SSRIs抗抑郁剂治疗效差的门诊抑郁症患者可取得好的疗效,且安全性好.  相似文献   

20.
帕罗西汀合用奎硫平治疗抑郁症的随机对照研究   总被引:1,自引:0,他引:1  
目的评估帕罗西汀合用奎硫平治疗无精神病性症状的抑郁症疗效和安全性。方法将符合入组标准和排除标准的无精神病性症状的抑郁症患者120例,随机分配到帕罗西汀合用奎硫平治疗组(研究组)和单用帕罗西汀治疗组(对照组),在入组时(第0天)和第7、14、21、28、42、56天分别评定HAMD和TESS,并测量生命体征;在治疗开始前、第4、8周末各进行一次血常规检查、尿常规检查、血生化、心电图检查。结果第1周末时,研究组的HAMD评分即下降了29.75%,显著高于对照组(12.05%),这种差异一直保持到研究结束,表明帕罗西汀合用奎硫平起效迅速;研究组的显效率(痊愈 显著进步)为85%,显著高于对照组(51.7%,)(χ2=15.93,P=0.001)。结论帕罗西汀合用奎硫平治疗无精神病性症状的抑郁症起效快,疗效优于单用帕罗西汀,不良反应无明显增多或加重。  相似文献   

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