暴露与反应阻止疗法治疗强迫症的临床对照研究

目的 探讨暴露与反应阻止疗法对首诊强迫症患者的疗效.方法 对符合入组标准的60名首诊强迫症患者随机分为暴露与反应阻止组和氟西汀组,观察比较治疗1个月末、3个月末、6个月末Yale-Brown强迫量表评分情况及临床疗效.结果 治疗6个月末暴露与反应阻止组有效率为66.6％,氟西汀组有效率为63.3％,两组差异无显著性(P＞0.05).暴露与反应阻止组强迫因子总分在1个月末,强迫行为因子分在1个月末及3个月末明显低于氟西汀组[( 16.47±5.45)分,(7.48±2.87)分,(6.01±3.28)分；(20.08±5.48)分,(10.76±2.91)分,(8.60±3.31)分；P＜0.05].结论 暴露与反应阻止疗法治疗强迫症和SSRI类药物疗效相当,虽然该疗法令部分患者难以承受,但与药物治疗相比起效快、安全性高,值得在临床上大力推广.

A control study of exposure-response prevention therapy in the treatment of obsessive compulsive disorder

Objective To assess the efficacy of exposure-response prevention (ERP) therapy of patients first diagnosticated obsessive compulsive disorder(OCD).Methods After defining the diagnosis,60 OCD patients were divided into ERP group ( n =30 ) and fluoxetine group ( n =30 ) randomly according to their own will,and Yale-Brown obsessive-compulsive scale,the assessment of the clinical effect was used to assess at the ends of 1 st,3th and 6th months.Results The clinical effective rate of ERP group was 66.6％,and 63.3％ of fluoxetine group.At the end of 1st month the ERP group was significantly lower marks in Yale-Brown obsessive-compulsive scale than fluoxetine groups(P ＜ 0.05 ).The scoces of compulsions in ERP group decrease more highly than those in fluoxetine group,there was significant difference at the end of 1st and 3rd month.Conclusion ERP has similar effect in treatment for obsessive-compulsive disorder.Although ERP may be intolerabl at least undesirable for many patients,ERP has efficacy more quickly and no side effect like medicine,it is worth developing strongly.