奥氮平联合艾司西酞普兰治疗难治性强迫症的疗效分析

目的 探讨奥氮平联合艾司西酞普兰治疗难治性强迫症的疗效。 方法 前瞻性收集内蒙古自治区精神卫生中心收治的难治性强迫症患者88例,将患者采用随机数字表法分为观察组和对照组,观察组给予奥氮平联合艾司西酞普兰治疗,对照组给予艾司西酞普兰,共治疗8周,比较两组患者临床疗效。 结果 两组患者入院时和治疗后2周时Yale-Brown强迫症量表评分、汉米尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)均差异无统计学意义 (P>0.05)。与对照组比较,治疗后8周时观察组Yale-Brown评分显著降低[(22.64±6.53)分 比(27.57±7.54)分,P=0.001]；HAMA评分显著降低[(14.34±4.59) 分 比 (16.70±5.55)分,P=0.032]；HAMD评分显著降低[(12.75±3.28)分 比 (17.93±4.07)分,P=0.000]。两组患者入院时Marks强迫恐怖量表(MSCPOR)评分差异无统计学意义[(71.43±9.11)分 比 (70.86±9.00)分,P=0.769]。治疗后第2周和第8周时观察组患者MSCPOR均显著低于对照组[(61.91±9.11)分 比 (67.52±8.84)分,P=0.004]和[(55.43±6.20)分 比 (59.50±6.61)分,P=0.004]。 结论 奥氮平联合艾司西酞普兰可显著改善难治性强迫症患者临床症状。

Efficacy of olanzapine combined with escitalopram in the treatment of refractory obsessive compulsive disorder

Objective To investigate the efficacy of olanzapine combined with escitalopram in the treatment of refractory obsessive compulsive disorder. Methods 88 patients with refractory obsessive compulsive disorder in our hospital were prospectively collected.All patients were randomly assigned into an observation group or a control group.Patients in the observation group received olanzapine combined with escitalopram,while patients in the control group received escitalopram only for 8 weeks.The clinical efficacy of the both groups were compared. Results There were no significant differences between the two groups in Yale-Brown Obsessive Compulsive Scale score,Hamilton Anxiety Scale (HAHA) and Hamilton Depression Scale (HAMD) on admission and at 2 weeks since the beginning of the treatment (P>0.05).When compared with the control group,patients in the observation group got a lower level of Yale-Brown score (22.64±6.53 vs.27.57±7.54,P= 0.001);a decrease in HAMA (14.34±4.59 vs.16.70±5.55,P= 0.032);and a decrease in HAMD (12.75±3.28 vs. 17.93±4.07,P= 0.000).There was no significant difference between the two groups in Marks Obsessive Compulsive Scale (MSCPOR) score (71.43±9.11 vs.70.86±9.00,P= 0.769).However,at 2 weeks and 8 weeks since the beginning of the treatment,patients in the observation group got lower levels of MSCPOR when compared with the control group [(61.91±9.11 vs. 67.52±8.84,P= 0.004) and (55.43±6.20 vs. 59.50±6.61,P= 0.004)]. Conclusion Olanzapine combined with escitalopram can significantly improve the clinical symptoms of patients with refractory obsessive compulsive disorder.