曲唑酮联合认知行为治疗对创伤后应激障碍的临床疗效

目的探讨曲唑酮联合认知行为治疗与单用曲唑酮对患者创伤后应激障碍的临床治疗效果。方法将解放军91医院心理科48例创伤后应激障碍患者随机分为2组,研究组24例（曲唑酮加认知行为治疗）,对照组24例（单用曲唑酮治疗）。于治疗前、治疗2、4周末分别进行简明精神病评定量表、汉密顿抑郁量表和汉密顿焦虑量表评定临床疗效,以治疗不良反应量表评定不良反应。结果治疗2、4周末,2组精神病评定量表、汉密顿抑郁量表和汉密顿焦虑量表总分均显著低于治疗前（P〈0.01）,但研究组4周末总分均显著低于对照组（P〈0.05）;研究组治疗4周末总有效率87.5%,显著高于对照组70.8%（P〈0.05）;2组不良反应无显著性差异（P〉0.05）。结论曲唑酮联合认知行为治疗对创伤后应激障碍患者与单用曲唑酮比较,前者具有更好的治疗效果和远期疗效,值得在临床推广。

Clinical Efficacy of Trazodone and Cognitive Behavioral Therapy on Post-traumatic Stress Disorder Soldiers

Objective To investigate the clinical effect of trazodone combined with cognitive behavioral therapy（CBT） or trazodone alone on post-traumatic stress disorder（PTSD）.Methods 48 soldiers with PTSD treated in our hospital were randomly divided into two groups：study group（24 patients,trazodone plus CBT） and control group（24 cases,trazodone therapy alone）.Prior to treatment,at the end of the 2nd and 4th week,Brief Psychiatric Rating Scale（BPRS）,Hamilton Depression Scale（HAMD） and Hamilton Anxiety Scale（HAMA） were used to assess the clinical efficacy and side effects.Results After two and four weeks of treatment,BPRS,HAMD and HAMA scores of the two groups significantly declined（P 〈 0.01）,especially in the study group（P 〈 0.05）.The effective rate of study group was 87.5%,significantly higher than 70.8% of control group（P 〈 0.05）.The side effects in the two groups were not significantly different（P 〉 0.05）.Conclusion Trazodone combination with CBT is more effective than trazodone alone for PTSD patients.