改良式森田疗法与药物治疗强迫症临床研究

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1、改良式森田疗法与药物治疗强迫症临床研究改良式森田疗法与药物治疗强迫症临床研究【摘要】目的探讨改良森田疗法对强迫症的疗效。方法以ICD-10诊断标准选择病例，随机分组；分为改良森田组(简称改良组)57例，传统森田加药物合并组(简称合并组)55例与传统森田组(简称传统组)53例，进行对照研究。评价工具：YBOCS、HAMA、SDSS、屮华医学会神经精神科分会五级疗效评定标准。结果改良组、传统组、合并组出院治疗效果无显著差异；住院初期患者依从性、YBOCS、HANA减分率合并组〉改良组＞传统组；合并组远期复发率显著高于传统组，提示药物使临床症状较早减轻，产生假愈使临床医生误

2、判；改良组加入认知疗法，可降低患者的焦虑、抑郁情绪，提高依从性,并降低远期复发率。结论改良森田疗法对强迫症的治愈率明显提高，远期复发率显著降低，治疗依从性提高，值得推广应用。【关键词】改良森田疗法；强迫症；氯丙咪嗪TheResearchofDrugandModifiedMoritaontheTreatmentofObsessive-compu1siveNeurosis・DengWencheng,LiangWenrui,LiangXinzhong,etal.XingtaiCountyHospital,HebeiProvince,Xingtai054001,P.R.Chi

3、na[Abstract]ObjectiveTostudytheefficacyofMoritaTherapyonthetreatmentofobsessive-compulsiveneurosis・MethodsTheadoptioncheckedagainstarandommethod.PatientswerescreenedthatmatchtheICD-10diagnosticstandardtogointoasetofrandomandassignedClassicalMoritaTherapygroup(CMT),ClassicalMoritaTherapy

4、combinedwithClomipraminegroup(CMTC)andModifiedMoritaTherapygroup(MMT),Thethreegroupshave57,55and53patients;adoptinganairtightofYBOCS,HAMA,SDSS・ResultsTheeffectsoftreatmentof3groupsarebasicequivalent・YBOCSandHANAreductirateofthepatientsofCMTCarehigherthanoneofMMTandevenmorehigherthanthat

5、ofCMT・LongrecurringrateofCMTChigherthanCMTandevenmorehigherthanthatofMMT.Drugincreasedtherecurringprobability,whichisshownthatdrugmadethesymptomdisappearsosoonthatcliniccuringfeintappeared・Thedoctorsmisjudgedanddecidedtoletthepatientsleavehospitaltooearly.CognitivetherapyofMMTreducedthe

6、anxietyanddepressivenessandraisedthecomplianceofthepatients・LongtermrecurringrateisremarkablydecreasedinMMT・ConclusionThecuringrateofMMTonthetreatmentofobsessive-compulsiveneurosisisremarkablyincreasedandlongrecurringrateisremarkablydecreased・MMTisworthpromotingandapplying・[Keyword】Modi

7、fiedmoritatherapy;Obsessive-compulsiveneurosis;Clomipramine强迫症是一种常见病、多发病、疑难症，青少年居多^[l]o我国15~59岁患病率0.3%,达390万之众^[2]；国外一般人群中年患病率1.1%〜1.8%,终生患病率1・9%~2・5%^[l]o随着就业、升学等压力的升高，强迫症的患病率有可能进一步升高。传统森田疗法治疗强迫症疗效确切，日本森田正马、竹山报告^[3],治愈率55%,好转率35%,平均住院40天