天智颗粒联合氟伏沙明治疗青少年强迫症的临床观察

Clinical Observation of Tianzhi Granules Combined with Fluvoxamine in the Treatment of Adolescents Obsessive-compulsive Disorder

关键词:  天智颗粒  氟伏沙明  青少年  强迫症  认知功能

Key words:  Tianzhi granules  fluvoxamine  adolescents  obsessive compulsive disorder  cognitive function

摘要:

目的 探讨天智颗粒联合氟伏沙明治疗青少年强迫症的临床疗效及安全性。方法 选取新乡医学院第二附属医院收治的165例青少年强迫症患者，随机分为对照组（82例）和治疗组（83例），对照组给予氟伏沙明治疗，治疗组给予氟伏沙明+天智颗粒治疗。8周后，分析对比2组患者的临床疗效、耶鲁-布朗强迫症状量表（Y-BCOS）评分、汉密尔顿焦虑量表（HAMA）评分、世界卫生组织生存质量测定量表简表（WHOQOL-BREF）评分及不良反应发生情况，并采用成套神经心理状态评估工具（RBANS）对认知功能进行评定。治疗前后测定并比较2组患者血清单胺类神经递质5-羟色胺（5-HT）和血清脑源性神经营养因子（BDNF）水平。结果 与对照组比较，治疗组总有效率高于对照组（P<0.01）。治疗前，2组患者Y-BCOS、HAMA、WHOQOL-BREF、RBANS评分比较以及5-HT、BDNF水平，差异均无统计学意义。治疗后，治疗组的Y-BCOS和HAMA评分明显低于对照组（P<0.05），治疗组的RBANS、WHOQOL-BRE评分以及5-HT、BDNF水平明显高于对照组（P<0.05）。治疗组的不良反应数及不良反应量表明显低于对照组（P<0.01）。结论 天智颗粒可提高氟伏沙明治疗青少年强迫症的临床疗效，且不良反应少，并能有效地调整认知能力，提高患者生存质量。

Abstract:

OBJECTIVE To study efficacy and safety of Tianzhi granules combined with fluvoxamine in the treatment of adolescents with obsessive-compulsive disorder. METHODS A total of 165 young patients with obsessive-compulsive disorder were admitted to the Second Affiliated Hospital of Xinxiang Medical College. They were randomly divided into control group(82 cases) and observation group(83 cases). Fluvoxamine was taken oral in control group, observation group took Tianzhi granules combined with fluvoxamine, all patients were treated for 8 weeks. Compared national institutes of clinical efficacy, Yale-Brown obsessive-compulsive symptoms(Y-BCOS) score, Hamilton anxiety(HAMA) score, WHO quality of life measurement scale (WHOQOL-BREF) score, adverse reaction, assessment of cognitive function used neuropsychological status assessment tool(RBANS). Serum monoamine neurotransmitters serotonin(5-HT) and serum brain-derived neurotrophic factor(BDNF) levels were measured and compared before and after treatment. RESULTS The total effective rate in observation group was significantly higher than control group, with statistical significance(P<0.01). Before treatment, the Y-BCOS, HAMA, WHOQOL-BREF and RBANS score, the 5-HT and BDNF in 2 groups were comparable. After treatment, compared with the control group, the Y-BCOS and HAMA score in observation group decreased(P<0.05), the WHOQOL-BREF, RBANS, BDNF score and 5-HT increased(P<0.05). The number of adverse reaction and treatment emergent symptom scale in the observation group was significantly lower than it in the control group. CONCLUSION Tianzhi granules can improve the clinical efficacy of fluvoxamine in treatment of obsessive-compulsive disorder in adolescence, and has fewer adverse reactions. It can effectively adjust cognitive ability and improve the quality of life of patients.