经颅磁刺激、奥氮平联合治疗难治性老年躯体化障碍的可行性分析
Feasibility of transcranial magnetic stimulation combined with olanzapine in the treatment of refractory somatization disorder in elderly patients
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| DOI |
| 刊名 |
Journal of International Psychiatry
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| 年，卷(期) |
2018, 45(1) |
| 作者 |
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| 作者单位 |
山东省济宁市精神病防治院 ;
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| 摘要 |
【摘要】探讨经颅磁刺激联合奥氮平在抗抑郁药物治疗无效的难治性老年躯体化障碍患者临床治疗中的价值。方法 选取84例难治性老年躯体化障碍患者为研究对象，随机数字表法分为研究组和对照组各42例；其中研究组中途脱落2例，共40例有效病例入组，予以重复经颅刺激+奥氮平+度洛西汀口服治疗；对照组中途脱落1例，共41例有效病例入组，予以口服奥氮平+度洛西汀方案。观察对比两组受试者治疗前、治疗3周、6周时睡眠质量评分[匹兹堡睡眠质量指数（PSQI）]、不良情绪评分[汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表（HAMA）]及症状自评量表(SCL-90)评估结果差异，记录其不良反应发生情况。结果 治疗前，两组受试者PSQI评分、不良情绪评分（HAMD、HAMA评分）及SCL-90评分结果比较，均无统计学意义（P＞0.05）；治疗3周、6周后，两组受试者PSQI评分、HAMD、HAMA评分及SCL-90评分结果均较治疗前显著降低，且研究组低于对照组，差异有统计学意义（P＜0.05)。两组受试者不良反应发生率比较，差异无统计学意义（7.5% vs 7.3%，P＞0.05）。结论 临床可将抗抑郁药物联合重复经颅磁刺激+奥氮平方案作为一种切实可行的疗法用于难治性老年躯体化障碍患者的临床治疗中，以此促进其病情转归、改善预后质量。
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| Abstract |
[Abstract] Objective To investigate the value of transcranial magnetic stimulation combined with olanzapine in the treatment of refractory somatization disorder in elderly patients who received antidepressant drug treatment and the treatment was ineffective. Methods Eighty-four elderly patients with refractory somatization disorder were randomized into study group and control group by the random number table method, with 42 cases in each group; There were 2 cases lost to follow up and a total of 40 effective cases enrolled in the study group and they were treated with repeated transcranial stimulation combined with oral administration of olanzapine and duloxetine. There was 1 case lost to follow up and a total of 41 effective cases enrolled in the control group and they were treated with oral administration of olanzapine combined with duloxetine. The differences in sleep quality scores [Pittsburgh sleep quality index (PSQI)], unhealthy emotion scores [Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA)] and symptom checklist (SCL-90) scores were observed and compared between the two groups before treatment, after 3 weeks and 6 weeks of treatment. The incidence of adverse reactions was recorded. Results Before treatment, there were no significant differences in PSQI score, unhealthy emotion score (HAMD, HAMA) and SCL-90 score between the two groups (P > 0.05); After 3 weeks and 6 weeks of treatment, PSQI scores, HAMD scores, HAMA scores and SCL-90 scores of the two groups were significantly lower than those before treatment. Besides, the above scores in study group were lower than those in control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two grooups (7.5% vs 7.3%，P>0.05). Conclusion The application of transcranial magnetic stimulation combined with oral administration of olanzapine and duloxetine can be used as a viable therapy for the clinical treatment of refractory somatization disorder in elderly patients.
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| 关键词 |
经颅磁刺激；奥氮平；难治性；老年躯体化障碍；可行性
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| KeyWord |
Transcranial magnetic stimulation; Olanzapine; Refractory; Elderly somatization disorder; Feasibility
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| 基金项目 |
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| 页码 |
88-91 |
郝英霞*.
经颅磁刺激、奥氮平联合治疗难治性老年躯体化障碍的可行性分析 [J].
国际精神病学杂志.
2018; 45; (1).
88 - 91.