内科

目的探讨氟伏沙明联合改良森田疗法治疗强迫症患者的临床疗效和安全性。方法选取2018年2月至2021年5月我院收治的强迫症患者78例，采用随机数字法分为研究组和对照组，每组39例。对照组患者给予氟伏沙明治疗，研究组患者给予氟伏沙明联合改良森田疗法治疗，疗程8周。比较两组患者治疗前、治疗4周和治疗8周后的耶鲁布朗强迫量表（Yale-Brown Obsessive-Compulsive Scale,Y-BOCS）、汉密尔顿焦虑量表（Hamilton Anxiety Scale,HAMA）评分；比较两组患者的临床疗效；比较两组患者治疗期间的药物不良反应发生情况。结果两组患者治疗前后的Y-BOCS评分比较，差异有统计学意义（P＜0.05）；两组患者的Y-BOCS评分与时间有交互效应（P＜0.05）。治疗4周、8周后，两组患者的Y-BOCS评分均显著降低，研究组患者的Y-BOCS评分均低于对照组，差异有统计学意义（P＜0.05）。两组患者治疗前后的HAMA评分比较，差异有统计学意义（P＜0.05）；两组患者的HAMA评分与时间有交互效应（P＜0.05）。治疗4周、8周后，两组患者的HAMA评分均显著降低，研究组患者的HAMA评分均低于对照组，差异有统计学意义（P＜0.05）。治疗8周后，研究组患者的治疗总有效率（84.6%）显著高于对照组（64.1%），差异有统计学意义（P＜0.05）。两组患者治疗期间的不良反应发生率比较，差异无统计学意义（P＞0.05）。结论氟伏沙明联合改良森田疗法治疗强迫症的临床效果明显优于单独使用氟伏沙明治疗，可明显改善患者的强迫症状和焦虑症状，治疗安全性良好。

ObjectiveTo investigate the clinical efficacy and safety of fluvoxamine combined with modified Morita therapy in the treatment of patients with obsessive-compulsive disorder. MethodsA total of 78 patients with obsessive-compulsive disorder admitted to our hospital from February 2018 to May 2021 were randomly divided into study group and control group by the random number method, with 39 cases in each group. Patients in the control group were treated with fluvoxamine, while patients in the study group were treated with fluvoxamine combined with modified Morita therapy, for an 8-week treatment course. The scores of Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Hamilton Anxiety Scale (HAMA) were compared between the two groups before treatment, 4 weeks after treatment and 8 weeks after treatment. The clinical efficacy of the two groups was compared. And the occurrence of adverse drug reactions during treatment was compared between the two groups. ResultsThere were statistically significant differences in the scores of Y-BOCS between the two groups before and after treatment (P＜0.05). The Y-BOCS scores of the two groups had an interaction with time (P＜0.05). After 4 weeks and 8 weeks of treatment, Y-BOCS scores significantly decreased in both groups and were significantly lower in the study group than in the control group, with statistically significant differences (P＜0.05). There were statistically significant differences in HAMA scores between the two groups before and after treatment (P＜0.05). And the HAMA scores of the two groups had an interaction with time (P＜0.05). After 4 weeks and 8 weeks of treatment, HAMA scores significantly decreased in both groups and were significantly lower in the study group than in the control group, with statistically significant differences (P＜0.05). After 8 weeks of treatment, the total effective rate of treatment of the observation group (84.6%) was significantly higher than that of the control group (64.1%), with a statistically significant difference (P＜0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups during treatment (P＞0.05). ConclusionFluvoxamine combined with modified Morita therapy is more effective than fluvoxamine monotherapy in the treatment of obsessive-compulsive disorder, which can significantly improve the obsessive-compulsive symptoms and anxiety symptoms of patients with great therapeutic safety.