期刊存档
氟伏沙明和氯丙咪嗪对强迫症患者疗效和认知功能的影响
温盛霖，程敏锋，岳计辉温盛霖、程敏锋，广州 中山大学附属第三医院精神科，510630；岳计辉，中山大学附属第五医院精神科
摘 要:目的 比较氟伏沙明与氯丙咪嗪的治疗对强迫症患者疗效和认知功能的影响。方法 80例首发强迫症患者随机分成两组，分别接受氟伏沙明和氯丙咪嗪治疗。采用Yale-Brown强迫量表（Y-BOCS）、韦氏成人智力量表、韦氏记忆量表、威斯康星卡片分类测验评定两组患者治疗前后成绩，与41例健康对照组的成绩进行对照研究。结果 （1）与治疗前相比，氟伏沙明组和氯丙咪嗪组Y-BOCS总分、强迫观念和强迫行为评分差异均有统计学意义（P＜0.05）；氟伏沙明组和氯丙咪嗪组相比，治疗前和治疗后上述评分均无统计学意义（P＞0.05）。（2）治疗前，氟伏沙明组和氯丙咪嗪组的操作智商、记忆商数、短时记忆均明显低于对照组（P＜0.01），持续错误数、随机错误数和连线B测验明显高于对照组（P＜0.05）。（3）治疗后，氟伏沙明组除操作智商、记忆商数和持续错误数外，其他测验成绩与对照组比较均差异无统计学意义（P均＞0.05）。氯丙咪嗪组的操作智商、记忆商数、短时记忆明显低于对照组，持续错误数明显高于对照组（P＜0.05）。氟伏沙明组的短时记忆明显高于氯丙咪嗪组，持续错误数明显低于氯丙咪嗪组（P＜0.05）。结论 氟伏沙明和氯丙咪嗪对强迫症的治疗均有效。氟伏沙明对记忆成绩和执行功能的改善作用优于氯丙咪嗪。
关键词:强迫性人格障碍； 认知； 氟伏沙明； 氯米帕明
Cognition function study of the first-episode patients with obsession-compulsion and the change before and after treatment
WEN Sheng-lin，CHENG Min-feng，YUE Ji-hui.Department of Psychology，Third Hospital of Sun Yat-sen University，Guangzhou 510630，China
Abstract:Objective To compare the effect and cognition function change of the first episode patients obsession-compulsion before and after fluvoxamine and chlorimipramine treatment. Methods The 80 cases of patient were parallelly divided into two groups receiving fluvoxamine and chlorimipramine respectively. Using Y-BOCS，WAIS-RC，WMS-RC，M-WCST and TMT TEST as research tools to compare the symptom and cognition function of the two groups before and after 12 week treatment with 41 cases of health people by an open，controlled clinical trial. Results （1）After the treatment，the patients had better scores of Y-BOCS obsession ideal and compulsion behavior. There were no significant different of the scores between fluvoxamine group and chlorimipramine group. （2）Before the treatment，the PIQ，MQ，STM，continue errors number，random errors number and TMT TEST -B scores in fluvoxamine and chlorimipramine group were worse than those in controlled group（P＜0.05）. （3）After the treatment，there were no significant different between the fluvoxamine group and the control group besides PIQ，MQ and STM；In the chlorimipramine group，the scores of PIQ，MQ，STM were lower than control group，and the continue errors of WCST obviously higher than the control group（P＜0.05）. The STM，continue errors of WCST in fluvoxamine group were better than those in the chlorimipramine group. Conclusions The fluvoxamine has the same effect as the chlorimipramine in the first-episode obsessional patients. Fluvoxamine has the prior in improving memory score and executive function than chlorimipramine does.
Key words:Compulsive personality disorder； Cognition； Fluvoxamine； Clomipramine
文献标引:温盛霖，程敏锋，岳计辉.氟伏沙明和氯丙咪嗪对强迫症患者疗效和认知功能的影响[J/CD].中华临床医师杂志：电子版,2010,4(3):297-300.
参考文献:
[1] 周云飞，张亚林，胡纪泽，等. 强迫症患者神经认知功能研究. 中国临床心理学杂志，2005，13（3）：337－339.
[2] Aardema F，Radomsky AS，O′Connor KP，et al. Inferential confusion，obsessive beliefs and obsessive-compulsive symptoms：a multidimensional investigation of cognitive domains. Clin Psychol Psychother，2008，15（4）：227－238.[PubMed]
[3] Nabeyama M，Nakagawa A，Yoshiura T，et al. Functional MRI study of brain activation alterations in patients with obsessive-compulsive disorder after symptom improvement. Psychiatry Res，2008，163（3）：236－247.[PubMed]
[4] Homberg JR，Schubert D，Gaspar P. New perspectives on the neurodevelopmental effects of SSRIs. Trends Pharmacol Sci，2009，4. [Epub ahead of print].[PubMed]
[5] Hashimoto K，Fujita Y，Iyo M. Phencyclidine-induced cognitive deficits in mice are improved by subsequent subchronic administration of fluvoxamine：role of sigma-1 receptors. Neuropsychopharmacology，2007，32（3）：514－521.[PubMed]
[6] Andrés S，Lázaro L，Salamero M，et al. Changes in cognitive dysfunction in children and adolescents with obsessive-compulsive disorder after treatment. J Psychiatr Res，2008，42（6）：507－514.[PubMed]