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目的探讨氟伏沙明合并利培酮治疗儿童强迫症的疗效和安全性。方法 96例符合国际疾病分类第10版(ICD-10)诊断标准的强迫症患者随机分为氟伏沙明合并利培酮组(简称合用组,n=48)和单用氟伏沙明组(简称单用组,n=48),治疗6周。采用耶鲁-布朗强迫症量表(Y-BOCS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)评定疗效,采用不良反应症状量表(TESS)评定安全性。结果治疗前,两组在一般人口学资料、病程、Y-BOCS、SDS、SAS各项评分差异均无统计学意义(P>均0.05)。治疗6周末,合用组使用氟伏沙明平均剂量(150.37±23.92)mg,单用组氟伏沙明平均剂量((153.61±21.32)mg,差异无统计学意义(P>0.05)。治疗6周后,合用组的显效率(66.7%)高于单用组(45.8%),差异有统计学意义(χ2=5.671,P<0.05);合用组Y-BOCS评分(12.66±4.41)较单用组(14.53±4.11)低,差异有统计学意义(P<0.05);合用组SDS评分[(41.12±5.69)vs(42.58±6.32),P>0.05]及SAS评分[(45.83±7.76)vs(48.37±9.13),P>0.05]与单用组比较差异无统计学意义;两组TESS评分在治疗后第2、4、6周末差异均无统计学意义(P均>0.05)。结论氟伏沙明合并小剂量利培酮治疗儿童强迫症可提高疗效,安全性较好。
Objective To investigate the efficacy and safety of fluvoxamine combined with risperidone in the treatment of obsessive-compulsive disorder in children. Methods A total of 96 obsessive-compulsive disorder patients who met the diagnostic criteria of International Classification of Diseases (ICD-10) were randomly divided into fluvoxamine combined with risperidone group (n = 48) and fluvoxamine alone (Single-use group, n = 48) for 6 weeks. The Y-BOCS, SAS and SDS were used to assess the efficacy of the treatment, and the safety of the patients was assessed by the symptom of adverse reaction symptom scale (TESS). Results Before treatment, there was no significant difference between the two groups in general demographic data, disease course, Y-BOCS, SDS and SAS scores (all P> 0.05). At the end of the 6th week of treatment, the average dose of fluvoxamine (150.37 ± 23.92) mg in the combined group and the average dose of fluvoxamine alone in the combined group were (153.61 ± 21.32) mg, with no significant difference (P> 0.05) Weekly, the effective rate of combined group (66.7%) was higher than that of single group (45.8%), the difference was statistically significant (χ2 = 5.671, P <0.05); Y-BOCS score of combined group was (12.66 ± 4.41) (14.53 ± 4.11), the difference was statistically significant (P <0.05); SDS score [(41.12 ± 5.69) vs (42.58 ± 6.32), P> 0.05] and SAS score [(45.83 ± 7.76) vs (48.37 ± 9.13), P> 0.05]. There was no significant difference in TESS score between the two groups at the 2nd, 4th, 6th week after treatment (all P> 0.05) .Conclusion Fluvoxamine combined with low-dose risperidone in children with obsessive-compulsive disorder can improve the efficacy and safety.