艾司西酞普兰与氯米帕明对强迫症患者执行功能影响的比较

摘要

Objective:To compare the effects of escitalopram and clomipramine on executive functions in patients with obsessive-compulsive disorder(OCD). Method:Eighty-two OCD patients were randomly divid-ed into study group(43 cases,treated with escitalopram)and control group(39 cases treated with clomipra-mine). The period of treatment was 8 weeks. The illness of patients were assessed by Yale-Brown obsessive com-pulsive scale(Y-BOCS),and the executive functions were assessed by trail making test( TMT)-A and B, Stroop test(Stroop-C,Stroop-CW)before treatment,and at end of 4th,8th week after treatment,respectively. Results:In the study group,the total score of Y-BOCS and factors’scores of obsessive ideas and compulsive behavior after 4 and 8 weeks’treatment were significantly lower than those in the control one(P ﹤ 0. 05 or P ﹤0. 01). At the end of 8 weeks’treatment,the times of TMT-B[(46. 2 ± 8. 6)s],Stroop-C[(53. 7 ± 8. 1)s] and Stroop-CW[(128. 5 ± 17. 2)s ]in the study group were significantly shorter than those in the control [(51. 3 ± 7. 4)s,(59. 3 ± 7. 7)s,(136. 9 ± 16. 5)s](P ﹤ 0. 05 or P ﹤ 0. 01). Conclusion:Escitalopram has better curative effect and improvement of executive function than clomipramine in OCD patients.%目的：比较艾司西酞普兰与氯米帕明对强迫症患者执行功能障碍的影响。方法：将强迫症患者随机分为研究组（43例）和对照组（39例），分别给予艾司西酞普兰和氯米帕明治疗，疗程8周。分别于治疗前、治疗4及8周末进行耶鲁布朗强迫症量表（Y-BOCS）评估病情及疗效，同时进行连线测验（TMT）、彩色文字阅读测验（Stroop-C、Stroop-CW）评估患者的执行功能。结果：治疗4及8周后研究组 Y-BOCS 总分和强迫观念、强迫行为因子分均显著低于对照组（P ﹤0.05或 P ﹤0.01）；8周后 TMT-B[（46.2±8.6）s]、Stroop-C[（53.7±8.1）s]、Stroop-CW[（128.5±17.2）s]显著短于对照组[（51.3±7.4）s、（59.3±7.7）s、（136.9±16.5）s，P ﹤0.05或 P ﹤0.01]。结论：艾司西酞普兰对强迫症患者的疗效及执行功能的改善可能优于氯米帕明。